Our analyses showed that the median data entry time for all hospitals combined was three minutes faster for electronic than for paper orders for each year; a significant difference. This significant difference was consistent for both tests (EUC and Automated Differential) across 2010 and 2011 (see Tables 15a and 15b). This faster data entry time translated into significantly lower median Total Laboratory TATs for electronic orders than for paper orders (for EUC tests the difference in medians was 12 minutes in 2010 and six minutes in 2011; for Automated Differential tests, the difference in medians was four minutes in 2010 and two minutes in 2011). In January 2011, the chemistry analyser in the clinical chemistry department servicing Hospitals A, B, and C, was replaced with an instrument with a longer analytical cycle time. This was the reason for an increased Total Laboratory TAT in 2011.
| Clinical chemistry | 2008 | 2009 | 2010 | 2011 | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Hosp | EUC |  | EMR | Paper | EMR | Paper | EMR | Paper | EMR | Paper |
| A | Median TAT (mins) | Data Entry | . | 14 | . | 9 | 5 | 8 | 5 | 8 |
| z=25.56, p<.001 | z=17.77, p<.001 | |||||||||
| Total Lab | . | 42 | . | 47 | 43 | 56 | 58 | 64 | ||
| z=20.53, p<.001 | z=15.72, p<.001 | |||||||||
| Test Count | . | 20325 | . | 19757 | 16926 | 3058 | 17252 | 3616 | ||
| B | Median TAT (mins) | Data Entry | . | 12 | . | 9 | 6 | 8 | 5 | 6 |
| z=7.36, p<.001 | z=2.88, p<.01 | |||||||||
| Total Lab | . | 42 | . | 49 | 44 | 51 | 61 | 65 | ||
| z=5.39, p<.001 | z=3.38, p<.01 | |||||||||
| Test Count | . | 2152 | . | 2205 | 1486 | 504 | 1435 | 481 | ||
| C | Median TAT (mins) | Data Entry | . | 10 | . | 9 | 5 | 8 | 5 | 8 |
| z=12.13, p<.001 | z=12.76, p<.001 | |||||||||
| Total Lab | . | 40 | . | 51 | 43 | 59 | 64 | 70 | ||
| z=12.51, p<.001 | z=6.02, p<.001 | |||||||||
| Test Count | . | 4953 | . | 5142 | 4475 | 663 | 3886 | 714 | ||
| D | Median TAT (mins) | Data Entry | . | 1 | 10 | 12 | 6 | 8 | 4 | 9 |
| z=4.06, p<.001 | z=4.03, p<.001 | z=12.64, p<.001 | ||||||||
| Total Lab | . | 52 | 66 | 74 | 68 | 74 | 59 | 70 | ||
| z=5.10, p<.001 | z=3.38, p<.01 | z=10.13, p<.001 | ||||||||
| Test Count | . | 5160 | 4560 | 357 | 4880 | 321 | 5134 | 646 | ||
| E | Median TAT (mins) | Data Entry | . | 10 | 10 | 15 | 10 | 15 | 7 | 13 |
| z=20.22, p<.001 | z=25.70, p<.001 | z=27.04, p<.001 | ||||||||
| Total Lab | . | 50 | 52 | 58 | 79 | 89 | 67 | 81 | ||
| z=16.38, p<.001 | z=14.33, p<.001 | z=22.60, p<.001 | ||||||||
| Test Count | . | 24266 | 19459 | 4482 | 20798 | 5071 | 23179 | 3747 | ||
| F | Median TAT (mins) | Data Entry | . | 12 | 14 | 12 | 9 | 9 | 6 | 7 |
| z=0.48, n.s. | z=0.56, n.s. z | =7.47, p<.001 | ||||||||
| Total Lab | . | 65 | 65 | 72 | 87 | 88 | 61 | 65 | ||
| z=16.69, p<.001 | z=3.95, p<.001 | z=12.43, p<.001 | ||||||||
| Test Count | . | 19517 | 15776 | 3950 | 15503 | 4017 | 16418 | 3345 | ||
| Overall | Median TAT (mins) | Data Entry | | 7 | 10 | 6 | 9 | |||
| z=35.16, p<.001 | z=33.56, p<.001 | |||||||||
| Total Lab | 66 | 78 | 62 | 68 | ||||||
| z=29.67, p<.001 | z=30.45, p<.001 | |||||||||
| Test Count | 64068 | 13634 | 67304 | 12549 | ||||||
Table 15a. A comparison, between electronic-orders (EMR) and paper-orders, for EUC in the clinical chemistry department, of the median test TATs for the pre-analytic data entry phase and the laboratory test process from the time a specimen was received in CSR until a result was available.
