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- Title
Clinical impact of intraoperative electronic health record downtime on surgical patients.
- Authors
Harrison, Andrew M; Siwani, Rizwan; Pickering, Brian W; Herasevich, Vitaly
- Abstract
<bold>Objective: </bold>Despite increased use of electronic health records (EHRs), the clinical impact of system downtime is unknown.<bold>Materials and Methods: </bold>This retrospective matched cohort study evaluated the impact of EHR downtime episodes lasting more than 60 minutes over a 6-year study period. Patients age 18 years or older who underwent surgical procedures at least 60 minutes in duration with an inpatient stay exceeding 24 hours within the study period were eligible for inclusion. Out of 4115 patients exposed to 1 of 176 EHR downtime episodes, 4103 patients were matched to an unexposed cohort in a 1:1 ratio. Multivariable regression analysis, as well as trend analysis for effect of duration of downtime on outcomes, was performed.<bold>Results: </bold>Downtime-exposed patients had operating room duration 1.1 times longer (p < .001) and postoperative length of stay 1.04 times longer (p = .007) compared to unexposed patients. The 30-day mortality rates were similar between these groups (odds ratio 1.26, p > .05). In trend analysis, there was no association between duration of downtime with respect to evaluated outcomes, postoperative length of stay, and 30-day mortality.<bold>Conclusion: </bold>EHR downtime had no impact on 30-day mortality. Potential associations for increased postoperative length of stay and duration of time spent in the operating room were observed among downtime-exposed patients. No trend effect was observed with respect to duration of downtime and postoperative length of stay and 30-day mortality rates.
- Subjects
ELECTRONIC health records; SYSTEM downtime; TREND analysis; LENGTH of stay in hospitals; OPERATING rooms; MEDICAL equipment reliability; OPERATIVE surgery; RETROSPECTIVE studies; HOSPITAL mortality; TREATMENT effectiveness
- Publication
Journal of the American Medical Informatics Association, 2019, Vol 26, Issue 10, p928
- ISSN
1067-5027
- Publication type
journal article
- DOI
10.1093/jamia/ocz029