Effect of Electronic Health Record Implementation in Critical Care on Survival and Medication Errors.

Autor:	Han JE; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. Electronic address: jehan2@emory.edu., Rabinovich M; Department of Pharmacy and Drug Information, Grady Memorial Hospital, Atlanta, Georgia., Abraham P; Department of Pharmacy and Drug Information, Grady Memorial Hospital, Atlanta, Georgia., Satyanarayana P; Florida State University, Tallahassee, Florida., Liao TV; Mercer Health Science Center, Mercer University College of Pharmacy, Atlanta, Georgia., Udoji TN; Division of Pulmonary, WellStar Health System, Atlanta, Georgia., Cotsonis GA; Emory University Rollins School of Public Health, Atlanta, Georgia., Honig EG; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia., Martin GS; Florida State University, Tallahassee, Florida.
Jazyk:	angličtina
Zdroj:	The American journal of the medical sciences [Am J Med Sci] 2016 Jun; Vol. 351 (6), pp. 576-81. Date of Electronic Publication: 2016 Apr 13.
DOI:	10.1016/j.amjms.2016.01.026
Abstrakt:	Background: Electronic health records (EHR) with computerized physician order entry have become exceedingly common and government incentives have urged implementation. The purpose of this study was to ascertain the effect of EHR implementation on medical intensive care unit (MICU) mortality, length of stay (LOS), hospital LOS and medication errors. Materials and Methods: Prospective, observational study from July 2010-June 2011 in MICU at an urban teaching hospital in Atlanta, Georgia of 797 patients admitted to the MICU; 281 patients before the EHR implementation and 516 patients post-EHR implementation. Results: Compared with the preimplementation period (N = 43 per 281), the mortality risk at 4 months post-EHR implementation (N = 41 per 247) and at 8 months post-EHR implementation (N = 26 per 269) significantly decreased (P < 0.001). In addition, the mean MICU LOS statistically decreased from 4.03 ± 1.06 days pre-EHR to 3.26 ± 1.06 days 4 months post-EHR and to 3.12 ± 1.05 days 8 months post-EHR (P = 0.002). However, the mean hospital LOS was not statistically decreased. Although medication errors increased after implementation (P = 0.002), this was attributable to less severe errors and there was actually a decrease in the number of severe medication errors (both P < 0.001). Conclusions: We report a survival benefit following the implementation of EHR with computerized physician order entry in a critical care setting and a concomitant decrease in the number of severe medication errors. Although overall hospital LOS was not shortened, this study proposes that EHR implementation in a busy urban hospital was associated with improved ICU outcomes. (Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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