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      Chart biopsy: an emerging medical practice enabled by electronic health records and its impacts on emergency department–inpatient admission handoffs

      Author(s): ,
      Publication date Created:
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      Journal: Journal of the American Medical Informatics Association
      Publisher: BMJ

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          To examine how clinicians on the receiving end of admission handoffs use electronic health records (EHRs) in preparation for those handoffs and to identify the kinds of impacts such usage may have.

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          Most cited references55

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          Technology as an occasion for structuring: evidence from observations of CT scanners and the social order of radiology departments.

          S R Barley (1986)
          New medical imaging devices, such as the CT scanner, have begun to challenge traditional role relations among radiologists and radiological technologists. Under some conditions, these technologies may actually alter the organizational and occupational structure of radiological work. However, current theories of technology and organizational form are insensitive to the potential number of structural variations implicit in role-based change. This paper expands recent sociological thought on the link between institution and action to outline a theory of how technology might occasion different organizational structures by altering institutionalized roles and patterns of interaction. In so doing, technology is treated as a social rather than a physical object, and structure is conceptualized as a process rather than an entity. The implications of the theory are illustrated by showing how identical CT scanners occasioned similar structuring processes in two radiology departments and yet led to divergent forms of organization. The data suggest that to understand how technologies alter organizational structures researchers may need to integrate the study of social action and the study of social form.
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            Effect of clinical decision-support systems: a systematic review.

            Tiffani Bright, Anthony Wong, Ravi Dhurjati … (2012)
            Despite increasing emphasis on the role of clinical decision-support systems (CDSSs) for improving care and reducing costs, evidence to support widespread use is lacking. To evaluate the effect of CDSSs on clinical outcomes, health care processes, workload and efficiency, patient satisfaction, cost, and provider use and implementation. MEDLINE, CINAHL, PsycINFO, and Web of Science through January 2011. Investigators independently screened reports to identify randomized trials published in English of electronic CDSSs that were implemented in clinical settings; used by providers to aid decision making at the point of care; and reported clinical, health care process, workload, relationship-centered, economic, or provider use outcomes. Investigators extracted data about study design, participant characteristics, interventions, outcomes, and quality. 148 randomized, controlled trials were included. A total of 128 (86%) assessed health care process measures, 29 (20%) assessed clinical outcomes, and 22 (15%) measured costs. Both commercially and locally developed CDSSs improved health care process measures related to performing preventive services (n= 25; odds ratio [OR], 1.42 [95% CI, 1.27 to 1.58]), ordering clinical studies (n= 20; OR, 1.72 [CI, 1.47 to 2.00]), and prescribing therapies (n= 46; OR, 1.57 [CI, 1.35 to 1.82]). Few studies measured potential unintended consequences or adverse effects. Studies were heterogeneous in interventions, populations, settings, and outcomes. Publication bias and selective reporting cannot be excluded. Both commercially and locally developed CDSSs are effective at improving health care process measures across diverse settings, but evidence for clinical, economic, workload, and efficiency outcomes remains sparse. This review expands knowledge in the field by demonstrating the benefits of CDSSs outside of experienced academic centers. Agency for Healthcare Research and Quality.
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              Can electronic medical record systems transform health care? Potential health benefits, savings, and costs.

              Richard Hillestad, James Bigelow, Anthony D. Bower … (2005)
              To broadly examine the potential health and financial benefits of health information technology (HIT), this paper compares health care with the use of IT in other industries. It estimates potential savings and costs of widespread adoption of electronic medical record (EMR) systems, models important health and safety benefits, and concludes that effective EMR implementation and networking could eventually save more than $81 billion annually--by improving health care efficiency and safety--and that HIT-enabled prevention and management of chronic disease could eventually double those savings while increasing health and other social benefits. However, this is unlikely to be realized without related changes to the health care system.
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                Author and article information

                Journal
                Title: Journal of the American Medical Informatics Association
                Abbreviated Title: J Am Med Inform Assoc
                Publisher: BMJ
                ISSN (Print): 1067-5027
                ISSN (Electronic): 1527-974X
                Publication date Created: March 01 2013
                Publication date Created: March 2013
                Publication date (Print): March 2013
                Publication date (Electronic): March 01 2013
                Volume: 20
                Issue: 2
                Pages: 260-267
                Article
                DOI: 10.1136/amiajnl-2012-001065
                PMC ID: 3638186
                PubMed ID: 22962194
                SO-VID: 75fe978b-0b29-4577-8230-f4ff211895d1
                Copyright © © 2013
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