Patterson Brian W, Hekman Daniel J, Liao Frank J, Hamedani Azita G, Shah Manish N, Afshar Majid
BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, United States.
Department of Information Services, UW Health, Madison, WI 53705, United States.
JAMIA Open. 2024 May 22;7(2):ooae039. doi: 10.1093/jamiaopen/ooae039. eCollection 2024 Jul.
Numerous studies have identified information overload as a key issue for electronic health records (EHRs). This study describes the amount of text data across all notes available to emergency physicians in the EHR, trended over the time since EHR establishment.
We conducted a retrospective analysis of EHR data from a large healthcare system, examining the number of notes and a corresponding number of total words and total tokens across all notes available to physicians during patient encounters in the emergency department (ED). We assessed the change in these metrics over a 17-year period between 2006 and 2023.
The study cohort included 730 968 ED visits made by 293 559 unique patients and a total note count of 132 574 964. The median note count for all encounters in 2006 was 5 (IQR 1-16), accounting for 1735 (IQR 447-5521) words. By the last full year of the study period, 2022, the median number of notes had grown to 359 (IQR 84-943), representing 359 (IQR 84-943) words. Note and word counts were higher for admitted patients.
The volume of notes available for review by providers has increased by over 30-fold in the 17 years since the implementation of the EHR at a large health system. The task of reviewing these notes has become commensurately more difficult. These data point to the critical need for new strategies and tools for filtering, synthesizing, and summarizing information to achieve the promise of the medical record.
众多研究已将信息过载确定为电子健康记录（EHR）的一个关键问题。本研究描述了电子健康记录中急诊医生可获取的所有记录中的文本数据量，并呈现了自电子健康记录建立以来随时间的变化趋势。
我们对一个大型医疗系统的电子健康记录数据进行了回顾性分析，检查了急诊科（ED）患者就诊期间医生可获取的所有记录中的记录数量以及相应的总单词数和总词元数。我们评估了2006年至2023年这17年间这些指标的变化。
研究队列包括293559名独特患者进行的730968次急诊就诊，记录总数为132574964条。2006年所有就诊的记录中位数为5条（四分位距1 - 16条），共计1735个单词（四分位距447 - 5521个）。到研究期的最后一整年，即2022年，记录中位数已增至359条（四分位距84 - 943条），共计359个单词（四分位距84 - 943个）。入院患者的记录和单词数更高。
自一个大型医疗系统实施电子健康记录以来的17年里，可供医护人员查阅的记录数量增加了30多倍。查阅这些记录的任务相应地变得更加困难。这些数据表明迫切需要新的策略和工具来筛选、综合和总结信息，以实现病历的价值。
