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Objective: Direct physician order entry (POE) offers many potential benefits, but evidence suggests that POE requires substantially more time than traditional paper-based ordering methods. The Medical Gopher is a well-accepted system for direct POE that has been in use for more than 15 years. The authors hypothesized that physicians using the Gopher would not spend any more time writing orders than physicians using paper-based methods.

Design: A randomized controlled trial of POE using the Medical Gopher system in 11 primary care internal medicine practices.

Measurements: The authors collected detailed time use data using time motion studies of the physicians and surveyed their opinions about the POE system.

Results: The authors found that physicians using the Gopher spent 2.2 min more per patient overall, but when duplicative and administrative tasks …