Improving Access to Longitudinal Patient Health Information within an Emergency Department

Journal: Applied Clinical Informatics
ISSN: 1869-0327
Issue: Vol. 3: Issue 3 2012
Pages: 290-300

Improving Access to Longitudinal Patient Health Information within an Emergency Department

Research Article

A. B. Wilcox (1), S. Shen (2, 3), D. A. Dorr (4), G. Hripcsak (1), L. Heermann (2), S. P. Narus (2, 5)

(1) Department of Biomedical Informatics, Columbia University, New York, NY; (2) Intermountain Healthcare, Salt Lake City, UT; (3) Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT; (4) Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR; (5) Department of Biomedical Informatics, University of Utah, Salt Lake City, UT


Electronic health records, health information exchange, reduced admissions


We designed and implemented an electronic patient tracking system with improved user authentication and patient selection. We then measured access to clinical information from previous clinical encounters before and after implementation of the system. Clinicians accessed longitudinal information for 16% of patient encounters before, and 40% of patient encounters after the intervention, indicating such a system can improve clinician access to information. We also attempted to evaluate the impact of providing this access on inpatient admissions from the emergency department, by comparing the odds of inpatient admission from an emergency department before and after the improved access was made available. Patients were 24% less likely to be admitted after the implementation of improved access. However, there were many potential confounders, based on the inherent pre-post design of the evaluation. Our experience has strong implications for current health information exchange initiatives.

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