ArticleBMJ (Clinical research ed.)2008
Implementation of computerised physician order entry (CPOE) and picture archiving and communication systems (PACS) in the NHS: quantitative before and after study.
Article in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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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
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effect of electronic records on mortality among patients in hospital and primary healthcare settings: a systematic review and meta-analyses.Frontiers in digital health · 2024Pooled it
- The impact of eHealth on the quality and safety of health care: a systematic overview.PLoS medicine · 2011Pooled it
- Understanding the Limits of Patient Safety Classification Systems for Health Information Technology-Related Incidents.JMIR human factors · 2026Article
- Does an electronic pathology ordering system change the volume and pattern of routine testing in hospital? An interrupted time series analysis.Journal of clinical pathology · 2024Article
- Adoption by clinicians of electronic order communications in NHS secondary care: a descriptive account.BMJ health & care informatics · 2024Article
- Investigating the satisfaction level of physicians in regards to implementing medical Picture Archiving and Communication System (PACS).BMC medical informatics and decision making · 2020Article
- Impact of an Intensive Care Information System on the Length of Stay of Surgical Intensive Care Unit Patients: Observational Study.JMIR perioperative medicine · 2019Article
- Challenges of Implementing Picture Archiving and Communication System in Multiple Hospitals: Perspectives of Involved Staff and Users.Journal of medical systems · 2019Article
- A categorisation of problems and solutions to improve patient referrals from primary to specialty care.BMC health services research · 2018Review
- Does Computerized Physician Order Entry Benefit from Dynamic Structured Data Entry? A Quasi-Experimental Study.BMC medical informatics and decision making · 2018Article
- Quasi-experimental study designs series-paper 5: a checklist for classifying studies evaluating the effects on health interventions-a taxonomy without labels.Journal of clinical epidemiology · 2017Article
- Determinant Factors in Applying Picture Archiving and Communication Systems (PACS) in Healthcare.Perspectives in health information managemen · 2017Article
- Patient safety problems from healthcare information technology in medical imaging.BJR case reports · 2016Article
- Towards Better Test Utilization - Strategies to Improve Physician Ordering and Their Impact on Patient Outcomes.EJIFCC · 2015Article
- Computerized physician order entry: promise, perils, and experience.The Neurohospitalist · 2014Article
- Multiple measurement of serum lipids in the elderly.Medical care · 2011Article
- Why is it difficult to implement e-health initiatives? A qualitative study.Implementation science : IS · 2011Article
- HIS-based electronic documentation can significantly reduce the time from biopsy to final report for prostate tumours and supports quality management as well as clinical research.BMC medical informatics and decision making · 2009Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the impact of components of the national programme for information technology (NPfIT) on measures of clinical and operational efficiency.
designQuasi-experimental controlled before and after study using routinely collected patient level data.
settingFour NHS acute hospital trusts in England. DATA SOURCES: Inpatient admissions and outpatient appointments, 2000-5.
interventionsA system for ordering pathology tests and browsing results (computerised physician order entry, CPOE) and a system for requesting radiological examinations and displaying images (picture archiving and communications system, PACS).
main outcome measuresRequests per inpatient, outpatient, or day case patient for full blood count, urine culture and urea and electrolytes tests, and plain x ray film, computed tomography, and ultrasonography examinations.
resultsCPOE was associated with a reduction in the proportion of outpatient appointments at which full blood count (odds ratio 0.25, 95% confidence interval 0.16 to 0.40), urea and electrolytes (0.55, 0.39 to 0.77), and urine culture (0.30, 0.17 to 0.51) tests were ordered, and at which full blood count tests were repeated (0.73, 0.53 to 0.99). Conversely, the same system was associated with an almost fourfold increase in the use of urea and electrolytes tests among day case patients (3.63, 1.66 to 7.94). PACS was associated with a reduction in repeat plain x ray films at outpatient appointments (0.62, 0.44 to 0.88) and a reduction in inpatient computed tomography (0.83, 0.70 to 0.98). Conversely, it was associated with increases in computed tomography requested at outpatient appointments (1.89, 1.26 to 2.84) and computed tomography repeated within 48 hours during an inpatient stay (2.18, 1.52 to 3.14).
conclusionsCPOE and PACS were associated with both increases and reductions in tests and examinations. The magnitude of the changes is potentially important with respect to the efficiency of provision of health care. Better information about the impact of modern IT is required to enable healthcare organisations to manage implementation optimally.
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