Department of Biostatistics and Medical Informatics, Faculty of Medicine of University of Porto, Al Prof Hernâni Monteiro, 4200-319 Porto, Portugal.
BMC Med Inform Decis Mak. 2010 Mar 16;10:15. doi: 10.1186/1472-6947-10-15.
The identification of clinically relevant information enables improvement in user interfaces and in data management. However, it is difficult to identify what information is important in daily clinical care, and what is used occasionally. This study aims to determine for how long clinical documents are used in a Hospital Information System (HIS).
The access logs of 3 years of usage of a HIS were analysed concerning report departmental source, type of hospital encounter, and inpatient encounter ICD-9-CM main diagnosis. Reports median life indicates the median time elapsed between information creation and its usage. The models that better explains report views over time were explored.
The number of report views in the study period was 656,583. Fifty two percent of the reports viewed by medical doctors in emergency encounters were from previous encounters - 21% at outpatient attendance, 19% in inpatient (wards) and 12% during emergency encounters. In an inpatient setting, 20% of the reports viewed were produced in previous encounters. The median life of information in documents is 1.5 days for emergency, 4.8 days for inpatient and 37.8 days for outpatient encounters. Immune-hemotherapy reports reach their median lives faster (7 days) than clinical pathology (15 days), gastroenterology (80 days) and pathology (118 days). The median life of reports produced in inpatient encounters varied from 36 days for neoplasms as the main diagnosis to 0.7 days for injury and poisoning. The model with the best fit (R2 > 0.9) was the exponential.
The usage of past patient information varied significantly according to patient age, type of information, type of hospital encounter and medical cause (main diagnosis) for the encounter. The exponential model is a good fit to model how the reports are seen over time, so the design of user interfaces and repository management algorithms should take it in consideration.
识别临床相关信息可以改进用户界面和数据管理。然而，确定在日常临床护理中哪些信息是重要的，哪些是偶尔使用的是很困难的。本研究旨在确定在医院信息系统（HIS）中临床文档的使用时间长度。
分析了 3 年 HIS 使用的访问日志，涉及报告部门来源、医院就诊类型和住院就诊 ICD-9-CM 主要诊断。报告的中位数寿命表示从信息创建到使用之间的中位数时间间隔。探索了更好地解释报告随时间变化的模型。
在研究期间，报告视图的数量为 656,583 次。在急诊就诊中，医生查看的报告中有 52%来自之前的就诊 - 21%在门诊就诊，19%在住院（病房），12%在急诊就诊。在住院环境中，查看的报告中有 20%是在之前的就诊中产生的。文档中信息的中位数寿命为急诊就诊 1.5 天，住院就诊 4.8 天，门诊就诊 37.8 天。免疫血液疗法报告达到中位数寿命的速度更快（7 天），而临床病理学（15 天）、胃肠病学（80 天）和病理学（118 天）则较慢。住院就诊中产生的报告的中位数寿命从主要诊断为肿瘤的 36 天到损伤和中毒的 0.7 天不等。拟合度最好（R2 > 0.9）的模型是指数模型。
根据患者年龄、信息类型、医院就诊类型和就诊的医疗原因（主要诊断），过去患者信息的使用情况有很大差异。指数模型很好地拟合了报告随时间的查看方式，因此用户界面和存储库管理算法的设计应考虑到这一点。
