Impact of an electronic information system on physician workflow and data collection in the intensive care unit

Apkon, Michael; Singhaviranon, P.

doi:10.1007/s001340000777

Cited by 83 publications

(54 citation statements)

References 16 publications

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“…Because of the lack of similar studies within the setting of an emergency department, we have to compare these results with those of studies performed in other settings: Apkon & Singhaviranon [17], in their study on the impact of an electronic information system on physician workflow and data collection in the intensive care unit, and Menke et al [18], in their study on a computerized clinical documentation system in a pediatric intensive care unit, found no difference regarding the amount of time consumed dependent on the charting method. Additionally, Apkon & Singhaviranon [17] report of a significantly more detailed electronic than handwritten Table 1.…”

Section: Discussionmentioning

confidence: 99%

Improved Data Quality by Pen Computer–Assisted Emergency Room Data Recording Following Major Trauma

Helm¹,

Kulla²,

Hauke³

et al. 2005

Eur J Trauma

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European Journal of Trauma Ab stractBackground: Quality management is a decisive factor in optimizing the treatment of major trauma cases. In this context high-quality data recording is of fundamental importance. Regarding data quality, "on-line" -especially pen computer-based -recording techniques are favored. Up to now, however, there is no study really proving a higher quality of emergency room (ER) data by use of such a technique in comparison with a paper-based technique. Material and Methods: In all major trauma cases a standardized ER data recording, using "TraumaWatch", was performed; the study collective was divided into two subgroups: the "pen" collective using a pen computer-based technique and the "paper" collective using a paper-based technique. Data quality was defined as level of data completeness. Results: A total of 207 major trauma cases underwent ER management. There was no statistically significant difference between the "pen" (n = 135) and the "paper" collective (n = 72) regarding gender, age, mechanism of injury, injury severity, and duration of ER management. There was no correlation between degree of injury severity and level of dataset completeness. Total dataset completeness was significantly higher within the "pen" collective (93.6% vs. 82.5%; p < 0.01); the same applies to the core dataset (Utstein style) completeness (97.3% vs. 91.3%; p < 0.01). Conclusion: Defining data quality as level of data completeness, a pen computer-based recording technique, which allows easy and fast -real-time -data acquisition during ER management, seems to be superior to the conventional paper-based technique.

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Section: Discussionmentioning

confidence: 99%

Improved Data Quality by Pen Computer–Assisted Emergency Room Data Recording Following Major Trauma

Helm¹,

Kulla²,

Hauke³

et al. 2005

Eur J Trauma

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“…In an ICU various systems are used for collecting different data [6]. These systems include medical devices, laboratory systems, patients demographics, EMR (Electronic Medical Record), pharmacy system and end users.…”

Section: Apps For Work Flow Automationmentioning

confidence: 99%

A Tablet PC based System for Ubiquitous Patient Monitoring and Smart Alert Generation in an Intensive Care Unit

Antony¹

2013

IJCA

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Providing critical care to patients admitted to an ICU is a very important aspect in healthcare. This requires mechanisms for ubiquitous monitoring and smart alert generation systems. The conventional systems in many hospitals are not able to cope up with this requirement. So that medication and other required actions will be getting delayed making life difficult for a patient. These issues can be addressed by implementing a Tablet PC based system focussed on ICU based work flows. Designing and developing of Apps can provide better solutions for clinical data entry, patient monitoring and meaningful alert generation. The clinical data entry can be made easier with the help of a Tablet PC which offers a number of possibilities for organised data entry. Once the data becomes available; forms, charts, graphs etc can be generated easily without much manual intervention. Interfacing bed side monitors to the central server can provide automated and ubiquitous solutions for monitoring and analysis of patient data . Another important aspect is the way in which alert generation is made. In existing systems alerts are generated based on hard limits set by the clinical staff. There is a need to develop a more comprehensive system that holistically looks at all available information about the situation before generating an alert. Towards this, it should continuously monitor all vital signals available and evaluate the cross functional effects between them before arriving at the seriousness of the conditions leading to more meaningful alerts.

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“…Some studies point to potential EHR-related quality and safety gains due to increased adherence to guideline-based care, 1,2 more complete documentation, 3,4 and fewer medical errors. 5,6 Efficiency gains have been shown to result from electronic ordering 7,8 and from improved access to clinical information, 9,10 which can reduce redundant services.…”

Section: Introductionmentioning

confidence: 99%

“…Studies conducted in large health systems and hospital settings have documented both increased work hours for clinicians as well as more efficient delivery of clinical care, along with the unintended creation of new work and potential safety problems following EHR implementation. 1,3,[11][12][13][14][15][16][17][18][19] A systematic review of EHR impact on efficiency concluded that "the goal of decreased documentation time is not likely to be fulfilled, especially for physicians. "…”

Section: Introductionmentioning

confidence: 99%

Electronic Health Record Impact on Work Burden in Small, Unaffiliated, Community-Based Primary Care Practices

Howard¹,

Clark²,

Friedman³

et al. 2012

J GEN INTERN MED

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BACKGROUND:The use of electronic health records (EHR) is widely recommended as a means to improve the quality, safety and efficiency of US healthcare. Relatively little is known, however, about how implementation and use of this technology affects the work of clinicians and support staff who provide primary health care in small, independent practices. OBJECTIVE: To study the impact of EHR use on clinician and staff work burden in small, communitybased primary care practices. DESIGN: We conducted in-depth field research in seven community-based primary care practices. A team of field researchers spent 9-14 days over a 4-8 week period observing work in each practice, following patients through the practices, conducting interviews with key informants, and collecting documents and photographs. Field research data were coded and analyzed by a multidisciplinary research team, using a grounded theory approach. PARTICIPANTS: All practice members and selected patients in seven community-based primary care practices in the Northeastern US. KEY RESULTS: The impact of EHR use on work burden differed for clinicians compared to support staff. EHR use reduced both clerical and clinical staff work burden by improving how they check in and room patients, how they chart their work, and how they communicate with both patients and providers. In contrast, EHR use reduced some clinician work (i.e., prescribing, some lab-related tasks, and communication within the office), while increasing other work (i.e., charting, chronic disease and preventive care tasks, and some lab-related tasks). Thoughtful implementation and strategic workflow redesign can mitigate the disproportionate EHRrelated work burden for clinicians, as well as facilitate population-based care. CONCLUSIONS: The complex needs of the primary care clinician should be understood and considered as the next iteration of EHR systems are developed and implemented.KEY WORDS: electronic health records; primary care; work burden; qualitative research.

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Impact of an electronic information system on physician workflow and data collection in the intensive care unit

Cited by 83 publications

References 16 publications

Improved Data Quality by Pen Computer–Assisted Emergency Room Data Recording Following Major Trauma

Improved Data Quality by Pen Computer–Assisted Emergency Room Data Recording Following Major Trauma

A Tablet PC based System for Ubiquitous Patient Monitoring and Smart Alert Generation in an Intensive Care Unit

Electronic Health Record Impact on Work Burden in Small, Unaffiliated, Community-Based Primary Care Practices

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