Appl Clin Inform - Improving access to longitudinal patient health information within an emergency department.

Tópicos

{ record(1888) medic(1808) patient(1693) }
{ inform(2794) health(2639) internet(1427) }
{ patient(2837) hospit(1953) medic(668) }
{ decis(3086) make(1611) patient(1517) }
{ system(1050) medic(1026) inform(1018) }
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{ implement(1333) system(1263) develop(1122) }
{ process(1125) use(805) approach(778) }
{ studi(1410) differ(1259) use(1210) }
{ can(774) often(719) complex(702) }
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{ health(3367) inform(1360) care(1135) }
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{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ can(981) present(881) function(850) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

We designed and implemented an electronic patient tracking system with improved user authentication and patient selection. We then measured access to clinical information from previous clinical encounters before and after implementation of the system. Clinicians accessed longitudinal information for 16% of patient encounters before, and 40% of patient encounters after the intervention, indicating such a system can improve clinician access to information. We also attempted to evaluate the impact of providing this access on inpatient admissions from the emergency department, by comparing the odds of inpatient admission from an emergency department before and after the improved access was made available. Patients were 24% less likely to be admitted after the implementation of improved access. However, there were many potential confounders, based on the inherent pre-post design of the evaluation. Our experience has strong implications for current health information exchange initiatives.

Resumo Limpo

design implement electron patient track system improv user authent patient select measur access clinic inform previous clinic encount implement system clinician access longitudin inform patient encount patient encount intervent indic system can improv clinician access inform also attempt evalu impact provid access inpati admiss emerg depart compar odd inpati admiss emerg depart improv access made avail patient less like admit implement improv access howev mani potenti confound base inher prepost design evalu experi strong implic current health inform exchang initi

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