In the old pre-computer days, physicians caring for patients in the hospital would order medications for their patients in a fairly simple way: just tell the nurse or write it into the order sheet. With the advent of entirely computerized record keeping, that simplicity is a thing of the past. Whether it improves patient care of safety, however, is not so clear.

At the present time, orders are made through a “Computerized Physician Order Entry” (CPOE). Physician orders, whether for medications, laboratory, radiology, or other purposes, now require the physician to go to the nearest computer, log in, and then use a password to get into the system. No more can the doctor tell the nurse or unit secretary, on the fly as he is passes by, “give the patient 600 mg of tylenol q 4 hours PRN.”

The doctor now has to enter this into the computer, thus interrupting what he or she was doing. It’s not a lot of time, but it adds up if this occurs dozens of times a day. And all of the time used in entering a computer order is time not spent with the patient. As one patient said about computers in the hospital: “I see the back of my doctor’s head more than I see his face.”

A recent article advocates development of an app that would allow voice commands to be placed via a smart phone. The nurse calls the physician asking for a medication order, and the physician dictates the patient’s name, which then pulls up the patient information on the phone. The physician would dictate the medication order and click “order.” In an age when almost anything can now be done via your smart phone, and the advent of voice recognition software, developing that app doesn’t seem like an insurmountable task. After all, anyone can now order their favorite pizza via their iPhone and dictating what they want before pushing a button or two. Computerized medicine is here to stay, and there should be a major effort to make it work faster and better and more safely.