Electronic patient records and the impact of the Internet

BackgroundUnderstanding the impact of a patient’s social history forms part of medical assessments and wider NHS data collection. To date, there has been little work examining the extent of social history recording by ambulance clinicians. The aim of this service evaluation is to examine how frequently staff complete social history fields on electronic patient records and to identify patterns in completion rate when comparing categories of call, localities of crew, conveyance or non-conveyance, and individual fields of social history data.MethodA retrospective review of one NHS ambulance trust’s electronic patient records (attended 01/01/2019 – 31/12/2019) was conducted. 10% of the records were analysed due to software limitations (n = 134434 adult cases).ResultsVery few cases (<0.05%) had every field completed, with 28.6% of all cases having no fields completed at all. In 45% of cases, between 8 and 11 fields were completed. The mean number of fields completed per case was 5.79 and the median number was 7.‘Mobility’ and ‘Home circumstances’ were the most frequently completed and ‘Sexual Orientation’ and ‘Language’ were the least.Category of call appears to have minimal impact on completion rates. Localities and specialists had more variation, ranging from 21.3% to 49.9% with no fields completed at all.ConclusionSocial history documentation is very infrequently fully completed by frontline ambulance crews within this service. The majority of cases have a partially complete social history however, due to software limitations, it is unknown whether the same fields are consistently completed throughout these cases.Further research, including qualitative work, is recommended to understand the low rate of recording of social history data and how this information is used by ambulance staff.

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Persecution complex: I am getting one over electronic patient records!

Faculty Dental Journal ◽

10.1308/rcsfdj.2016.78 ◽

2017 ◽

Vol 8 (2) ◽

pp. 78-81

Author(s):

S Misra ◽

F Dyer ◽

Professor P Sandler

Keyword(s):

Information Technology ◽

Secondary Care ◽

Patient Records ◽

Electronic Patient Records ◽

Plain Language ◽

National Programme ◽

Care Processes ◽

Health And Social Care ◽

The Impact ◽

Blair Government

The electronic patient record (EPR) is a core organisational document in which integrated health and social care records and secondary care processes can be stored. EPR was the brain child of the NHS’ National Programme for Information Technology, under the Blair government. 1 Since then, attempts have been made to install EPR in secondary care – a typical example being the installation of specialist imaging systems in hospital trusts. 2 The primary aim of EPR was to make the NHS services efficient via digitised patient records that could be viewed, discussed and transferred electronically between clinicians and/or trusts. 1 , 3 Other anticipated uses of EPR were to provide easy patient access to services such as e-referrals and e-prescriptions, as well as appointment systems. 3 , 4 Here, we discuss EPR and information technology in plain language, and assess the impact of EPR on NHS secondary care orthodontic services.

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EP.WE.555Impact of COVID 19 on Renal access surgery

British Journal of Surgery ◽

10.1093/bjs/znab308.065 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Abdallah Abdelwahed ◽

Raghvinder Gambhir ◽

Hiren Mistry ◽

Fatima de'figededu ◽

Domenico Valenti ◽

...

Keyword(s):

Surgical Intervention ◽

Recovery Phase ◽

Day Surgery ◽

Patient Records ◽

Electronic Patient Records ◽

Time Period ◽

Independent Sector ◽

The Impact ◽

Access Surgery ◽

Radiological Intervention

Abstract Aims To assess the impact of COVID -19 on renal access surgery. Methods Electronic patient records and renal ware were accessed to obtain data of all renal access activity during the COVID period. Results There as a shutdown of all elective activity which affected the renal access surgery as well. No new Arterio venous fistulas (AVFs) were created in the time period 14 March to 05th May 2020. No pre-fistula mapping scans were performed. All new starters started with a tunneled dialysis line. In the recovery phase special theatre sessions were asked for and procedures carried out in Day surgery and in independent sector (n-18). A total of 203 new AVF’s were created compared to 272 the year before a fall of 25%. There were 48 patients admitted with blocked access, 70% of whom underwent radiological intervention compared to 52% in 2019. Surgical intervention was offered to just 4% compared to 25% in 2019. The number of access abandoned was 27% in 2020 vs 19% in 2019. Conclusion COVID-19 adversely affected the renal access population and none of the British Renal access surgery targets were met for 2020.

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PP20 A retrospective service evaluation of the presentation of anaphylaxis to a UK ambulance service

Emergency Medicine Journal ◽

10.1136/emermed-2019-999abs.20 ◽

2019 ◽

Vol 36 (10) ◽

pp. e9.2-e9

Author(s):

Nicholas Groom ◽

Sarah Taylor ◽

Ed England ◽

Helen Pocock ◽

Charles D Deakin

Keyword(s):

Service Evaluation ◽

Ambulance Service ◽

Small Scale ◽

Patient Records ◽

Electronic Patient Records ◽

Self Administration ◽

Patient Demographics ◽

The Mean ◽

The Impact ◽

To Receive

BackgroundThere is a lack of data relating to frequency and presentation of anaphylaxis to the ambulance service in England. Little research exists relating to the patients’ self-treatment of anaphylaxis and there is an absence of evidence to evaluate the impact of self-administered adrenaline, there is a need to describe this patient group to evaluate any potential to develop their care.MethodsRetrospective data were collected from the electronic patient records of a single NHS ambulance service serving a population of approximately four million. Records between 1stApril 2017 and 31st March 2018 were included where a diagnosis of anaphylaxis was recorded. Gender, age, incident location, allergy history, were summarised to identify any trends in presentation. The frequency of patient self-administration, as well as ambulance administration, of adrenaline was also included for analysis to determine any correlation.Results326 records were included in the analysis. The mean, median and modal patient ages were 34, 29 and 20 respectively. Patient ages ranged from six months to 95 years. Patients were 65% female, 35% male and 59% of incidents occurred at home. 76% of patients reported having a known allergy with food being the most common allergen (44%). Peak times for calling 999 were midday and 6pm. 35% of patients had self-administered adrenaline. 52% received ambulance-administered adrenaline. The doses of self-administered adrenaline ranged from 0–3 doses and ambulance administered adrenaline ranged from 0–8 doses. Patients who self-administered adrenaline were less likely to receive further adrenaline from the ambulance service. No correlation was found between the number of self-administered doses and ambulance administered doses.ConclusionPatient demographics such as age, gender and allergies were consistent with two previous small-scale studies. This study suggests that early self-administration of adrenaline is beneficial. Opportunities for improvements in data recording as well as patient education were identified.

