ArticleBMC medical informatics and decision making2013
The impact of EHR and HIE on reducing avoidable admissions: controlling main differential diagnoses.
Article in BMC medical informatics and decision making, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Health Outcomes and Healthcare Efficiencies Associated with the Use of Electronic Health Records in Hospital Emergency Departments: a Systematic Review.Journal of medical systems · 2020Pooled it
- Using electronic health record audit logs to study clinical activity: a systematic review of aims, measures, and methods.Journal of the American Medical Informatics Association : JAMIA · 2020Pooled it
- Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review.Journal of medical Internet research · 2018Pooled it
- The role and benefits of accessing primary care patient records during unscheduled care: a systematic review.BMC medical informatics and decision making · 2017Pooled it
- Pooled it
- Impact of Provider Health Information Exchange Services on Patient Utilization of Emergency Room and Inpatient Practices in Colorado.Journal of clinical medicine · 2025Article
- Influence of Previous Emergency Department Visit Information on Care of Current Patients.The western journal of emergency medicine · 2025Article
- Acquisition of patients' EHR information under ED congestion - an empirical investigation.Health systems (Basingstoke, England) · 2025Review
- Harnessing the Power of Complementarity Between Smart Tracking Technology and Associated Health Information Technologies: Longitudinal Study.JMIR formative research · 2024Article
- Diagnosing an overcrowded emergency department from its Electronic Health Records.Scientific reports · 2024Article
- Article
- Value of Electronic Health Records Measured Using Financial and Clinical Outcomes: Quantitative Study.JMIR medical informatics · 2024Article
- Reducing Unplanned Readmissions in Pediatric Hospitals: Applying Patient and Family-Centered Care.Global journal on quality and safety in healthcare · 2023Article
- Understanding the perceived role of electronic health records and workflow fragmentation on clinician documentation burden in emergency departments.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Evaluating the Impact of a Point-of-Care Cardiometabolic Clinical Decision Support Tool on Clinical Efficiency Using Electronic Health Record Audit Log Data: Algorithm Development and Validation.JMIR medical informatics · 2022Article
- Use of My Health Record by Clinicians in the Emergency Department: An Analysis of Log Data.Frontiers in digital health · 2021Article
- The associations between query-based and directed health information exchange with potentially avoidable use of health care services.Health services research · 2019Article
- Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.Journal of the American Medical Informatics Association : JAMIA · 2019Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany medical organizations have invested heavily in electronic health record (EHR) and health information exchange (HIE) information systems (IS) to improve medical decision-making and increase efficiency. Despite the potential interoperability advantages of such IS, physicians do not always immediately consult electronic health information, and this decision may result in decreased level of quality of care as well as unnecessary costs. This study sought to reveal the effect of EHR IS use on the physicians' admission decisions. It was hypothesizing the using EHR IS will result in more accurate and informed admission decisions, which will manifest through reduction in single-day admissions and in readmissions within seven days.
methodsThis study used a track log-file analysis of a database containing 281,750 emergency department (ED) referrals in seven main hospitals in Israel. Log-files were generated by the system and provide an objective and unbiased measure of system usage, Thus allowing us to evaluate the contribution of an EHR IS, as well as an HIE network, to decision-makers (physicians). This is done by investigating whether EHR IS lead to improved medical outcomes in the EDs, which are known for their tight time constraints and overcrowding. The impact of EHR IS and HIE network was evaluated by comparing decisions on patients classified by five main differential diagnoses (DDs), made with or without viewing the patients' medical history via the EHR IS.
resultsThe results indicate a negative relationship between viewing medical history via EHR systems and the number of possibly redundant admissions. Among the DDs, we found information viewed most impactful for gastroenteritis, abdominal pain, and urinary tract infection in reducing readmissions within seven days, and for gastroenteritis, abdominal pain, and chest pain in reducing the single-day admissions' rate. Both indices are key quality measures in the health system. In addition, we found that interoperability (using external information provided online by health suppliers) contributed more to this reduction than local files, which are available only in the specific hospital. Thus, reducing the rate of redundant admissions by using external information produced larger odds ratios (of the β coefficients; e.g. viewing external information on patients resulted in negative associations of 27.2% regarding readmissions within seven days, and 13% for single-day admissions as compared with viewing local information on patients respectively).
conclusionsViewing medical history via an EHR IS and using HIE network led to a reduction in the number of seven day readmissions and single-day admissions for all patients. Using external medical history may imply a more thorough patient examination that can help eliminate unnecessary admissions. Nevertheless, in most instances physicians did not view medical history at all, probably due to the limited resources available, combined with the stress of rapid turnover in ED units.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.