![]() ![]() It is likely that one reason for missing data is delayed transfer of clinical information in a paper-based system for instance, delays in documentation from a subspecialty visit arriving in the patient's record in the primary care office. Prior studies have shown that data are often missing during clinical encounters within settings that predominantly rely on paper-based systems, and that the missing data may lead to adverse outcomes. HIT also has potential for improving the care of individual patients, including improving communication between providers and allowing quicker access to information at the point of care by providing clinical documentation in a timely manner. A study in Boston in 2001 demonstrated the accurate identification of lower respiratory tract infections with a comprehensive EMR, but did not explore the time to data availability associated with the EMR and to our knowledge there are no studies demonstrating this relationship. Newer electronic medical records (EMR) systems include many of the key capabilities for EMRs described by the Institute of Medicine in 2004, such as electronic charting, computerized physician order entry, and clinical decision support. Similarly, coordination during natural disasters also benefits from timely exchange of clinical data, as seen during Hurricane Katrina in 2005. For instance, population surveillance for and monitoring of infectious disease outbreaks requires real time clinical information. Timely information is critical at both the population and the individual patient levels. Health information technology (HIT) systems have the potential to improve health care quality and outcomes, in part by making important clinical data quickly available. Timely clinical data are critical for real-time population surveillance, and valuable for routine clinical care. Use of HIT systems is associated with dramatic increases in the timely availability of diagnostic information, though the effects may vary by sophistication of HIT system. By December 2006, 95% of all office visits had diagnoses available on the same day as the visit, when 98% of office visits used some form of HIT for entry of visit diagnoses (Advanced HIT for 67% of visits). In January 2004, when only Basic HIT was available, 10% of office visits had diagnoses entered on the same day as the visit and 90% within a week 85% of office visits used paper forms for recording visit diagnoses, 16% used Basic at that time. We calculated the monthly percentage of visits using the various types of HIT for entry of visit diagnoses into the delivery system's electronic database, and the time between the visit and the availability of the visit diagnoses in the database. We used an historical observation design (2004–2006) using electronic data from office visits in an integrated delivery system with three types of HIT: Basic, Intermediate, and Advanced. We hypothesized that timely availability of data would improve with use of increasingly sophisticated forms of HIT. However, there are few studies documenting the changes in timely availability of data with the use of a sophisticated electronic medical record (EMR), nor a description of how the timely availability of data might differ with different types of EMRs. Health information technology (HIT) may improve health care quality and outcomes, in part by making information available in a timelier manner. ![]()
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