Physician order entry: a mixed blessing to pharmacy?

Abstract

Objective. The Alberta Cancer Board (ACB) Pharmacy conducted a timing study to determine how electronic prescription ordering impacts the workload in pharmacy in comparison to the current paper system. The objective was to compare the mean time required to review orders generated by an electronic physician order entry system to the existing paper method, and to determine whether such an implementation would decrease pharmacist intervention rates. Methods. Self-reporting and measurement by stopwatch timing were used to record the timing data on the prescription order review process on all outpatient parenteral chemotherapy orders for adults handled within the ACB’s two main tertiary centres for the month of June. The primary endpoint measured was mean pharmacist order review time for manual and electronic orders. The secondary endpoint measured was pharmacist intervention rate for manual and electronic orders. Results. Among all 836 chemotherapy orders reviewed, the mean pharmacist order review time was increased by 5.15 min with the implementation of an electronic order entry system. A total of 62 pharmacist interventions were recorded in the study. The pharmacist intervention rate was 7.14% for the electronic orders and 7.47% for the manual paper orders. Conclusions. The study showed that the implementation of an electronic physician order entry system has significant impacts on pharmacy workload without providing significant reductions in pharmacist intervention rates.