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We conducted a randomized controlled trial comparing joint disability examinations supported by computerized templates to the examinations documented via dictation, to determine if the system met the intended goals or had unintended consequences. Consenting veterans were randomized to undergo exams documented using computerized templates or via dictation. We compared exam report quality, documentation time costs, encounter length, total time to fulfill an exam request with a finalized exam report, and veteran satisfaction. Computer-based templates resulted in disability exam reports that had higher quality scores (p. 0.042) and were returned to the requesting office faster than exam reports created via dictation (p. 0.02).<\/jats:p>\n          <jats:p>Documentation time and veteran satisfaction were similar for both the documentation techniques. Encounter length was significantly longer for the template group. Computer-based templates impacted the VA disability evaluation system by improving report quality scores and production time and lengthening encounter times. Oversight bodies have called for mandated use of computer-based templates nationwide. We believe mandates regarding use of health information technology should be guided by data regarding its positive and negative impacts.<\/jats:p>","DOI":"10.1145\/2166788.2166790","type":"journal-article","created":{"date-parts":[[2012,5,7]],"date-time":"2012-05-07T18:47:42Z","timestamp":1336416462000},"page":"1-17","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Documentation quality and time costs"],"prefix":"10.1145","volume":"3","author":[{"given":"Steven","family":"Brown","sequence":"first","affiliation":[{"name":"U.S. Department of Veterans Affairs and Vanderbilt University, Nashville, TN"}]},{"given":"Trent S.","family":"Rosenbloom","sequence":"additional","affiliation":[{"name":"Vanderbilt University, Nashville, TN"}]},{"given":"Shawn P.","family":"Hardenbrook","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs"}]},{"given":"Terry","family":"Clark","sequence":"additional","affiliation":[{"name":"MD Informatics, Park city, UT"}]},{"given":"Elliot","family":"Fielstein","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs and Vanderbilt University, Nashville, TN"}]},{"given":"Peter","family":"Elkin","sequence":"additional","affiliation":[{"name":"Mount Sinai Center for Biomedical Informatics, New York, NY"}]},{"given":"Ted","family":"Speroff","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs and Vanderbilt University, Nashville, TN"}]}],"member":"320","published-online":{"date-parts":[[2012,5,7]]},"reference":[{"key":"e_1_2_1_1_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-197610000-00022"},{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340000777"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jamia.2000.0070055"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1197\/jamia.M1471"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-197811000-00007"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198304000-00003"},{"volume-title":"Proceedings of the Annual Symposium on Computer Applications Medical Care. 216--222","author":"Bell D. 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