Evaluation of a command-line parser-based order entry pathway for the Department of Veterans Affairs electronic patient record

Objective: To improve and simplify electronic order entry in an existing electronic patient record, the authors developed an alternative system for entering orders, which is based on a command-line interface using robust and simple natural-language techniques. Design: The authors conducted a randomized evaluation of the new entry pathway, measuring time to complete a standard set of orders, and users' satisfaction measured by questionnaire. A group of 16 physician volunteers from the staff of the Department of Veterans Affairs Puget Sound Health Care System-Seattle Division participated in the evaluation. Results: Thirteen of the 16 physicians (81 %) were able to enter medical orders more quickly using the natural-language-based entry system than the standard graphical user interface that uses menus and dialogs (mean time spared, 16.06 +/- 4.52 minutes; P = 0.029). Compared with the graphical user interface, the command-line-based pathway was perceived as easier to learn (P < 0.01), was considered easier to use and faster (P < 0.01), and was rated better overall (P < 0.05). Conclusion: Physicians found the command-line interface easier to learn and faster to use than the usual menu-driven system. The major advantage of the system is that it combines an intuitive graphical user interface with the power and speed of a natural-language analyzer.