Summary
We designed and implemented an electronic patient tracking system with improved user
authentication and patient selection. We then measured access to clinical information
from previous clinical encounters before and after implementation of the system. Clinicians
accessed longitudinal information for 16% of patient encounters before, and 40% of
patient encounters after the intervention, indicating such a system can improve clinician
access to information. We also attempted to evaluate the impact of providing this
access on inpatient admissions from the emergency department, by comparing the odds
of inpatient admission from an emergency department before and after the improved
access was made available. Patients were 24% less likely to be admitted after the
implementation of improved access. However, there were many potential confounders,
based on the inherent pre-post design of the evaluation. Our experience has strong
implications for current health information exchange initiatives.
Keywords
Health information exchange - reduced admissions - electronic health records
