Medication IT doesn't take time away from patient care

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Using an electronic medication management system did not significantly affect the amount of time doctors and nurses in an Australian study spent on direct patient care or medication-related tasks.

The Australian research, published in the Journal American Medical Informatics Association, involved time and motion studies of 129 doctors and nurses for 633.2 hours on four wards in a 400-bed hospital in Sydney. It compared a period before the system was implemented and the period after the hospital installed the Cerner Millennium PowerOrders technology into its CPOE system, also comparing wards using the new technology on both computers on wheels and desk PCs with wards that still used paper charts.

A study published in in JAMIA in February found that using computerized physician order entry averted 17.4 million medication errors in the United States in a single year. However, ensuring that health IT fits into clinicians' workflow has been central to the effort to introduce new technologies.

It found that in the post-period, doctors using paper charts spent 19.7 percent of their time (2 hours out of a 10-hour shift) on direct care and 7.4 percent (44.4 minutes out of a 10-hour shift) on medication tasks. Meanwhile, doctors using the electronic system spent 25.7 percent of the their time (2.6 hours per shift) on direct care and 8.5 percent on medication tasks (51 minutes per shift.

Nurses using paper charts in the post-period spent 22.1 percent of their time (1.9 hour per 8.5-hour shift) on direct care and 23.7 percent on medication tasks, while nurses using the computerized system spent 26.1 percent of their time  (2.2 hours per shift) on direct care and and 22.6 percent (1.9 hours per shift) on medication tasks.

Over the course of the study, there was an overall increase in time for both spent in direct patient care unrelated to the new system and also an increase for both in time spent on medication tasks.

Doctors who used the new system, however, spent less time alone and more time with other doctors and patients, and nurses using the new system spent less time with doctors.

Research from Johns Hopkins University School of Medicine found that medical interns spend 12 percent of their time examining and talking to patients, and more than 40 percent of their time behind a computer.  It called for better EHRs to reduce the amount of time doctors spend looking up patient histories.

With big Medicare penalties for high readmission rates, hospitals are focusing on ways pharmacists can help prevent them. Atlanta Medical Center keeps pharmacists involved during the stay and afterward. Barnes-Jewish Hospital in St. Louis found a link between readmission and patients never filling their prescriptions upon dismissal. It now uses technology that allows patients to fill their prescriptions before they leave.

To learn more:
- find the research

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