| Haematology | 2008 | 2009 | 2010 | 2011 | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Hosp | Automated DIff | EMR | Paper | EMR | Paper | EMR | Paper | EMR | Paper | |
| A | Median TAT (mins) | Data Entry | | 14 | | 9 | 5 | 9 | 5 | 8 |
| z=28.69, p<.001 | z=20.29, p<.001 | |||||||||
| Total Lab | | 15 | | 33 | 28 | 32 | 29 | 30 | ||
| z=11.34, p<.001 | z=5.77, p<.001 | |||||||||
| Test Count | | 19561 | | 19121 | 15836 | 3160 | 16237 | 3771 | ||
| B | Median TAT (mins) | Data Entry | | 16 | | 9 | 6 | 7 | 6 | 8 |
| z=7.28, p<.001 | z=7.45, p<.001 | |||||||||
| Total Lab | | 51 | | 35 | 32 | 32 | 30 | 31 | ||
| z=0.04, n.s. | z=2.57, p<.05 | |||||||||
| Test Count | | 3087 | | 2996 | 1642 | 1333 | 1647 | 1376 | ||
| C | Median TAT (mins) | Data Entry | | 12 | | 9 | 5 | 9 | 4 | 9 |
| z=17.46, p<.001 | z=15.81, p<.001 | |||||||||
| Total Lab | | 46 | | 36 | 33 | 33 | 32 | 32 | ||
| z=0.70, n.s. | z=0.81, n.s. | |||||||||
| Test Count | | 3963 | | 3809 | 3378 | 636 | 3056 | 751 | ||
| D | Median TAT (mins) | Data Entry | | 1 | 10 | 12 | 6 | 7 | 4 | 9 |
| z=3.80, p<.001 | z=4.42, p<.001 | z=12.35, p<.001 | ||||||||
| Total Lab | | 29 | 42 | 47 | 43 | 50 | 26 | 33 | ||
| z=3.60, p<.001 | z=3.01, p<.01 | z=6.30, p<.001 | ||||||||
| Test Count | | 4979 | 4419 | 346 | 4744 | 329 | 5231 | 688 | ||
| E | Median TAT (mins) | Data Entry | | 10 | 10 | 15 | 10 | 15 | 7 | 13 |
| z=21.06, p<.001 | z=25.55, p<.001 | z=26.59, p<.001 | ||||||||
| Total Lab | | 45 | 43 | 47 | 38 | 44 | 37 | 44 | ||
| z=10.19, p<.001 | z=18.54, p<.001 | z=18.27, p<.001 | ||||||||
| Test Count | | 22367 | 17305 | 4791 | 19490 | 5453 | 21473 | 4373 | ||
| F | Median TAT (mins) | Data Entry | | 12 | 13 | 12 | 9 | 8 | 6 | 6 |
| z=2.41, p<.05 | z=0.21, n.s. | z=5.56, p<.001 | ||||||||
| Total Lab | | 74 | 71 | 73 | 78 | 78 | 58 | 64 | ||
| z=1.57, n.s. | z=0.06, n.s. | z=2.57, p<.05 | ||||||||
| Test Count | | 20139 | 15838 | 4662 | 15811 | 4417 | 16717 | 3733 | ||
| Overall | Median TAT (mins) | Data Entry | | 7 | 10 | 6 | 9 | |||
| z=34.41, p<.001 | z=35.35, p<.001 | |||||||||
| Total Lab | 40 | 44 | 36 | 38 | ||||||
| z=12.79, p<.001 | z=11.70, p<.001 | |||||||||
| Test Count | 60901 | 15328 | 64361 | 14692 | ||||||
Mann-Whitney U tests of significance; n.s.: Not Significant
Table 15b. A comparison, between electronic-orders (EMR) and paper-orders, for Automated Differential in haematology, of the median test TATs for the pre-analytic data entry phase, and the laboratory test process from the time a specimen was received in CSR until a result was available.
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