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The Impact of e-Prescribing on Prescriber and Staff Time in Ambulatory Care Clinics: A Time–Motion Study

^a Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, WA
^b Department of Radiology, University of Washington, Seattle, WA
^c The Everett Clinic, Everett WA
^d Department of Medicine, University of Washington, Seattle, WA
^e Department of Health Services, University of Washington, Seattle, WA.

^_* Correspondence: Will Hollingworth, PhD, Research Assistant Professor, Department of Radiology, University of Washington, Box 359960, 325 Ninth Avenue, Seattle, WA 98104-2499 (Email: willh{at}u.washington.edu).

Received for publication: 01/12/07; accepted for publication: 08/07/07.

Electronic prescribing has improved the quality and safety of care. One barrier preventing widespread adoption is the potential detrimental impact on workflow. We used time-motion techniques to compare prescribing times at three ambulatory care sites that used paper-based prescribing, desktop, or laptop e-prescribing. An observer timed all prescriber (n = 27) and staff (n = 42) tasks performed during a 4-hour period. At the sites with optional e-prescribing >75% of prescription-related events were performed electronically. Prescribers at e-prescribing sites spent less time writing, but time-savings were offset by increased computer tasks. After adjusting for site, prescriber and prescription type, e-prescribing tasks took marginally longer than hand written prescriptions (12.0 seconds; –1.6, 25.6 CI). Nursing staff at the e-prescribing sites spent longer on computer tasks (5.4 minutes/hour; 0.0, 10.7 CI). E-prescribing was not associated with an increase in combined computer and writing time for prescribers. If carefully implemented, e-prescribing will not greatly disrupt workflow.