Transactions of the International Conference on Health Information Technology Advancement

Document Type

Article

Version

publisher_pdf

Publication Date

11-2019

Abstract

The manual transcription of patients’ vital signs often delays entry of critical information to Electronic Medical Record (EMR) systems. This documentation delay within inpatient settings results in a lack of recent information on patient condition, decreased ability for providers to make clinical decisions, and an increased risk of data error. To alleviate these concerns, hospitals are adopting device interface systems which digitally integrate medical devices and EMRs. Prior studies have found that this type of system integration can potentially reduce the time spent on manual entry of information in the EMR and support other value-added activities in the hospital. However, these studies suffered from intervention bias from direct monitoring of clinicians using time-motion methodologies, which are resource restrictive and can affect patient care. In this study, we utilize a natural experiment setting to understand how the implementation of a device interface system between vitals monitors used on medical/surgical units and the EMR has impacted hospital workflows and patient care in a regional hospital. Our investigation focuses on two areas. First, we examine if the new system influenced documentation delays, and whether the impact was similar for different employee roles. Since vitals on medical/surgical units are typically taken by Patient Care Assistants (PCA’s) or other ancillary staff, we hypothesize that a greater average decrease in documentation delay will be found in their role. Second, we study the effect of interface system implementation on downstream patient care activities, such as models designed to identify patients in deteriorating condition. We analyze data on documentation delays across more than 5,000 patients and 330,000 documentation events for one week before and after system implementation. Additionally, we intend to utilize hierarchical models to distinguish the impact of systems for various roles (including PCA’s and nurses) across the hospital. Preliminary findings suggest that the interface system results in a statistically significant decrease in time between when vital signs are taken and documented, as well as The findings from this research would inform hospitals of the benefits and the requirements for a successful integration of medical devices and EMR systems, as well as the impact on activities dependent on accurate and timely vital signs documentation.

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