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A qualitative comparison of paper flowsheets vs a computer-based clinical information system
J Hammond1, H M Johnson, R Varas
1University of Miami School of Medicine.
Chest
|January 1, 1991
Summary
Computerized clinical information systems (CIS) show significant improvements in documentation accuracy and volume compared to handwritten records. While cost-effectiveness and reduced mortality are not yet proven, enhanced documentation impacts patient care and quality assurance.
Area of Science:
- Health Informatics
- Clinical Information Systems
- Medical Documentation
Background:
- Evaluating the cost-effectiveness of Computerized Clinical Information Systems (CIS) presents challenges.
- Traditional methods of value demonstration, such as reduced mortality or staffing, have not been clearly linked to CIS implementation.
Purpose of the Study:
- To assess the impact of CIS on clinical documentation quality and volume.
- To explore potential benefits of CIS beyond direct cost savings.
Main Methods:
- Comparative analysis of documentation between CIS and handwritten flowsheets.
- Evaluation of documentation volume and accuracy metrics.
Main Results:
- CIS significantly improves the volume and accuracy of patient documentation compared to handwritten flowsheets.
- No significant decrease in intensive care unit mortality or nursing staff reduction was directly attributed to CIS.
Conclusions:
- CIS offers substantial benefits in enhancing the quality and completeness of medical records.
- Improved documentation through CIS may positively influence medicolegal outcomes, quality assurance, and overall patient care.