Literature DB >> 23758310

Computer-facilitated review of electronic medical records reliably identifies emergency department interventions in older adults.

Kevin J Biese1, Cory R Forbach, Richard P Medlin, Timothy F Platts-Mills, Matthew J Scholer, Brenda McCall, Frances S Shofer, Michael LaMantia, Cherri Hobgood, J S Kizer, Jan Busby-Whitehead, Charles B Cairns.   

Abstract

OBJECTIVES: An estimated 14% to 25% of all scientific studies in peer-reviewed emergency medicine (EM) journals are medical records reviews. The majority of the chart reviews in these studies are performed manually, a process that is both time-consuming and error-prone. Computer-based text search engines have the potential to enhance chart reviews of electronic emergency department (ED) medical records. The authors compared the efficiency and accuracy of a computer-facilitated medical record review of ED clinical records of geriatric patients with a traditional manual review of the same data and describe the process by which this computer-facilitated review was completed.
METHODS: Clinical data from consecutive ED patients age 65 years or older were collected retrospectively by manual and computer-facilitated medical record review. The frequency of three significant ED interventions in older adults was determined using each method. Performance characteristics of each search method, including sensitivity and positive predictive value, were determined, and the overall sensitivities of the two search methods were compared using McNemar's test.
RESULTS: For 665 patient visits, there were 49 (7.4%) Foley catheters placed, 36 (5.4%) sedative medications administered, and 15 (2.3%) patients who received positive pressure ventilation. The computer-facilitated review identified more of the targeted procedures (99 of 100, 99%), compared to manual review (74 of 100 procedures, 74%; p < 0.0001).
CONCLUSIONS: A practical, non-resource-intensive, computer-facilitated free-text medical record review was completed and was more efficient and accurate than manually reviewing ED records.
© 2013 by the Society for Academic Emergency Medicine.

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Year:  2013        PMID: 23758310      PMCID: PMC5936073          DOI: 10.1111/acem.12145

Source DB:  PubMed          Journal:  Acad Emerg Med        ISSN: 1069-6563            Impact factor:   3.451


  18 in total

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3.  Accuracy of the Emergency Severity Index triage instrument for identifying elder emergency department patients receiving an immediate life-saving intervention.

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