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Methods Inf Med
DOI: 10.1055/a-2744-7059
Short Paper

A Multicentre Evaluation of the Impact of Computerised Physician Order Entry on Medication Documentation Workflow, Time, and Quality

Authors

  • Viktoria Jungreithmayr

    1   Heidelberg University, Medical Faculty Heidelberg/Heidelberg University Hospital, Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology, Cooperation Unit Clinical Pharmacy, Heidelberg, Germany

  • Alina Fischer

    2   Bonifatius Hospital Lingen GmbH, Hospital Pharmacy, Logistics Centre, Lingen, Germany

  • Jan Leininger

    1   Heidelberg University, Medical Faculty Heidelberg/Heidelberg University Hospital, Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology, Cooperation Unit Clinical Pharmacy, Heidelberg, Germany
    3   Frankfurt University Hospital, Hospital Pharmacy, Frankfurt am Main, Germany

  • Raphael Kotte

    2   Bonifatius Hospital Lingen GmbH, Hospital Pharmacy, Logistics Centre, Lingen, Germany

  • Nils Keiner

    3   Frankfurt University Hospital, Hospital Pharmacy, Frankfurt am Main, Germany

  • Hanna M. Seidling

    1   Heidelberg University, Medical Faculty Heidelberg/Heidelberg University Hospital, Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology, Cooperation Unit Clinical Pharmacy, Heidelberg, Germany
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Abstract

Background

Multicentre evaluations are key to provide generalisable results on medication safety interventions. Yet, for computerised physician order entry (CPOE) assessment, evaluations are mostly singe-centred and poorly comparable.

Objectives

We performed a multicentre simulation-based lab study at three independent study sites implementing varying CPOE systems with the aim to compare the effects of CPOE implementation on workflow changes, time requirement, and quality of medication documentation.

Methods

At each study site, medication documentation processes with and without CPOE usage were analysed. Based on patient case scenarios, a simulation-based lab study was performed where the time required to document medication according to the analysed processes was measured. Additionally, the quality of medication documentation with and without CPOE usage was evaluated. Results were compared between the three study sites.

Results

At two hospitals, CPOE implementation led to a streamlining of the medication documentation process with less documentation systems and professional groups involved and an elimination of double documentation. However, at one hospital multiple documentation of medication orders persisted even after CPOE implementation. In total, the time required to document medication according to the case scenarios was faster without than with a CPOE system (median time without CPOE = 13:56 minutes [range = 07:29–32:17], median time with CPOE = 16:51 minutes [09:18–33:41], p = 0.047, +20.8%). One hospital was taking considerably longer for medication documentation than the two others, both with and without CPOE usage. Medication documentation quality rose significantly and to a median of 100.0% at each study site with CPOE usage.

Conclusion

This study showed that a simulation-based lab study methodology is suitable for comparing CPOE effects across study sites. Furthermore, it provides evidence on the changes in medication documentation workflow, time requirement, and quality that occur with a CPOE implementation.

Keywords

medical order entry systems - multicentre study - medication documentation - time requirement

Supplementary Material



Publication History

Received: 23 May 2025

Accepted: 01 November 2025

Article published online:
27 December 2025

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