Future of electronic health records: Implications for decision support

Brian Rothman, Joan C. Leonard, Michael M. Vigoda

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data in real-time for decision support and process automation has the potential to both reduce costs and improve the quality of patient care.

Original languageEnglish
Pages (from-to)757-768
Number of pages12
JournalMount Sinai Journal of Medicine
Volume79
Issue number6
DOIs
StatePublished - Nov 1 2012

Fingerprint

Clinical Decision Support Systems
Electronic Health Records
Automation
Documentation
Anesthesia
Delivery of Health Care
Costs and Cost Analysis
Medication Errors
Postoperative Nausea and Vomiting
Data Mining
Cost Control
Quality of Health Care
Drug-Related Side Effects and Adverse Reactions
Health Status
Compliance
Decision Making
Patient Care
Guidelines
Anti-Bacterial Agents
Education

Keywords

  • anesthesia information management systems
  • clinical decision support
  • compliance
  • electronic health records

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Future of electronic health records : Implications for decision support. / Rothman, Brian; Leonard, Joan C.; Vigoda, Michael M.

In: Mount Sinai Journal of Medicine, Vol. 79, No. 6, 01.11.2012, p. 757-768.

Research output: Contribution to journalArticle

Rothman, Brian ; Leonard, Joan C. ; Vigoda, Michael M. / Future of electronic health records : Implications for decision support. In: Mount Sinai Journal of Medicine. 2012 ; Vol. 79, No. 6. pp. 757-768.
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