Difference between revisions of "A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care"

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== Summary ==
 
== Summary ==
This is a review of the article by Kalra, et al. (2012), "A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care" <ref name="Kalra, 2012”> Kalra, Dipak, Fernando, Bernard, Morrison, Zoe, Sheikh, Aziz (2012). Informatics in Primary Care, Volume 20, Number 3, May 2012, pp. 171-180(10) </ref>.
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This is a review of the article by Kalra, et al. (2012), "A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care" <ref name="Kalra, 2012”>Kalra, D., Fernando, B., Morrison, Z., & Sheikh, A. (2012). A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care. Informatics in primary care, 20(3), 171-180. http://www.ingentaconnect.com/content/bcs/ipc/2012/00000020/00000003/art00003</ref>.
  
 
=== Background ===
 
=== Background ===

Latest revision as of 20:05, 15 November 2015

Abstract

Background: The case has historically been presented that structured and/or coded electronic health records (EHRs) benefit direct patient care, but the evidence base for this is not well documented.

Methods: We searched for evidence of direct patient care value from the use of structured and/or coded information within EHRs. We interrogated nine international databases from 1990 to 2011. Value was defined using the Institute of Medicine's six areas for improvement for healthcare systems: effectiveness, safety, patient-centredness, timeliness, efficiency and equitability. We included studies satisfying the Cochrane Effective Practice and Organisation of Care (EPOC) group criteria.

Results: Of 5016 potentially eligible papers, 13 studies satisfied our criteria: 10 focused on effectiveness, with eight demonstrating potential for improved proxy and actual clinical outcomes if a structured and/or coded EHR was combined with alerting or advisory systems in a focused clinical domain. Three studies demonstrated improvement in safety outcomes. No studies were found reporting value in relation to patient-centredness, timeliness, efficiency or equitability.

Conclusions: We conclude that, to date, there has been patchy effort to investigate empirically the value from structuring and coding EHRs for direct patient care. Future investments in structuring and coding of EHRs should be informed by robust evidence as to the clinical scenarios in which patient care benefits may be realised.

Summary

This is a review of the article by Kalra, et al. (2012), "A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care" [1].

Background

Although structured and/or coded electronic health records (EHRs) continues to be promoted as a beneficial element in direct patient care, the evidence for this assumption is not well shown in the literature.

Methods

The authors' conducted a literature review of nine international databases from 1990 to 2011. The authors sought to determine the value of EHR implementation on direct patient care. Value was defined using the Institute of Medicine's six areas for improvement for healthcare systems: effectiveness, safety, patient-centeredness, timeliness, efficiency and equitability. Studies included in the analysis satisfied the Cochrane Effective Practice and Organization of Care (EPOC) group criteria.

Results

The literature search retrieved 5016 papers. After reviewing the studies for elidjability, only 13 studies satisfied the authors' criteria. Ten articles focused on effectiveness. Eight paper demonstrated the potential for improved proxy and actual clinical outcomes if a structured and/or coded EHR was combined with alerting or advisory systems in a focused clinical domain. Three studies demonstrated improvements in safety outcomes. None of the studies reported value in relation to patient-centeredness, timeliness, efficiency, or equitability.

Conclusion

The authors concluded that efforts to investigate the empirical the value of structuring and coding EHRs for direct patient care is insufficient. Therefore, future research should investigate the structuring and coding of EHRs providing robust evidence for the clinical scenarios in which this technology can benefit direct patient care.

Comments

One limitation of the study is that the literature review was conducted in 2012 and the body of work has grown rapidly in the past three years. In-order to increase the validity and reliability of future studies, research should take place across multiple hospitals setting in multiple locations. The analysis should determine if a correlation exists between structured and coded clinical information and improvements in direct patient care.

Second Review

Add next review here.

References

  1. Kalra, D., Fernando, B., Morrison, Z., & Sheikh, A. (2012). A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care. Informatics in primary care, 20(3), 171-180. http://www.ingentaconnect.com/content/bcs/ipc/2012/00000020/00000003/art00003