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J Hand Microsurg 2023; 15(05): 358-364
DOI: 10.1055/s-0042-1749465
Original Article

The Development and Validation of Data Elements and Process Steps for an Electronic Health Record for Hand Surgery Outreach Trips

Lauren M. Shapiro
1   Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, United States
,
James Chang
2   Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, United States
,
Paige M. Fox 
2   Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, United States
,
Scott Kozin
3   Department of Orthopaedic Surgery, Shriners Children's Philadelphia, Philadelphia, Pennsylvania, United States
,
Kevin C. Chung
4   Section of Plastic Surgery, University of Michigan, Ann Arbor, Michigan, United States
,
George S.M. Dyer
5   Department of Orthopaedics, Harvard Combined Orthopaedics Residency Program, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Duretti Fufa
6   Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, United States
,
Fraser Leversedge
7   Department of Orthopaedic Surgery, University of Colorado Anschutz, Aurora, Colorado, United States
,
Julie Katarincic
8   Department of Orthopaedic Surgery, University Orthopedics, Rhode Island, United States
,
Robin Kamal 
9   Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University, Redwood City, California, United States
› Author Affiliations Funding This work was supported by a National Institutes of Health K23AR073307-01 award (R.N.K.).
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Abstract

Background The surgical burden in low- and middle-income countries (LMICs) as reported by the number of surgical cases per capita is great. To improve global health and help address this burden, there has been a rise in surgical outreach to LMICs. In high-income countries, an electronic health record (EHR) is used to document and communicate data critical to the quality of care and patient safety. Despite this, there is little guidance or precedence on the data elements or processes for utilizing an EHR on outreach trips. We validated data elements and process steps for utilizing an EHR for hand surgery outreach trips.

Methods We conducted a literature review to identify data elements collected during surgical outreach trips. A future-state process map for the collection and documentation of data elements within an EHR was developed through literature review and semistructured interviews with experts in global outreach. An expert consortium completed a modified RAND/University of California at Los Angeles Delphi process to evaluate the importance and feasibility of each data element and process step.

Results In total, 65 data elements (e.g., date of birth) and 24 process steps (e.g., surgical site marking) were validated for use in an EHR for hand surgery outreach trips to LMICs.

Conclusion This validated portfolio of data elements/process steps can serve as the foundation for pilot testing of an EHR to document and communicate critical patient data on hand surgery outreach trips. Utilization of an EHR during outreach trips to LMICs may serve to improve the safety and quality of care provided. The validated data elements/process steps can serve as a guide for EHR development and implementation of other surgical specialties.

Keywords

data collection - electronic health records - global outreach - hand surgery - quality improvement

Supplementary Material



Publication History

Article published online:
05 July 2022

© 2022. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

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