Can we understand population healthcare needs using electronic medical records?
| Autor: | Marcus Eng Hock Ong, Jia Loon Chong, Yuzeng Shen, Lian Leng Low, Thiri Naing Thin, David B. Matchar, Darren Yak Leong Chan |
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| Rok vydání: | 2019 |
| Předmět: |
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health care facilities manpower and services Population Nurses 030204 cardiovascular system & hematology behavioral disciplines and activities InformationSystems_GENERAL 03 medical and health sciences 0302 clinical medicine health services administration Patient-Centered Care Physicians Health care Medicine Electronic Health Records Humans Quality (business) 030212 general & internal medicine Prospective Studies education health care economics and organizations media_common Retrospective Studies education.field_of_study Health Services Needs and Demand Singapore Social work business.industry Medical record Incidence Reproducibility of Results General Medicine Patient-centered care medicine.disease Hospitals Identification (information) Needs assessment Emergency Medicine Original Article Medical emergency business Emergency Service Hospital Algorithms Needs Assessment |
| Zdroj: | Singapore Med J |
| ISSN: | 0037-5675 |
| Popis: | INTRODUCTION: The identification of population-level healthcare needs using hospital electronic medical records (EMRs) is a promising approach for the evaluation and development of tailored healthcare services. Population segmentation based on healthcare needs may be possible using information on health and social service needs from EMRs. However, it is currently unknown if EMRs from restructured hospitals in Singapore provide information of sufficient quality for this purpose. We compared the inter-rater reliability between a population segment that was assigned prospectively and one that was assigned retrospectively based on EMR review. METHODS: 200 non-critical patients aged ≥ 55 years were prospectively evaluated by clinicians for their healthcare needs in the emergency department at Singapore General Hospital, Singapore. Trained clinician raters with no prior knowledge of these patients subsequently accessed the EMR up to the prospective rating date. A similar healthcare needs evaluation was conducted using the EMR. The inter-rater reliability between the two rating sets was evaluated using Cohen’s Kappa and the incidence of missing information was tabulated. RESULTS: The inter-rater reliability for the medical ‘global impression’ rating was 0.37 for doctors and 0.35 for nurses. The inter-rater reliability for the same variable, retrospectively rated by two doctors, was 0.75. Variables with a higher incidence of missing EMR information such as ‘social support in case of need’ and ‘patient activation’ had poorer inter-rater reliability. CONCLUSION: Pre-existing EMR systems may not capture sufficient information for reliable determination of healthcare needs. Thus, we should consider integrating policy-relevant healthcare need variables into EMRs. |
| Databáze: | OpenAIRE |
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