Data utilization for medical decision making at the time of patient admission to ICU

Brian W Pickering, Ognjen Gajic, Adil Ahmed, Vitaly D Herasevich, Mark T. Keegan

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVES: Information overload in electronic medical records can impede providers' ability to identify important clinical data and may contribute to medical error. An understanding of the information requirements of ICU providers will facilitate the development of information systems that prioritize the presentation of high-value data and reduce information overload. Our objective was to determine the clinical information needs of ICU physicians, compared to the data available within an electronic medical record. DESIGN: Prospective observational study and retrospective chart review. SETTING: Three ICUs (surgical, medical, and mixed) at an academic referral center. SUBJECTS: Newly admitted ICU patients and physicians (residents, fellows, and attending staff). MEASUREMENTS AND MAIN RESULTS: The clinical information used by physicians during the initial diagnosis and treatment of admitted patients was captured using a questionnaire. Clinical information concepts were ranked according to the frequency of reported use (primary outcome) and were compared to information availability in the electronic medical record (secondary outcome). Nine hundred twenty-five of 1,277 study questionnaires (408 patients) were completed. Fifty-one clinical information concepts were identified as being useful during ICU admission. A median (interquartile range) of 11 concepts (6-16) was used by physicians per patient admission encounter with four used greater than 50% of the time. Over 25% of the clinical data available in the electronic medical record was never used, and only 33% was used greater than 50% of the time by admitting physicians. CONCLUSIONS: Physicians use a limited number of clinical information concepts at the time of patient admission to the ICU. The electronic medical record contains an abundance of unused data. Better electronic data management strategies are needed, including the priority display of frequently used clinical concepts within the electronic medical record, to improve the efficiency of ICU care.

Original languageEnglish (US)
Pages (from-to)1502-1510
Number of pages9
JournalCritical Care Medicine
Volume41
Issue number6
DOIs
StatePublished - Jun 2013

Fingerprint

Electronic Health Records
Patient Admission
Physicians
Medical Errors
Information Systems
Observational Studies
Clinical Decision-Making
Referral and Consultation
Prospective Studies

Keywords

  • concept orientated data
  • critical care
  • electronic medical record
  • ICU admission
  • information overload
  • medical decision making
  • medical informatics
  • patient safety
  • point of care

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Data utilization for medical decision making at the time of patient admission to ICU. / Pickering, Brian W; Gajic, Ognjen; Ahmed, Adil; Herasevich, Vitaly D; Keegan, Mark T.

In: Critical Care Medicine, Vol. 41, No. 6, 06.2013, p. 1502-1510.

Research output: Contribution to journalArticle

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