title: Contrasting views of physicians and nurses about an inpatient computer-based provider order-entry system.
abstract: OBJECTIVE
  Many hospitals are investing in computer-based provider order-entry (POE) systems, and providers' evaluations have proved important for the success of the systems. The authors assessed how physicians and nurses viewed the effects of one modified commercial POE system on time spent patients, resource utilization, errors with orders, and overall quality of care.
  
  
  METHODS
  Survey.
  
  
  METHODS
  Opinions of 271 POE users on medicine wards of an urban teaching hospital: 96 medical house officers, 49 attending physicians, 19 clinical fellows with heavy inpatient loads, and 107 nurses.
  
  
  RESULTS
  Responses were received from 85 percent of the sample. Most physicians and nurses agreed that orders were executed faster under POE. About 30 percent of house officers and attendings or fellows, compared with 56 percent of nurses, reported improvement in overall quality of care with POE. Forty-four percent of house officers and 34 percent of attendings/fellows reported that their time with patients decreased, whereas 56 percent of nurses indicated that their time with patients increased (P < 0.001). Sixty percent of house officers and 41 percent of attendings/fellows indicated that order errors increased, whereas 69 percent of nurses indicated a decrease or no change in errors. Although most nurses reported no change in the frequency of ordering tests and medications with POE, 61 percent of house officers reported an increased frequency.
  
  
  CONCLUSIONS
  Physicians and nurses had markedly different views about effects of a POE system on patient care, highlighting the need to consider both perspectives when assessing the impact of POE. With this POE system, most nurses saw beneficial effects, whereas many physicians saw negative effects.
authors.affiliation: Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. michael@weiner.org
authors.forename: M
authors.initials: M
authors.lastname: Weiner
authors.forename: T
authors.initials: T
authors.lastname: Gress
authors.forename: D R
authors.initials: DR
authors.lastname: Thiemann
authors.forename: M
authors.initials: M
authors.lastname: Jenckes
authors.forename: S L
authors.initials: SL
authors.lastname: Reel
authors.forename: S F
authors.initials: SF
authors.lastname: Mandell
authors.forename: E B
authors.initials: EB
authors.lastname: Bass
mesh_terms: D001292:Attitude to Computers; D003625:Data Collection; D006784:Hospitals, Teaching; D006801:Humans; D016347:Medical Records Systems, Computerized; D008510:Medication Systems, Hospital; D009726:Nurses; D005791:Patient Care; D010820:Physicians