The Effects of Health Information Technology on Quality of Care in Emergency Departments: A Systematic Review

医疗信息技术对急诊科医疗质量的影响:系统评价

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Abstract

BACKGROUND AND AIMS: To assess the effectiveness on quality of care when leveraging health information technology in the emergency department. Using MeSH terms, secondary data sources from CINAHL, PubMed (MEDLINE), Web of Science, and ScienceDirect were queried for the use of health information technology (HIT) in the emergency department and any effects on quality of care. METHODS: This systematic review was conducted between June 2020 and January 2021 using the Kruse Protocol. It was reported using the Preferred Reporting items for Meta-analyses and Systematic Reviews (PRISMA). Articles were considered eligible for analysis if they were published between January 1, 2016, and January 29, 2021, written in the English language, and if they reported effects of HIT usage on quality in the emergency department setting. No other intervention was utilized. A standardized Excel spreadsheet was used to extract data from 27 articles. A narrative analysis identified themes, which were reported in tables and summarized in affinity matrices. RESULTS: Twenty-seven articles were chosen to review. HIT tools, such as standardized procedures, protocols, checklists, health information exchange, and e-prescribing, were introduced into the ED environment. These resulted in an increase in communication, clinical documentation, improved clinical handoffs, better prediction of falls and readmission, and a decrease in error. CONCLUSION: HIT implementation in emergency departments can improve workflow, documentation, individualized care, and communication between providers. EHRs can also reduce medical errors at the time of patient care. Quality training for providers in an EHR system may improve overall satisfaction with the implementation process.

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