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Informatics in the Emergency Department

Informatics in the Emergency Department. Katrina Hurley, MD September 6, 2007. Objectives. Clinical perspective Complexity of information in emergency care Electronic patient data in Canadian Emergency Departments Local tools/technology Opportunities. You’re taking a walk downtown….

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Informatics in the Emergency Department

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  1. Informatics in the Emergency Department Katrina Hurley, MD September 6, 2007

  2. Objectives • Clinical perspective • Complexity of information in emergency care • Electronic patient data in Canadian Emergency Departments • Local tools/technology • Opportunities Introduction to Health Informatics

  3. You’re taking a walk downtown… • A man clutches his chest and collapses • Witness calls 9-1-1 on cell phone • You start CPR • Ambulance arrives within 3 minutes • Cardiac arrest • Advanced life support and transport Introduction to Health Informatics

  4. Arrival: Resuscitation Room • Patient has no identification • Flurry of activity • Actions to stabilize, diagnose and treat • “Registration” • Generate paper chart • Facilitate tests Introduction to Health Informatics

  5. Continued care… • Patient is having a heart attack • Transferred to cardiology for therapy Introduction to Health Informatics

  6. Unanswered questions • Who is the patient? • What is the patient’s medical history? • What medications does he take? • Who is his next of kin? • What happens after he leaves the ED? Introduction to Health Informatics

  7. Patient outcomes • Link EDIS data with Vital Statistics data that is provided monthly on a diskette: • Identifies patients who DIE within 30 days of visiting the ED • EDIS can track patients who bounce back to the ED after a visit: • Used for performance evaluation and feedback • Informal feedback Introduction to Health Informatics

  8. Quality assurance • How long did it take for the ambulance to get dispatched? • How long before the ambulance arrived? • Was appropriate medical care provided? • How long did the patient stay in the ED before definitive treatment? Introduction to Health Informatics

  9. Need for data • Assess system performance • Assess patient outcomes Data Knowledge Improve outcomes Introduction to Health Informatics

  10. Use of EDIS in Canada • 2005 survey with 65% response rate • 39% had an EDIS • 9/13 jurisdictions access death data • 8/13 can access admission data • 2/13 collect comprehensive data • NO national database Introduction to Health Informatics

  11. Overcrowding • Why does it happen? • How can we predict it? • Can we use liaise with EDIS to create a warning system? Introduction to Health Informatics

  12. Performance evaluation • Can we use EDIS to liaise with other hospital information systems in the province to determine patient outcomes? • Can we give out-come based feedback to clinicians to improve their performance? Introduction to Health Informatics

  13. Disaster planning • Activate disaster plan. • Available as a paper/MS Word document. • Could we create an electronic disaster activation system that interfaced with EDIS to enhance patient flow and communication in a disaster? Introduction to Health Informatics

  14. Information flow & management • Information flow in emergency care is complex: • Interfaces with numerous information systems • Redundancies and inefficiencies • E.g. Pre-hospital ePCR must be printed • Lots of data captured on paper or pdf • Electronically inaccessible Introduction to Health Informatics

  15. Questions???

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