Clinical information transfer and data capture in the acute myocardial infarction pathway: an observational study
Sujatha Kesavan1, Tanika Kelay, Ruth E Collins
1Clinical Research Fellow Post Doctoral Reaearch Associate Research Assistant Senior Lecturer in Surgical Graphics and Computing Professor of Surgical Education Senior Lecturer in Patient Safety, Department of Surgery and Cancer, Imperial College London, London, UK Reader, Business School, Imperial College London, London, UK.
Insights
Fragmented clinical information systems hinder acute myocardial infarction (MI) care. Improving data capture and transfer is crucial for patient safety and efficient treatment during MI pathways.
Area of Science:
- Cardiology
- Health Informatics
- Healthcare Systems Research
Background:
- Acute myocardial infarctions (MIs) require prompt intervention, making timely and accurate patient information critical for effective care.
- Current clinical information systems (CIS) may not adequately support the seamless transfer of data during the MI patient journey.
- Information fragmentation can impact the quality and safety of patient care in acute cardiac settings.
Purpose of the Study:
- To assess the utilization of clinical information systems (CIS) in acute cardiac care settings.
- To evaluate the real-time availability and completeness of patient information across the MI care pathway.
- To identify gaps and redundancies in clinical data capture and transfer during MI patient management.
Main Methods:
- A prospective, descriptive, structured observational study was conducted.
- Assessed CIS utilization and real-time information availability in an acute cardiac care environment.
- Examined patient information completeness at four key stages of the MI care pathway.
Main Results:
- Thirteen distinct information systems were used across the MI pathway, with users accessing an average of six systems.
- Clinical information capture varied significantly between pathway stages and patient risk groups.
- Information completeness was highest at discharge (100%) but lowest at admission (58%).
Conclusions:
- Significant fragmentation, duplication, and discrepancies exist in current clinical information capture and transfer for MI patients.
- An integrated, user-friendly electronic data system is needed to streamline information flow.
- Improved data management can enhance efficiency and ensure complete information at the point of care.
Rationale, Aims And Objectives:
Acute myocardial infarctions (MIs) or heart attacks are the result of a complete or an incomplete occlusion of the lumen of the coronary artery with a thrombus. Prompt diagnosis and early coronary intervention results in maximum myocardial salvage, hence time to treat is of the essence. Adequate, accurate and complete information is vital during the early stages of admission of an MI patient and can impact significantly on the quality and safety of patient care. This study aimed to record how clinical information between different clinical teams during the journey of a patient in the MI care pathway is captured and to review the flow of information within this care pathway.
Method:
A prospective, descriptive, structured observational study to assess (i) current clinical information systems (CIS) utilization and (ii) real-time information availability within an acute cardiac care setting was carried out. Completeness and availability of patient information capture across four key stages of the MI care pathway were assessed prospectively.
Results:
Thirteen separate information systems were utilized during the four phases of the MI pathway. Observations revealed fragmented CIS utilization, with users accessing an average of six systems to gain a complete set of patient information. Data capture was found to vary between each pathway stage and in both patient cohort risk groupings. The highest level of information completeness (100%) was observed only in the discharge stage of the MI care pathway. The lowest level of information completeness (58%) was observed in the admission stage.
Conclusion:
The study highlights fragmentation, CIS duplication, and discrepancies in the current clinical information capture and data transfer across the MI care pathway in an acute cardiac care setting. The development of an integrated and user-friendly electronic data capture and transfer system would reduce duplication and would facilitate efficient and complete information provision at the point of care.
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