J Med Syst - Using electronic medical record systems for admission decisions in emergency departments: examining the crowdedness effect.

Tópicos

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Resumo

Many medical organizations have deployed electronic medical record (EMR) information systems (IS) to improve medical decision-making and increase efficiency. Despite their advantages, however, EMR IS may make less of a contribution in the stressful environment of an emergency department (ED) that operates under tight time constraints. The high level of crowdedness in the EDs itself can cause physicians to make medical decisions resulting in more unnecessary admissions and fewer necessary admissions. Thus this study evaluated the contribution of an EMR IS to physicians by investigating whether EMR IS leads to improved medical outcomes in points of care in EDs under different levels of crowdedness. For this purpose a track log-file analysis of a database containing 3.2 million ED referrals in seven main hospitals in Israel (the whole population in these hospitals) was conducted. The findings suggest that viewing medical history via the EMR IS leads to better admission decisions, and reduces the number of possibly avoidable single-day admissions. Furthermore, although the ED can be very stressful especially on crowded days, physicians used EMR IS more on crowded days than on non-crowded days. These results have implications as regards the viability of EMR IS in complex, fast-paced environments.

Resumo Limpo

mani medic organ deploy electron medic record emr inform system improv medic decisionmak increas effici despit advantag howev emr may make less contribut stress environ emerg depart ed oper tight time constraint high level crowded ed can caus physician make medic decis result unnecessari admiss fewer necessari admiss thus studi evalu contribut emr physician investig whether emr lead improv medic outcom point care ed differ level crowded purpos track logfil analysi databas contain million ed referr seven main hospit israel whole popul hospit conduct find suggest view medic histori via emr lead better admiss decis reduc number possibl avoid singleday admiss furthermor although ed can stress especi crowd day physician use emr crowd day noncrowd day result implic regard viabil emr complex fastpac environ

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