ArticleAnnals of emergency medicine2017
A Custom-Developed Emergency Department Provider Electronic Documentation System Reduces Operational Efficiency.
Article in Annals of emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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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
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Does autotext usage decrease documentation time among resident physicians? A retrospective analysis of electronic health record usage data.JAMIA open · 2025Article
- Designing Health Care Provider-Centered Emergency Department Interventions: Participatory Design Study.JMIR formative research · 2025Article
- Benefits, facilitators, and barriers of electronic medical records implementation in outpatient settings: A scoping review.Healthcare management forum · 2024Article
- Value of the Electronic Medical Record for Hospital Care: Update From the Literature.Journal of medical Internet research · 2021Review
- Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content.Life (Basel, Switzerland) · 2020Article
- Impact of Scribes with Flow Coordination Duties on Throughput in an Academic Emergency Department.The western journal of emergency medicine · 2020Article
- Implementation of electronic charting is not associated with significant change in physician productivity in an academic emergency department.JAMIA open · 2018Article
- Analysis of the effects of EHR implementation on timeliness of care in a dermatology clinic: a simulation study.Journal of the American Medical Informatics Association : JAMIA · 2018Article
- Validation of chief complaints, medical history, medications, and physician diagnoses structured with an integrated emergency department information system in Japan: the Next Stage ER system.Acute medicine & surgeryArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
STUDY
objectiveElectronic health record implementation can improve care, but may also adversely affect emergency department (ED) efficiency. We examine how a custom, ED provider, electronic documentation system (eDoc), which replaced paper documentation, affects operational performance.
methodsWe analyzed retrospective operational data for 1-year periods before and after eDoc implementation in a single ED. We computed daily operational statistics, reflecting 60,870 pre- and 59,337 postimplementation patient encounters. The prespecified primary outcome was daily mean length of stay; secondary outcomes were daily mean length of stay for admitted and discharged patients and daily mean arrival time to disposition for admitted patients. We used a prespecified multiple regression model to identify differences in outcomes while controlling for prespecified confounding variables.
resultsThe unadjusted change in length of stay was 8.4 minutes; unadjusted changes in secondary outcomes were length of stay for admitted patients 11.4 minutes, length of stay for discharged patients 1.8 minutes, and time to disposition 1.8 minutes. With a prespecified regression analysis to control for variations in operational characteristics, there were significant increases in length of stay (6.3 minutes [95% confidence interval 3.5 to 9.1 minutes]) and length of stay for discharged patients (5.1 minutes [95% confidence interval 1.9 to 8.3 minutes]). There was no statistically significant change in length of stay for admitted patients or time to disposition.
conclusionIn our single-center study, the isolated implementation of eDoc was associated with increases in overall and discharge length of stay. Our findings suggest that a custom-designed electronic provider documentation may negatively affect ED throughput. Strategies to mitigate these effects, such as reducing documentation requirements or adding clinical staff, scribes, or voice recognition, would be a valuable area of future research.
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