Trial reportJournal of the American Medical Informatics Association : JAMIA
Controlled trial of direct physician order entry: effects on physicians' time utilization in ambulatory primary care internal medicine practices.
Trial report in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
78 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Case management for dementia in primary health care: a systematic mixed studies review based on the diffusion of innovation model.Clinical interventions in aging · 2014Pooled it
- Evaluation of outpatient computerized physician medication order entry systems: a systematic review.Journal of the American Medical Informatics Association : JAMIAPooled it
- The impact of electronic health records on time efficiency of physicians and nurses: a systematic review.Journal of the American Medical Informatics Association : JAMIAPooled it
- The effectiveness of integrated health information technologies across the phases of medication management: a systematic review of randomized controlled trials.Journal of the American Medical Informatics Association : JAMIAPooled it
- Evaluation of the effect of decision support on the efficiency of primary care providers in the outpatient practice.Journal of primary care & community health · 2015Trial
- Work outside of work: after-hours use of the electronic medical record among residents at an academic veterinary teaching hospital.Frontiers in veterinary science · 2026Article
- Trial of an Internet-Based Cataract and Lens Exchange Registry in a Tertiary Teaching Hospital: Insights and Impact on Clinical Workflow.Journal of ophthalmology · 2026Article
- Optimizing Documentation Integrity of Ophthalmic Diagnostic Test Interpretation through Electronic Health Record Clinical Decision Support.Applied clinical informatics · 2025Article
- Impact of a Disease-Focused Electronic Health Record Dashboard on Clinical Staff Efficiency in Previsit Patient Review in an Ambulatory Pulmonary Hypertension Care Clinic.Applied clinical informatics · 2024Article
- Evaluating Electronic Health Record Limitations and Time Expenditure in a German Medical Center.Applied clinical informatics · 2021Article
- Studying Workflow and Workarounds in Electronic Health Record-Supported Work to Improve Health System Performance.Annals of internal medicine · 2020Review
- A Theoretical Framework for Understanding Creator-Consumer Information Interaction Behaviors in Healthcare Documentation Systems.Applied ergonomics · 2020Article
- The Impact of Electronic Health Records on the Duration of Patients' Visits: Time and Motion Study.JMIR medical informatics · 2020Article
- eRegTime, Efficiency of Health Information Management Using an Electronic Registry for Maternal and Child Health: Protocol for a Time-Motion Study in a Cluster Randomized Trial.JMIR research protocols · 2019Article
- BALANCING DOCUMENTATION AND DIRECT PATIENT CARE ACTIVITIES: A STUDY OF A MATURE ELECTRONIC HEALTH RECORD SYSTEM.International journal of industrial ergonomics · 2019Article
- Measuring the operational impact of digitized hospital records: a mixed methods study.BMC medical informatics and decision making · 2016Article
- How Do Residents Spend Their Shift Time? A Time and Motion Study With a Particular Focus on the Use of Computers.Academic medicine : journal of the Association of American Medical Colleges · 2016Article
- Exploring Dental Providers' Workflow in an Electronic Dental Record Environment.Applied clinical informatics · 2016Article
- Impact of electronic health record technology on the work and workflow of physicians in the intensive care unit.International journal of medical informatics · 2015Observational
- Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system.Journal of the American Medical Informatics Association : JAMIA · 2015Article
18 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectiveDirect physician order entry (POE) offers many potential benefits, but evidence suggests that POE requires substantially more time than traditional paper-based ordering methods. The Medical Gopher is a well-accepted system for direct POE that has been in use for more than 15 years. The authors hypothesized that physicians using the Gopher would not spend any more time writing orders than physicians using paper-based methods.
designA randomized controlled trial of POE using the Medical Gopher system in 11 primary care internal medicine practices. MEASUREMENTS: The authors collected detailed time use data using time motion studies of the physicians and surveyed their opinions about the POE system.
resultsThe authors found that physicians using the Gopher spent 2.2 min more per patient overall, but when duplicative and administrative tasks were taken into account, physicians were found to have spent only 0.43 min more per patient. With experience, the order entry time fell by 3.73 min per patient. The survey revealed that the physicians believed that the system improved their patient care and wanted the Gopher to continue to be available in their practices.
conclusionsLittle extra time, if any, was required for physicians to use the POE system. With experience in its use, physicians may even save time while enjoying the many benefits of POE.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.