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Appl Clin Inform 2012; 03(03): 290-300
DOI: 10.4338/ACI-2011-03-RA-0019
Research Article
Schattauer GmbH

Improving Access to Longitudinal Patient Health Information within an Emergency Department

A.B. Wilcox
1   Department of Biomedical Informatics, Columbia University, New York, NY
,
S. Shen
2   Intermountain Healthcare, Salt Lake City, UT
3   Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
,
D.A. Dorr
4   Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
,
G. Hripcsak
1   Department of Biomedical Informatics, Columbia University, New York, NY
,
L. Heermann
2   Intermountain Healthcare, Salt Lake City, UT
,
S.P. Narus
2   Intermountain Healthcare, Salt Lake City, UT
5   Department of Biomedical Informatics, University of Utah, Salt Lake City, UT
› Author Affiliations
Further Information

Publication History

received: 18 January 2012

accepted: 18 June 2012

Publication Date:
16 December 2017 (online)

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Summary

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.

Keywords

Health information exchange - reduced admissions - electronic health records
 

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