Abstract
BackgroundHealth information technology (HIT) may improve health care quality and outcomes, in part by making information available in a timelier manner. However, there are few studies documenting the changes in timely availability of data with the use of a sophisticated electronic medical record (EMR), nor a description of how the timely availability of data might differ with different types of EMRs. We hypothesized that timely availability of data would improve with use of increasingly sophisticated forms of HIT.MethodsWe used an historical observation design (2004–2006) using electronic data from office visits in an integrated delivery system with three types of HIT: Basic, Intermediate, and Advanced. We calculated the monthly percentage of visits using the various types of HIT for entry of visit diagnoses into the delivery system's electronic database, and the time between the visit and the availability of the visit diagnoses in the database.ResultsIn January 2004, when only Basic HIT was available, 10% of office visits had diagnoses entered on the same day as the visit and 90% within a week; 85% of office visits used paper forms for recording visit diagnoses, 16% used Basic at that time. By December 2006, 95% of all office visits had diagnoses available on the same day as the visit, when 98% of office visits used some form of HIT for entry of visit diagnoses (Advanced HIT for 67% of visits).ConclusionUse of HIT systems is associated with dramatic increases in the timely availability of diagnostic information, though the effects may vary by sophistication of HIT system. Timely clinical data are critical for real-time population surveillance, and valuable for routine clinical care.
Highlights
Health information technology (HIT) may improve health care quality and outcomes, in part by making information available in a timelier manner
We focused on the time to availability of visit diagnoses as recorded by clinicians either on paper visit diagnosis forms, or through two types of electronic medical record (EMR) systems in a large, prepaid, integrated delivery system (IDS) over a three-year period
For pooled visits across all medical centers and for each month of the study period, Figure 2a depicts the percentage with entry of diagnoses using paper or one of the HIT systems
Summary
Health information technology (HIT) may improve health care quality and outcomes, in part by making information available in a timelier manner. There are few studies documenting the changes in timely availability of data with the use of a sophisticated electronic medical record (EMR), nor a description of how the timely availability of data might differ with different types of EMRs. We hypothesized that timely availability of data would improve with use of increasingly sophisticated forms of HIT. Health information technology (HIT) systems have the potential to improve health care quality and outcomes, in part by making important clinical data quickly available. BMC Medical Informatics and Decision Making 2009, 9:35 http://www.biomedcentral.com/1472-6947/9/35 surveillance for and monitoring of infectious disease outbreaks requires real time clinical information. Newer electronic medical records (EMR) systems include many of the key capabilities for EMRs described by the Institute of Medicine in 2004,[14] such as electronic charting, computerized physician order entry, and clinical decision support. A study in Boston in 2001 demonstrated the accurate identification of lower respiratory tract infections with a comprehensive EMR, but did not explore the time to data availability associated with the EMR[15] and to our knowledge there are no studies demonstrating this relationship.
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