Jung Kwang Yul, Kim SuJin, Kim Kihyung, Lee Eun Ju, Kim Kyunga, Lee Jeanhyoung, Choi Jong Soo, Kang Mira, Chang Dong Kyung, Cha Won Chul
Department of Emergency Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
Department of Digital Health, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Republic of Korea.
JMIR Mhealth Uhealth. 2020 Feb 14;8(2):e14487. doi: 10.2196/14487.
Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios.
For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use.
This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors' log frequencies were obtained from the mobile EMR, and we merged data using doctors' deidentification numbers. Pearson's product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors' mobile EMR usage and the response time to consultation requests.
A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=-0.19; 95% CI -0.32 to -0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors' mobile EMR usage and the response time to consultation requests (coefficient=-0.18; 95% CI -0.30 to -0.04; P=.009).
Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.
专科会诊是急诊科诊疗工作的关键环节,会诊延迟可能产生重大临床影响并加剧急诊科拥挤状况。尽管移动电子病历(EMR)的使用日益广泛,且已知其可改善医护人员的工作流程,但在实际临床场景中评估其有效性的研究有限。
本研究旨在确定急诊科专科会诊请求的响应时长与移动EMR使用频率之间的关联。
本回顾性研究在韩国首尔一家学术性急诊科开展。我们分析了2018年5月至2018年12月的电子病历和移动电子病历数据。从基于电脑的电子病历中检索急诊科会诊请求的时间戳,并计算响应间隔。从移动电子病历中获取医生的登录频率,我们使用医生的去识别码合并数据。采用Pearson积矩相关分析来确定这种关联。主要结局是移动EMR使用频率与专科医生从急诊科请求到会诊完成的时间间隔之间的关系。次要结局是专科医生移动EMR使用频率与会诊请求响应时间之间的关系。
共对15555例患者提出了25454次会诊请求,252名专科医生提供了急诊科专科会诊。在742名使用移动EMR的医生中,208名医生在专科会诊过程中使用了它。在排除缺乏关键信息的病例后,纳入208名医生的21885次会诊进行分析。根据移动EMR使用模式,所有用户的平均使用频率为每天13.3次登录,专科会诊完成的平均时长为51.7分钟。专科医生移动EMR使用频率与从急诊科请求到会诊完成的时间间隔之间存在显著负相关(系数=-0.19;95%CI -0.32至-0.06;P=.005)。对响应时间进行了二次分析。专科医生移动EMR使用频率与会诊请求响应时间之间也存在显著负相关(系数=-0.18;95%CI -0.30至-0.04;P=.009)。
我们的研究结果表明,频繁使用移动EMR与对急诊科会诊请求更快的响应时间相关。