Guidelines via Computerized Drug and Test Ordering. Executive Summary and FinalReport

摘要

This research implemented a computer order entry system on a hospital inpatientgeneral medicine service and conducted four randomized controlled trials to measure its impact on patient care and provider behavior. The first study demonstrated a significant and important reduction on hospital costs with the computerized system compared to the manual system. The second intervention studied the effect of on-line and patient specific reminders about preventive care. No study effects were detected. The third intervention measured the effect of 'pop-up-reminders' about tests and drugs that should be ordered as a consequence of another order. The overall effect of the intervention was very strong and it effectively altered physicians' ordering practices to conform more closely to medical guidelines. A fourth study (results not yet available) is measuring the effect of reporting markedly abnormal tests and vital sign measurements directly to the ordering physician via a digital pager.