| Description |
The objective of this thesis was to evaluate the impact of an outpatient computer system, know as the Clinical Workstation (CW), on personnel at three outpatient clinics. The primary evaluation took place between June 1997 and June 1998. Thirteen provides and sixty-two staff members were initially included in this evaluation. Six providers and twenty-nine staff members completed the entire evaluation. Evaluation topics included staff and provider productivity, system availability, quality of patient care, patient record organization, communication, and provider and patient satisfaction. Methodologies used to evaluate these topics included surveys, work-study techniques, and automated tracking of computer used and productivity indicators. Provider productivity, as defined by relative value units (RVUs) per month, decreased immediately after implementation of the CW; however RVU per month measured at the end of the evaluation period showed a positive slope for then of eleven providers, indicating and increase in provider productivity by the end of the evaluation period. Transcription costs decreased to zero at Clinic X following utilization of the profile browser, a clinical data-entry application. Eighty-six percent of all survey participants reported that information retrieval time was better with the CW pilot system than their previous system (n + 14). Eighty percent of the providers believed that they provided better care for their patients by using CW (n = 6). Eighty-eight percent of the providers (n = 6) and 93 percent (n = 14) of all respondents did not want to return to their previous system. Productivity of the providers and staff was initially adversely impacted; however, productivity returned to near preimplementation levels for most participants. Reported benefits of CW implementation included improved intraoffice communication, decrease transcription costs, perceived quality of patient care, and improved record accessibility. Most users valued the system enough to prefer not to return to their previous charting system. Computer system availability, as measured by computer response time and downtime, needed to be improved before more widespread implementation could be undertaken. |
