Impact of Computerized Provider Order Entry on Pharmacist Productivity

Abstract

Purpose To examine the impact of computerized provider order entry (CPOE) implementation on average time spent on medication order entry and the number of order actions processed. Methods An observational time and motion study was conducted from March 1 to March 17, 2011. Two similar community hospital pharmacies were compared: one without CPOE implementation and the other with CPOE implementation. Pharmacists in the central pharmacy department of both hospitals were observed in blocks of 1 hour, with 24 hours of observation in each facility. Time spent by pharmacists on distributive, administrative, clinical, and miscellaneous activities associated with order entry were recorded using time and motion instrument documentation. Information on medication order actions and order entry/verifications was obtained using the pharmacy network system. Results The mean ± SD time spent by pharmacists per hour in the CPOE pharmacy was significantly less than the non-CPOE pharmacy for distributive activities (43.37 ± 7.75 vs 48.07 ± 8.61) and significantly greater than the non-CPOE pharmacy for administrative (8.58 ± 5.59 vs 5.72 ± 6.99) and clinical (7.38 ± 4.27 vs 4.22 ± 3.26) activities. The CPOE pharmacy was associated with a significantly higher number of order actions per hour (191.00 ± 82.52 vs 111.63 ± 25.66) and significantly less time spent (in minutes per hour) on order entry and order verification combined (28.30 ± 9.25 vs 36.56 ± 9.14) than the non-CPOE pharmacy. Conclusion The implementation of CPOE facilitated pharmacists to allocate more time to clinical and administrative functions and increased the number of order actions processed per hour, thus enhancing workflow efficiency and productivity of the pharmacy department.

Impact of Computerized Provider Order Entry Systems on hospital staff pharmacist workflow productivity: A three site comparative analysis based on level of CPOE implementation

“…These results are unexpected and opposite to those of the previously mentioned study published by Hatfield et al, in which it was found that CPOE implementation was associated with a decrease in the amount of time pharmacists spent on distributive activities and increase the amount of time spent on clinical activities. [20] One possibility to explain the difference is that the previous study was conducted in the span of two weeks, with only a total of 48 observations, and included 11 different pharmacists compared to this study which was conducted during two different time periods of the year, had 238 observations, with 31 different pharmacists, allowing a greater depth and variety of data collection. In addition, factors that were not measured, such as number of orders requested, could have significantly differed among the hospitals.…”

“…[19] In an article published previously, implementation of CPOE was shown to increase pharmacist time spent on clinical activities. [20] The present study differs from previous studies in that it compares three levels of CPOE implementation rather than two, namely the present study compares a non-CPOE hospital, a short-term CPOE hospital, and a long-term CPOE hospital.…”

“…The pharmacists' activities were divided into 38 unique tasks (see Table 1), comprised of four general categories: clinical, distributive, administrative, and miscellaneous. The general categories were based on a list of four major activities (clinical, distributive, administrative, and miscellaneous) performed by hospital pharmacists, from a study published by Hatfield et al in 2014. [20] The list used by Hatfield et al was refined from categories outlined in a study published by Gupta et al in 2006 after consultation with pharmacy management and clinical pharmacists.…”

“…The general categories were based on a list of four major activities (clinical, distributive, administrative, and miscellaneous) performed by hospital pharmacists, from a study published by Hatfield et al in 2014. [20] The list used by Hatfield et al was refined from categories outlined in a study published by Gupta et al in 2006 after consultation with pharmacy management and clinical pharmacists. [20][21][22] The distributive category was broken down into three sub-categories: order entry, order verification, and other distributive task.…”

“…[20] The list used by Hatfield et al was refined from categories outlined in a study published by Gupta et al in 2006 after consultation with pharmacy management and clinical pharmacists. [20][21][22] The distributive category was broken down into three sub-categories: order entry, order verification, and other distributive task. The task list used by the Hatfield's study was modified for the present study to capture additional tasks which were observed during the pilot phase of the data collection tool.…”