Evaluation of Digital Health Strategy to Support Clinician-Led Critically Ill Patient Population Management: A Randomized Crossover Study.

Autor:	Herasevich S; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN., Pinevich Y; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.; Department of Anesthesiology, Republican Clinical Medical Center, Minsk, Belarus., Lipatov K; Division of Pulmonary and Critical Care Medicine, Mayo Clinic Health Systems, Eau Claire, WI., Barwise AK; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.; Bioethics Research Program, Mayo Clinic, Rochester, MN., Lindroth HL; Department of Nursing, Mayo Clinic, Rochester, MN.; Center for Health Innovation and Implementation Science, Center for Aging Research, School of Medicine, Indiana University, Indianapolis, IN., LeMahieu AM; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN., Dong Y; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN., Herasevich V; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN., Pickering BW; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Jazyk:	angličtina
Zdroj:	Critical care explorations [Crit Care Explor] 2023 May 03; Vol. 5 (5), pp. e0909. Date of Electronic Publication: 2023 May 03 (Print Publication: 2023).
DOI:	10.1097/CCE.0000000000000909
Abstrakt:	To investigate whether a novel acute care multipatient viewer (AMP), created with an understanding of clinician information and process requirements, could reduce time to clinical decision-making among clinicians caring for populations of acutely ill patients compared with a widely used commercial electronic medical record (EMR). Design: Single center randomized crossover study. Setting: Quaternary care academic hospital. Subjects: Attending and in-training critical care physicians, and advanced practice providers. Interventions: AMP. Measurements and Main Results: We compared ICU clinician performance in structured clinical task completion using two electronic environments-the standard commercial EMR (Epic) versus the novel AMP in addition to Epic. Twenty subjects (10 pairs of clinicians) participated in the study. During the study session, each participant completed the tasks on two ICUs (7-10 beds each) and eight individual patients. The adjusted time for assessment of the entire ICU and the adjusted total time to task completion were significantly lower using AMP versus standard commercial EMR (-6.11; 95% CI, -7.91 to -4.30 min and -5.38; 95% CI, -7.56 to -3.20 min, respectively; p < 0.001). The adjusted time for assessment of individual patients was similar using both the EMR and AMP (0.73; 95% CI, -0.09 to 1.54 min; p = 0.078). AMP was associated with a significantly lower adjusted task load (National Aeronautics and Space Administration-Task Load Index) among clinicians performing the task versus the standard EMR (22.6; 95% CI, -32.7 to -12.4 points; p < 0.001). There was no statistically significant difference in adjusted total errors when comparing the two environments (0.68; 95% CI, 0.36-1.30; p = 0.078). Conclusions: When compared with the standard EMR, AMP significantly reduced time to assessment of an entire ICU, total time to clinical task completion, and clinician task load. Additional research is needed to assess the clinicians' performance while using AMP in the live ICU setting. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
Databáze:	MEDLINE
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