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The impact of using electronic patient records on practices of reading and writing

Health Informatics Journal ◽

10.1177/1460458213492445 ◽

2014 ◽

Vol 20 (4) ◽

pp. 235-249 ◽

Cited By ~ 6

Author(s):

Heleena Laitinen ◽

Marja Kaunonen ◽

Paivi Åstedt-Kurki

Keyword(s):

Patient Records ◽

Electronic Patient Records ◽

Reading And Writing ◽

The Impact

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Mental health in South East London general hospitals: using electronic patient records to explore associations between psychiatric diagnoses and length of stay in a patient cohort receiving liaison psychiatry input

BJPsych Open ◽

10.1192/bjo.2019.79 ◽

2019 ◽

Vol 5 (6) ◽

Author(s):

Abbeygail Jones ◽

Helen Todman ◽

Mujtaba Husain

Keyword(s):

Mental Health ◽

Length Of Stay ◽

Research Centre ◽

Psychiatric Diagnoses ◽

Patient Records ◽

Electronic Patient Records ◽

Liaison Psychiatry ◽

General Hospitals ◽

Bipolar Affective Disorders ◽

The Impact

Background Psychiatric illnesses are prevalent in general hospitals and associated with length of stay (LOS). Liaison psychiatry teams provide psychiatric care in acute hospitals and can improve mental health-related outcomes but, to achieve ambitious policy targets, services must understand local need. Aims Using electronic patient records, we investigate associations between psychiatric diagnoses and LOS in South East London hospitals. Method Patient records were extracted using the South London and Maudsley NHS Foundation Trust Biomedical Research Centre Case Register Interactive Search system. There were 6378 admissions seen by liaison psychiatry aged <65 years between 2011 and 2016. Linear mixed-effects models investigated the impact of psychiatric diagnoses on LOS. Potential confounders included medical diagnoses, gender, age, ethnicity, social deprivation, hospital site and investment per admission. Results According to marginal means, longer LOS is associated with primary diagnoses of organic disorders (mean: 23 days, 95% CI 20.39–25.61), depressive disorders (mean: 11.03 days, 95% CI 9.74–25.61) and psychotic disorders (mean: 10.63 days, 95% CI 8.75–12.51). Shorter LOS is associated with personality disorders (mean: 6.28 days, 95% CI 4.12–8.45), bipolar affective disorders (mean 6.81 days, 95% CI 3.49–10.14) and substance-related problems (mean 7.53 days, 95% CI 6.01–9.05). Conclusions Psychiatric diagnoses have differential associations with in-patient LOS. Liaison psychiatry teams aim to mitigate the impact of psychiatric illness on patient and hospital outcomes but understanding local need and the wider context of care provision is needed to maximise potential benefits. Declaration of interest M.H. is a consultant liaison psychiatrist for King's College Hospital adult liaison psychiatry team. At the time of writing, H.T. was senior business manager at SLaM psychological medicine and integrated care clinical academic group. These may be considered financial and/or non-financial interests given the implications of findings for service funding.

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Using electronic patient records to assess the impact of swine flu (influenza H1N1) on mental health patients

Journal of Mental Health ◽

10.3109/09638237.2010.542787 ◽

2011 ◽

Vol 20 (1) ◽

pp. 60-69 ◽

Cited By ~ 12

Author(s):

Lisa A. Page ◽

Seeta Seetharaman ◽

Imran Suhail ◽

Simon Wessely ◽

Jerson Pereira ◽

...

Keyword(s):

Mental Health ◽

Swine Flu ◽

Patient Records ◽

Electronic Patient Records ◽

Mental Health Patients ◽

The Impact ◽

Influenza H1n1

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The Impact of a Highly Publicized Celebrity Suicide on Suicide-Related Online Information Seeking

Crisis ◽

10.1027/0227-5910/a000455 ◽

2017 ◽

Vol 38 (3) ◽

pp. 207-209 ◽

Cited By ~ 9

Author(s):

Florian Arendt ◽

Sebastian Scherr

Keyword(s):

Suicide Prevention ◽

Information Seeking ◽

The Internet ◽

Online Information ◽

Search Queries ◽

Related Information ◽

Search Terms ◽

Celebrity Suicide ◽

Online Information Seeking ◽

The Impact

Abstract. Background: Research has already acknowledged the importance of the Internet in suicide prevention as search engines such as Google are increasingly used in seeking both helpful and harmful suicide-related information. Aims: We aimed to assess the impact of a highly publicized suicide by a Hollywood actor on suicide-related online information seeking. Method: We tested the impact of the highly publicized suicide of Robin Williams on volumes of suicide-related search queries. Results: Both harmful and helpful search terms increased immediately after the actor's suicide, with a substantial jump of harmful queries. Limitations: The study has limitations (e.g., possible validity threats of the query share measure, use of ambiguous search terms). Conclusion: Online suicide prevention efforts should try to increase online users' awareness of and motivation to seek help, for which Google's own helpline box could play an even more crucial role in the future.

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