Mercy Medical Center – North Iowa implemented electronic health records (EHR), computerised provider order entry (CPOE) and event tracking systems in the emergency department (ED) as part of hospital-wide implementation of clinical information systems. This case study examines the changes in outcomes and processes in the ED following implementation. Although the system was designed to enhance efficiency, there was a significant increase in the mean length of stay (about 17 minutes, or 15%) in the ED after implementation. This surprising finding was examined in relationship to the multiple process-of-care changes in the ED.
AronskyD.JonesI.LanaghanK.SlovisC. (2008). Supporting patient care in the emergency department with a computerized whiteboard system. Journal of the American Medical Association15(2) 184–94.
2.
BahenskyJ.A.JaanaM.WardM.M., (2008). Health care information technology in rural America: Electronic medical record adoption status in meeting the national agenda. The Journal of Rural Health24(2):101–105.
3.
ChaudhryB.WangJ.WuS.MaglioneM.MojicaW.RothE.MortonS.C.ShekelleP.G., (2006). Systematic review: Impact of health information technology on quality, efficiency and costs of medical care. Annals of Internal Medicine144(10) 742–52.
4.
CrandallD.BrokelJ.SchwichtenbergT.HendersonS.HaskinsR.WakefieldD.WardM.M.DixonB.E., (2007). Redesigning care delivery through health IT implementation. Journal of Healthcare Information Management21(4) 41–48, 2007.
5.
GargA.X.AdhikariN.K.McDonaldH.Rosas-ArellanoM.P.DevereauxP.J.BeyeneJ.SamJ.HaynesR.B., (2005). Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: A systematic review. Journal of the American Medical Association293(10) 1223–38.
6.
Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st Century. Committee on Quality of Health Care in America, ed. Washington, DC: National Academy Press.
7.
Institute of Medicine (2006). Hospital-based emergency care: At the breaking point. Committee on the Future of Emergency Care in the United States Health System. Board on Health Care Services, ed. Washington, DC: National Academy Press.
8.
MekhjianH.S.KumarR.R.KuehnL.BentleyT.D.TeaterP.ThomasA.PayneB.AhmadA. (2002). Immediate benefits realized following implementation of physicians order entry at an academic medical center. Journal of the American Medical Association9(5) 529–39.
9.
OverhageJ.M.PerkinsS.TierneyW.M.McDonaldC.J., (2001). Controlled trial of direct physician order entry: Effects of physician's time utilization in ambulatory primary care internal medicine practices. Journal of the American Medical Association8(4) 361–71.
10.
PiaseckiJ.K.CalhounE.EngelbergJ.RiceW.DiltsD.BelserD.AronskyD.JonesI.MasonD.SteadB. (2005). Computerized provider order entry in the emergency department: Pilot evaluation of a return on investment analysis instrument. American Medical Informatics Association, Annual Symposium Proceedings Archive.
11.
YoonP.SteinerI.ReinhardtG. (2003). Analysis of factors influencing length of stay in the emergency department, Canadian Journal of Emergency Medicine5(3):155–61.
