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Proc Annu Symp Comput Appl Med Care. 1995 : 708–711.
PMCID: PMC2579185

Acceptance and performance by clinicians using an ambulatory electronic medical record in an HMO.


The Northwest Region of Kaiser Permanente implemented a comprehensive clinical information system in two sites between February and December 1994. By year end 46 primary care clinicians and 95 supporting personnel used the system on a daily basis to provide patient care. Clinicians use the product to select coded diagnoses, and directly order laboratory, imaging, and other tests, internal referrals, and prescriptions. They enter progress notes into the system, and use it to generate patient focused visit summaries. Clinicians took approximately 2 minutes longer, on average, to complete patient visits post-implementation. Most of this time was spent performing "orders and diagnosis" work, which included new required elements in the post-implementation period. Clinicians worked approximately 30 days before reaching their baseline visit rate and "lost" approximately 48 hours of productivity during the learning, including classroom training. User acceptance improved from 2 to 4 months of use.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Sittig DF, Stead WW. Computer-based physician order entry: the state of the art. J Am Med Inform Assoc. 1994 Mar-Apr;1(2):108–123. [PMC free article] [PubMed]
  • Kaplan B. Reducing barriers to physician data entry for computer-based patient records. Top Health Inf Manage. 1994 Aug;15(1):24–34. [PubMed]
  • McDonald CJ, Tierney WM, Overhage JM, Martin DK, Wilson GA. The Regenstrief Medical Record System: 20 years of experience in hospitals, clinics, and neighborhood health centers. MD Comput. 1992 Jul-Aug;9(4):206–217. [PubMed]

Articles from Proceedings of the Annual Symposium on Computer Application in Medical Care are provided here courtesy of American Medical Informatics Association