scholarly journals Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores

2017 ◽  
Vol 08 (03) ◽  
pp. 880-892 ◽  
Author(s):  
Rong Chen ◽  
Hans Blomqvist ◽  
Sabine Koch ◽  
Niclas Skyttberg

Summary Background: Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. Objectives: This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores. The study also provides reference data on triage vital signs in Swedish emergency care. Methods: We extracted a dataset including vital signs, demographic and administrative data from emergency care visits (n=335027) at five Swedish emergency hospitals during 2013 using either completely paper-based, completely electronic or mixed documentation practices. Descriptive statistics were used to assess fitness for use in emergency care decision support systems aiming to calculate warning and triage scores, and data quality was described in three categories: currency, completeness and correctness. To estimate correctness, two further categories –plausibility and concordance –were used. Results: The study showed an acceptable correctness of the registered vital signs irrespectively of the type of documentation practice. Completeness was high in sites where registrations were routinely entered into the Electronic Health Record (EHR). The currency was only acceptable in sites with a completely electronic documentation practice. Conclusion: Although vital signs that were recorded in completely electronic documentation practices showed plausible results regarding correctness, completeness and currency, the study concludes that vital signs documented in Swedish emergency care EHRs cannot generally be considered fit for use for calculation of triage and warning scores. Low completeness and currency were found if the documentation was not completely electronic. Citation: Skyttberg N, Chen R, Blomqvist H, Koch S. Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores. Appl Clin Inform 2017; 8: 880–892 https://doi.org/10.4338/ACI-2017-05-RA-0075

2010 ◽  
Vol 7 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Amr Al Mallah ◽  
Paul Guelpa ◽  
Sharon Marsh ◽  
Tibor van Rooij

2020 ◽  
Author(s):  
Daniel Lewkowicz ◽  
Attila Wohlbrandt ◽  
Erwin Boettinger

Abstract Background Unnecessary healthcare utilization, non-adherence to current clinical guidelines, or insufficient personalized care are perpetual challenges and remain potential major cost-drivers for healthcare systems around the world. Implementing decision support systems into clinical care is promised to improve quality of care and thereby yield substantial effects on reducing healthcare expenditure. In this article, we evaluate the economic impact of clinical decision support (CDS) interventions based on electronic health records (EHR).Methods We searched for studies published after 2014 using MEDLINE, CENTRAL, WEB OF SCIENCE, EBSCO, and TUFTS CEA registry databases that encompass an economic evaluation or consider cost outcome measures of EHR based CDS interventions. Thereupon, we identified best practice application areas and categorized the investigated interventions according to an existing taxonomy of front-end CDS tools. Results and discussion Twenty-seven studies are investigated in this review. Of those, twenty-two studies indicate a reduction of healthcare expenditure after implementing an EHR based CDS system, especially towards prevalent application areas, such as unnecessary laboratory testing, duplicate order entry, efficient transfusion practice, or reduction of antibiotic prescriptions. On the contrary, order facilitators and undiscovered malfunctions revealed to be threats and could lead to new cost drivers in healthcare. While high upfront and maintenance costs of CDS systems are a worldwide implementation barrier, most studies do not consider implementation cost. Finally, four included economic evaluation studies report mixed monetary outcome results and thus highlight the importance of further high-quality economic evaluations for these CDS systems. Conclusion Current research studies lack consideration of comparative cost-outcome metrics as well as detailed cost components in their analyses. Nonetheless, the positive economic impact of EHR based CDS interventions is highly promising, especially with regard to reducing waste in healthcare.


2019 ◽  
Vol 7 (4) ◽  
pp. 36-39
Author(s):  
Rengalakshmi Balasubramanian

Electronic health records (EHRs), an integrated approach is gaining importance not only within healthcare organizations and with their related stakeholders but also with the clinical research studies. EHR-based clinical decision support (CDS) systems in clinical studies have been proven successful in many clinical studies. The World Health Organization has emphasised the necessity to revolutionise the healthcare system in all levels, from primary health care and community service to health care research and this started with the implementation of EHR services extensively in various health care systems. Further, American and European healthcare systems are keen in improving EHR-based measurements to enable interoperability for future integrations of multiple data sources, which in turn would prove beneficial in the global platform for not only to the provider, patient, and other healthcare stakeholders but also for clinical research studies. This paper discusses the EHR in clinical research, the challenges in the EHR, and the need for developing nations to adopt and develop EHR.


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