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September 9, 1988

The Alteration of Physicians' Orders by Nonphysicians

Author Affiliations

Marina, Calif

Marina, Calif

JAMA. 1988;260(10):1403-1404. doi:10.1001/jama.1988.03410100093018

To the Editor.—  Based on 15 years of experience as a participant/consultant in the development of totally computerized patient medical record systems, I found the report by Finn et al1 in the May 6 issue of JAMA concerning non-physician alteration of physician laboratory orders to be hardly surprising. In fact, it seemed to be quite predictable given (1) the current paper-based medical record system that requires ancillary personnel to spend considerable time processing physician orders, orders that are often illegible, incomplete, misspelled, and illogical and (2) a medical system that requires physician reliance on memory for many information-processing tasks rather than offering information guidance at the time of ordering.What may not be realized is that solutions to the previously mentioned problems already exist and have been available for approximately 15 years. I refer to computerized order transfer systems, which enable the physician personally to enter orders for laboratory