HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wilson, G A Articles by McCabe, G P Search for Related Content PubMed PubMed Citation Articles by Wilson, G A Articles by McCabe, G P, Jr

The effect of immediate access to a computerized medical record on physician test ordering: a controlled clinical trial in the emergency room.

G A Wilson, C J McDonald and G P McCabe, Jr

We performed a randomized clinical trial of the effect of immediately printed summaries of a computerized medical record on physician test ordering rates in an Emergency Room setting. The computerized medical record contained medication history, the results of most diagnostic studies, an outpatient problem list, and inpatient and emergency room diagnoses. Physicians were presented with a printed summary of the patient's computerized record for study but not for control encounters. All other patient information was equally available to both kinds of encounters. All results were provided for one period of the study, designated T1. Due to a program error, summaries were printed without recent data during a period of the study, designated T2. Two-thirds of the visits were cared for by internists, one-third by surgeons. During T1, internists ordered an average of 3.2 tests, costing $34.91 for control visits, and 2.7 tests, costing $29.94 for study control visits (p less than .026). Surgeons also ordered fewer tests during study visits as compared to controls (1.32 vs 1.54) but the differences were not statistically significant. There was no significant effect on either medical or surgical test ordering during time period T2.

This article has been cited by other articles:

				C. van Walraven, G. Cernat, and P. C. Austin Effect of Provider Continuity on Test Repetition Clin. Chem., December 1, 2006; 52(12): 2219 - 2228. [Abstract] [Full Text] [PDF]

				C. J. Stille, T. J. McLaughlin, W. A. Primack, K. M. Mazor, and R. C. Wasserman Determinants and Impact of Generalist-Specialist Communication About Pediatric Outpatient Referrals Pediatrics, October 1, 2006; 118(4): 1341 - 1349. [Abstract] [Full Text] [PDF]

				B. Chaudhry, J. Wang, S. Wu, M. Maglione, W. Mojica, E. Roth, S. C. Morton, and P. G. Shekelle Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care Ann Intern Med, May 16, 2006; 144(10): 742 - 752. [Abstract] [Full Text] [PDF]

				D. J Vreeman, S. L Taggard, M. D Rhine, and T. W Worrell Evidence for Electronic Health Record Systems in Physical Therapy Physical Therapy, March 1, 2006; 86(3): 434 - 446. [Abstract] [Full Text] [PDF]

				C. J. Stille, A. Jerant, D. Bell, D. Meltzer, and J. G. Elmore Coordinating Care across Diseases, Settings, and Clinicians: A Key Role for the Generalist in Practice Ann Intern Med, April 19, 2005; 142(8): 700 - 708. [Abstract] [Full Text] [PDF]

				M. Weiner, C. M. Callahan, W. M. Tierney, J M. Overhage, B. Mamlin, P. R. Dexter, and C. J. McDonald Using Information Technology To Improve the Health Care of Older Adults Ann Intern Med, September 2, 2003; 139(5_Part_2): 430 - 436. [Abstract] [Full Text] [PDF]

				M. T. Forthman, L. D. Wooster, W. C. Hill, J. M. Homa-Lowry, and S. I. DesHarnais Insights Into Successful Change Management: Empirically Supported Techniques for Improving Medical Practice Patterns American Journal of Medical Quality, September 1, 2003; 18(5): 181 - 189. [Abstract] [PDF]

				C. J McDonald The Barriers to Electronic Medical Record Systems and How to Overcome Them JAMIA, May 1, 1997; 4(3): 213 - 221. [Abstract] [Full Text] [PDF]

				E. A. Balas, S. M. Austin, J. A. Mitchell, B. G. Ewigman, K. D. Bopp, and G. D. Brown The Clinical Value of Computerized Information Services: A Review of 98 Randomized Clinical Trials Arch Fam Med, May 1, 1996; 5(5): 271 - 278. [Abstract] [PDF]

				W. M. Tierney, M. E. Miller, J. M. Overhage, and C. J. McDonald Physician Inpatient Order Writing on Microcomputer Workstations: Effects on Resource Utilization JAMA, January 20, 1993; 269(3): 379 - 383. [Abstract] [PDF]

				D. S. Macpherson, R. Snow, and R. P. Lofgren Preoperative Screening: Value of Previous Tests Ann Intern Med, December 15, 1990; 113(12): 969 - 973. [Abstract] [PDF]

				J. S. Spiegel, M. F. Shapiro, B. Berman, and S. Greenfield Changing Physician Test Ordering in a University Hospital: An Intervention of Physician Participation, Explicit Criteria, and Feedback Arch Intern Med, March 1, 1989; 149(3): 549 - 553. [Abstract] [PDF]

				C. J. McDonald and W. M. Tierney Computer-Stored Medical Records: Their Future Role in Medical Practice JAMA, June 17, 1988; 259(23): 3433 - 3440. [Abstract] [PDF]

				W. M. TIERNEY, C. J. McDONALD, D. K. MARTIN, S. L. HUI, and M. P. ROGERS Computerized Display of Past Test Results: Effect on Outpatient Testing Ann Intern Med, October 1, 1987; 107(4): 569 - 574. [Abstract] [PDF]

				J. L. Rogers, O. M. Haring, and J. F. Phifer Carry-Over of Medical Information System Influence to Control Patients Eval Health Prof, March 1, 1984; 7(1): 43 - 51. [Abstract] [PDF]