The care of patients with shunted hydrocephalus can be complicated. The best assessment is provided when all data are available to the neurosurgery practitioner. However, data can be time-consuming to gather, especially in the setting of a busy practice, a trainee environment with duty-hour restrictions, and an electronic medical record (EMR) not specifically designed for the needs of subspecialists. For these reasons, the complete clinical picture, especially the historical component, is sometimes not assembled.
To address these shortcomings, the authors created a patient-level electronic CSF shunt history tool that leverages the power of the EMR concordant with the United States Centers for Medicare and Medicaid Services meaningful use principles. It is immediately available within the EMR for all users in all patient care contexts (e.g., outpatient, inpatient, perioperative, emergency, and remote access), centrally located, and designed to capture the vast range of circumstances inherent to the hydrocephalus population. Essential shunt data can be rapidly acquired and, as such, may decrease the likelihood of error in diagnosis and/or treatment. The tool also has the potential to aid the practicing neurosurgeon from clinical, quality improvement, and research standpoints. The authors have endeavored to describe this tool in a manner that would allow an interested neurosurgeon to share this publication with health information technology professionals to facilitate the development of a similar tool within their institution's own EMR platform.
Computerized Physician Order Entry and Electronic Medical Record Systems in Korean Teaching and General Hospitals: Results of a 2004 Survey
