Computerized Databases for Emergency Care: What Impact on Patient Care?

G. E. Pugh; J. K. H. Tan

doi:10.1055/s-0038-1635054

Methods of Information in Medicine, Table of Contents

Methods Inf Med 1994; 33(05): 507-513
DOI: 10.1055/s-0038-1635054

Original Article

Schattauer GmbH

Computerized Databases for Emergency Care: What Impact on Patient Care?

Authors

G. E. Pugh

¹Department of Emergency Medicine, Mount St. Joseph Hospital, Vancouver, BC, Canada
J. K. H. Tan

²Division of Health Policy and Management, Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

Abstract

Abstract:

A field-based evaluation is conducted of a Clinical Computerized Information System (CCIS™). Following training, the use of the CCIS™ database, word processing and other programs by thirteen full-time practicing emergency physicians in two urban emergency departments of a University-associated teaching hospital was studied over a one-year period. A tracking program automatically logged frequency and duration of use by the physicians, and user satisfaction was assessed by a reliable and validated questionnaire instrument. Based on utilization data and verbal reports of these physicians, CCIS™ database searching was not only found to be easy-to-leam but was readily accessible during emergency shifts. Individual physicians were found to perform an average of 3.5 searches per month lasting a mean search time of 8 min. Positive notes about the CCIS™ system included ease-of-use, accuracy of data, accessibility of system, and value of output while negative perceptions included a lack of integration with other systems, a lack of system completeness, and a high subscription cost. It was suggested that a less costly telephone link to a high-volume Centre would be desirable in actual implementation of the system.

Keywords:

Clinical Information Systems - Databases - User Satisfaction - Software Evaluation - Technology Management

Full Text

References

REFERENCES
1 Laupacis A, Feeny D, Detsky AS, Tugwell PX. How attractive does a new technology have to be to warrent adoption and utilization? Tentative guidelines for using clinical and economic evaluations. Can Med Assoc J 1992; 146: 473-81.
2 Emery J. Cost/benefit analysis of information systems. In: Cougar JD, Colter MA, Knapp RW. eds. Advanced System Development/Feasibility Techniques. Wiley & Sons; 1982: 459-88.
3 Marshall JG. On-line databases for health professionals: are they really useful?. Can Fam Physician 1987; 33: 887-93.
4 Lindberg DAB. Information systems to support medical practice and scientific discovery. Meth Inform Med 1989; 28: 202-6.
5 Micromedex Computerized Clinical Information System. Vol. 73. Expires Aug 31th, 1992, 600 Grant St. Denver, CO; 80203-3527.
6 Rann LS, Winokur MG, Kuchta NE. The computerized clinical information system on CD-ROM. Optical Information Systems 1986; 06: 313-6.
7 Yamamoto LG, Wiebe RA. Pediatric and adult emergency management assistance using computerized guidelines. Am J Emerg Med 1989; 07: 91-6.
8 Goldman B. Computers in primary care teaching. Canad Family Physician 1990; 30: 1983-6.
9 Bailey JE. Development of an instrument for the management of computer user attitudes in hospitals. Meth Inform Med 1990; 29: 51-6.
10 Hayes RB, McKibbon KA, Walker CJ, Ryan N, Fitzgerald D, Ramsden MF. Online access to MEDLINE in clinical settings. Ann Intern Med 1990; 112: 78-84.
11 Silver H, Dennis S. Monitoring patron use of CD-ROM Databases using Signln-Stat. Bull Med Libr Assoc 1990; 78: 252-7.
12 Tobias R, Bierschenk NF, Knodel LC, Bow-den VM. Improving access to computer-based library and drug information services in patient-care areas. Am J of Hosp Pharm 1990; 47: 137-41.
13 Dvorak JC. Data has no worth. PC Magazine April 1991; 81.
14 Tan JKH, McCormick E, Sheps S. Utilization care plans and effective patient data management. Hosp Health Serv Admin 1993; 38: 81-99.