| Description |
Computerized provider order entry (CPOE) is proposed to improve overall delivery of health care by increasing medication safety, decreasing cost, and improving efficiency of health care providers. As the health care industry continues to incorporate information technology into daily operations, the impact on provider work activities will be important to evaluate. Existing literature on health information technology implementation has predominantly come from internally developed programs that were designed specifically for the institution in which they reside. The University of Utah Hospital is a 450-bed academic health care center that implemented a commercially available CPOE system. The objective of this study was to evaluate the impact of CPOE implementation on decentral and central pharmacist work activities as measured by a work sampling evaluation. Participants used the Divilbiss Electronics JD-7 Random Reminder for data collection in order to assess the proportion of time each pharmacist spent on itemized work activities. The data collection form was organized according to Clinical, Professional, and Technical work activities. Data were collected before CPOE implementation in April 2009 and 6 months after implementation in November 2009. Data were summed by category and evaluated as nonparametric data using chi-square analysis. Results demonstrated significant changes in the Professional (16.7% vs. 56.8%, p<0.001) and Technical work activities (56.8% vs. 11%, p<0.001) performed by central pharmacists due to CPOE implementation. The improved efficiency of order verification may allow for administrators to reduce pharmacist staff or use increased available pharmacist time to expand pharmacy services. Decentral pharmacist overall work activities demonstrated minimal change. However, time spent on education increased after CPOE (6% vs. 10.8%, p<0.001). The increase in education time is consistent with the mission of the academic medical center. Reporter bias was possible due to a perception that the study was evaluating individual participants. However, assurance that no data would be associated with any individual, the nearly 6 months between sampling periods, and the large number of observations limited this potential bias. This study provided the pharmacy department with a better understanding of pharmacy work activities and the impact of CPOE on pharmacists' daily work activities. |
