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繁忙急诊科电子病历停机时间的评估

Evaluation of Electronic Medical Record Downtime in a Busy Emergency Department.

作者信息

Jenkins Dominic, Sharfeen Qureshi Raheel, Moinudheen Jibin, Pathan Sameer A, Thomas Stephen H

机构信息

Hamad Medical Corporation, Doha, Qatar.

出版信息

Qatar Med J. 2020 Jul 29;2020(1):20. doi: 10.5339/qmj.2020.20. eCollection 2020.

DOI:10.5339/qmj.2020.20
PMID:32775247
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7393182/
Abstract

OBJECTIVES

This study aimed to investigate electronic medical record (EMR) implementation in a busy urban academic emergency department (ED) and to determine the frequency, duration, and predictors of EMR downtime episodes.

MATERIALS AND METHODS

This study retrospectively analyzed data collected real time by the EMR and by the operations group at the study ED from May 2016 to December 2017. The study center has used the First Net Millennium EMR (Cerner Corporation, Kansas City, Missouri, USA). The ED operations data have been downloaded weekly from the EMR and transferred to the analytics software Stata (version 15MP, StataCorp, College Station, Texas, USA).

RESULTS

During the study period, 12 episodes of EMRD occurred, with a total of 58 hours and a mean of 4.8 ± 2.7 hours. The occurrence of EMRD event has not been associated with on-duty physician coverage levels (0.831), month (0.850), or clinical shift (morning, evening, or night shift) (0.423). However, EMRD occurrence has been statistically significantly associated with weekdays (0.020).

DISCUSSION

In a real-world implementation of EMR in a busy ED, EMRD episodes averaging approximately 5 hours occurred at unpredictable intervals, with a frequency that remained unchanged over the first 20 months of the EMR deployment.

CONCLUSION

The study could define downtime characteristics at the study center. The EMRD episodes have been associated with inaccuracies in hourly census reporting, with a rebound phenomenon of over-reporting in the first hour or two after restoration of EMR operations.

摘要

目的

本研究旨在调查繁忙的城市学术急诊科（ED）中电子病历（EMR）的实施情况，并确定EMR停机事件的频率、持续时间和预测因素。

材料与方法

本研究回顾性分析了2016年5月至2017年12月期间研究急诊科通过EMR和运营团队实时收集的数据。研究中心使用的是First Net Millennium EMR（美国密苏里州堪萨斯城的erner公司）。ED运营数据每周从EMR下载，并传输到分析软件Stata（版本15MP，美国德克萨斯州大学城的StataCorp公司）。

结果

在研究期间，发生了12次EMRD事件，总时长为58小时，平均时长为4.8±2.7小时。EMRD事件的发生与值班医生覆盖水平（0.831）、月份（0.850）或临床班次（早班、中班或夜班）（0.423）无关。然而，EMRD的发生与工作日有统计学显著关联（0.020）。

讨论

在繁忙的急诊科实际实施EMR时，平均约5小时的EMRD事件以不可预测的间隔发生，在EMR部署的前20个月中频率保持不变。

结论

该研究可以定义研究中心的停机特征。EMRD事件与每小时人口普查报告中的不准确有关，在EMR恢复运行后的头一两个小时存在报告过度的反弹现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/428267982b90/qmj-2020-020-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/5cff85da5f4c/qmj-2020-020-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/c59568d4ecaf/qmj-2020-020-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/de2eb3f2d5f2/qmj-2020-020-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/428267982b90/qmj-2020-020-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/5cff85da5f4c/qmj-2020-020-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/c59568d4ecaf/qmj-2020-020-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/de2eb3f2d5f2/qmj-2020-020-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890f/7393182/428267982b90/qmj-2020-020-g004.jpg

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