|
AUTHOR(S): Tony Shannon MD; Craig Feied MD, FACEP, FAAEM; Mark Smith, MD, FACEP
|
|
ADDRESS:
|
|
Title: Wireless handheld computer access to Electronic Patient Records improves availability of clinical data in 25 percent of cases. Introduction: Clinical decision-making depends on information, yet important clinical information often is not available when decisions are being made. Using wireless handheld computers, we made clinical results available at the moment of clinical decision-making and identified cases in which the same data had not yet become available to clinicians using traditional means of data-gathering. Objectives: Quantify the effect of wireless handheld computers on information availability during clinical decision-making. Methods: A prospective observational study in a single ward of a 900-bed urban hospital in Washington, DC, where traditional resources for data-gathering include a PC-based electronic medical record as well as paper charts and telephone queries. We introduced HTML-based wireless handheld computers providing real-time access to patient data, including laboratory and X-ray results, prior history, dictated notes, medications, and x-ray images. During the study period, all daily patient reviews (clinical rounds) were observed while traditionally-gathered clinical data was discussed, clinical decisions were made, and orders were written. We identified recent laboratory and radiology results that were available using the handheld device but had not been available to physicians using other data-gathering methods. Clinical decision-making had been carried out without knowledge of these results. Results: 110 patient reviews were observed. In 28 of those reviews (25.5% of reviews) recent test results were available through the handheld device, but had not been available to clinicians through traditional means. In each case, daily orders (if any) had been written without knowledge of the newer results. Conclusion: Inefficiencies in traditional delivery of test results and other clinical data cause 25% of clinical decisions to be based on incomplete information. Wireless handheld EPR solutions can improve access to current clinical data at the moment of clinical decision-making. |