The feasibility of full computerization in the ED

Area of Science:

• Health Informatics
• Emergency Medicine
• Health Information Management

Background:

• Implementing full computerization in emergency departments (EDs) presents challenges in data recording.
• Evaluating the feasibility and efficiency of electronic health record (EHR) systems is crucial for modern healthcare.

Purpose of the Study:

• To assess the completion rates of data entry by different healthcare professionals (doctors, nurses, registration clerks) after ED computerization.
• To analyze the transition from handwritten to fully computerized chart recording and its impact on data accuracy.

Main Methods:

• A 18-month study analyzing monthly reports of data execution rates in a fully computerized ED.
• Statistical analysis using Wilcoxon rank-sum test and Kruskal-Wallis one-way ANOVA.
• Comparison of data entry efficiency between nurses and clerks for disposition status, and physician execution rates across three study phases.

Main Results:

• High execution rates for mode of arrival (97.1%) and triage classification (97.2%).
• Registration clerks demonstrated significantly higher data entry rates for disposition status compared to nurses (e.g., 96.7% vs. 72.0% for non-trauma).
• Physician data entry rates improved over time, with statistically significant increases in the third phase (13-18 months) for trauma and pediatric sections.

Conclusions:

• Data entry by registration clerks is more efficient than by nurses in a computerized ED.
• Physician adoption and proficiency in using EHR systems improve with time and dedicated education.
• Full computerization is feasible and can enhance data recording efficiency with appropriate workflow adjustments and staff training.