Interface design dividing physical findings into medical and trauma findings facilitates clinical document entry in the emergency department: A prospective observational study. (April 2018)

• Record Type: Journal Article
• Authors: Inokuchi, Ryota; Maehara, Hiromu; Iwai, Satoshi; Iwagami, Masao; Sato, Hajime; Yamaguchi, Yoko; Asada, Toshifumi; Yamamoto, Miyuki; Nakamura, Kensuke; Hiruma, Takahiro; Doi, Kent; Morimura, Naoto
• Is Part Of: International journal of medical informatics. Volume 112(2018)
• Page Start: 143
• Page End: 148
• Publication Date: 2018-04
• Subjects: ED emergency department -- EMR electronic medical record -- IQR interquartile range; Emergency care systems -- Patient support -- Prehospital care -- Critical care transport; Medical informatics -- Periodicals; Information science -- Periodicals; Computers -- Periodicals; Medical technology -- Periodicals; Medical Informatics -- Periodicals; Technology, Medical -- Periodicals; Computers; Information science; Medical informatics; Medical technology; Electronic journals; Periodicals; Electronic journals; 610.285
• DOI: 10.1016/j.ijmedinf.2018.01.017
• Languages: English
• ISSNs: 1386-5056

Abstract

Highlights: The interface design and its effect on workflow are key determinants of the usability of electronic medical records. Poor user interface design has been reported to pose a threat to patient safety. Dividing the interface design of physical findings into medical and trauma findings was effective for shortening the time for clinical documentation for trauma patients. Dividing the interface design of physical findings into medical and trauma findings may help increase the time of direct patient care. Abstract: Purpose: The interface design and its effect on workflow are key determinants of the usability of electronic medical records (EMRs) in the emergency department (ED). However, whether the overall clinical care can be improved by dividing the interface design of physical findings into medical and trauma findings is unknown. We previously developed an EMR system in which the checkpoints were separated into different sections according to the body part. Herein, we modified this EMR system by remaking the interface design specifically for trauma patients, and evaluated its performance. Methods: This study was undertaken in a single-center ED between October 2014 and September 2015. In the modified EMR system, all trauma findings are displayed together on the screen, according to the Japan Advanced Trauma Evaluation and Care. We compared the time to final documentation entry and the length of ED stay between the previous (used in the first 6 months) and current systems (used in the latter 6 months). Furthermore, we stratified the patients by triage levels. Results: The study involved 2141 patients (934 and 1207 assessed using the previous and modified EMR systems, respectively). The modified EMR in trauma patients significantly decreased the time to final documentation entry from 131.5 [interquartile range, 86.8–207.3] to 115 [78.8–161] min (p = 0.049). When stratifying trauma patients by triage level, significantly shorter clinical documentation times were observed with the modified EMR system in levels 2 (emergency) and 3 (urgent). Conclusions: Using different interfaces for trauma findings shortened the time for clinical documentation for trauma patients.