Adoption of information technology in Massachusetts emergency departments

Information technology improves outcomes (e.g., by reducing error), and universal implementation of electronic medical records throughout the United States is a national goal. Prior studies have shown low rates of implementation.

To assess the current state of acquisition and implementation of information technology tools in Massachusetts emergency departments (EDs).

This was part of a larger survey that sought to describe various attributes of all non-federal Massachusetts EDs. We asked about implementation of technologies listed below, and report proportions (95% confidence intervals) and medians (interquartile ranges). We compare responding to non-responding EDs to guard against response bias.

We identified and surveyed 74 non-federal EDs; 61 (82%) responded. Of these, the following number (%) reported full implementation of the following technologies: medication ordering, 9 (15%); medication error checking, 7 (11%); current visit information (e.g., chief complaint), 25 (41%); computerized management recommendations based on clinical decision rules, 6 (10%); electronic laboratory results, 55 (90%); computerized clinical reminders, 10 (17%); tracking information, 31 (51%); hospital discharge summaries, 50 (82%); current outpatient medications, 15 (25%); ED visit notes, 30 (49%); radiographic images from a prior visit, 39 (64%); old electrocardiograms, 33 (54%); and computer system to collect real-time clinical data, 23 (38%).

Massachusetts EDs have been slow to adopt evidence-based information technologies. A collaborative approach to determining the best available technologies and their implementation would decrease duplication of effort, frustration, and financial waste (due to non-implementation of acquired systems), and would facilitate inter-operability of ED computer systems.