Appl Clin Inform 2010; 01(01): 32-37
DOI: 10.4338/ACI-2009-12-RA-0023
Research Article
Schattauer GmbH

Distribution of Problems, Medications and Lab Results in Electronic Health Records: The Pareto Principle at Work

Adam Wright PhD
1  Brigham and Women’s Hospital, Boston, MA, USA
2  Harvard Medical School, Boston, MA, USA
3  Partners HealthCare, Boston, MA, USA
,
David W. Bates MD, MSc
1  Brigham and Women’s Hospital, Boston, MA, USA
2  Harvard Medical School, Boston, MA, USA
3  Partners HealthCare, Boston, MA, USA
› Author Affiliations
Further Information

Correspondence to:

Adam Wright, Ph.D.
Division of General Medicine and Primary Care
Brigham and Women’s Hospital
1620 Tremont St.
Boston, MA 02120
Phone: (781) 416-8764   
Fax: (617) 732-7072   

Publication History

received: 15 December 2009

accepted: 10 March 2010

Publication Date:
16 December 2017 (online)

 

Summary

Background: Many natural phenomena demonstrate power-law distributions, where very common items predominate. Problems, medications and lab results represent some of the most important data elements in medicine, but their overall distribution has not been reported.

Objective: Our objective is to determine whether problems, medications and lab results demonstrate a power law distribution.

Methods: Retrospective review of electronic medical record data for 100,000 randomly selected patients seen at least twice in 2006 and 2007 at the Brigham and Women’s Hospital in Boston and its affiliated medical practices.

Results: All three data types exhibited a power law distribution. The 12.5% most frequently used problems account for 80% of all patient problems, the top 11.8% of medications account for 80% of all medication orders and the top 4.5% of lab result types account for all lab results.

Conclusion: These three data elements exhibited power law distributions with a small number of common items representing a substantial proportion of all orders and observations, which has implications for electronic health record design.


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Conflict of Interest

Neither Dr. Wright nor Dr. Bates have any conflicts to report. Dr. Wright had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.


Correspondence to:

Adam Wright, Ph.D.
Division of General Medicine and Primary Care
Brigham and Women’s Hospital
1620 Tremont St.
Boston, MA 02120
Phone: (781) 416-8764   
Fax: (617) 732-7072