Kuisma Markku, Väyrynen Taneli, Hiltunen Tuomas, Porthan Kari, Aaltonen Janne
Helsinki EMS, Helsinki University Central Hospital, Helsingin kaupunki, Finland.
Am J Emerg Med. 2009 Oct;27(8):948-55. doi: 10.1016/j.ajem.2008.07.033.
We examined the effect of the change from paper records to the electronic patient records (EPRs) on ambulance call duration.
We retrieved call duration times 6 months before (group 1) and 6 months after (group 2) the introduction of EPR. Subgroup analysis of group 2 was fulfilled depending whether the calls were made during the first or last 3 months after EPR introduction.
We analyzed 37 599 ambulance calls (17 950 were in group 1 and 19 649 were in group 2). The median call duration in group 1 was 48 minutes and in group 2 was 49 minutes (P = .008). In group 2, call duration was longer during the first 3 months after EPR introduction. In multiple linear regression analysis, urgency category (P < .0001), unit level (P < .0001), and transportation decision (P < .0001) influenced the call duration. The documentation method was not a significant factor.
Electronic patient record system can be implemented in an urban ambulance service in such a way that documentation method does not become a significant factor in determining call duration in the long run. Temporary performance drop during the first 3 months after introduction was noticed, reflecting adaptation process to a new way of working.
我们研究了从纸质记录转换为电子病历（EPR）对救护车呼叫时长的影响。
我们获取了引入EPR前6个月（第1组）和引入后6个月（第2组）的呼叫时长数据。根据呼叫是在引入EPR后的前3个月还是后3个月进行，对第2组进行亚组分析。
我们分析了37599次救护车呼叫（第1组17950次，第2组19649次）。第1组的呼叫时长中位数为48分钟，第2组为49分钟（P = 0.008）。在第2组中，引入EPR后的前3个月呼叫时长更长。在多元线性回归分析中，紧急程度类别（P < 0.0001）、单位级别（P < 0.0001）和转运决策（P < 0.0001）影响呼叫时长。记录方法不是一个显著因素。
电子病历系统可以在城市救护车服务中实施，从长远来看，记录方法不会成为决定呼叫时长的重要因素。引入后的前3个月出现了暂时的性能下降，这反映了对新工作方式的适应过程。
