J Am Med Inform Assoc - Design and evaluation of a wireless electronic health records system for field care in mass casualty settings.

Tópicos

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Resumo

CKGROUND: There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD).MATERIALS AND METHODS: WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds.RESULTS: WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, p<0.001). The total time of the field was nearly identical (38:20 vs 38:23, IQR 26:53-1:05:32 vs 18:55-57:22).CONCLUSION: Overall, the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters.

Resumo Limpo

ckground grow interest use technolog enhanc track qualiti clinic inform avail patient disast set paper describ design evalu wireless internet inform system medic respons disast wiisardmateri method wiisard combin advanc network technolog electron triag tag report victim posit record medic inform wireless pulseoximet monitor patient vital sign wireless electron medic record emr disast care emr system includ wifi handheld devic barcod scanner use frontlin respond comput tablet roletailor softwar use manag triag treatment transport medic communic team addit softwar system provid situat awar incid command wiisard system evalu largescal simul exercis design train first respond random trial overlaid exercis simul victim control pathway paperbas complet electron wiisard pathway patient electron pathway care within wiisard system without paperbas workaroundsresult wiisard reduc rate miss andor duplic patient identifi vs p total time field near ident vs iqr vs conclus overal result wiisard show wireless emr system care victim disast complex develop potenti feasibl build deploy like improv qualiti inform avail deliveri care disast

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