Electronic Patient Record Use On Mortality In Renal Disease
Effects on mortality and cost of an electronic patient record used in a chronic disease, End Stage Renal Disease, treated by chronic maintenance hemodialysis.
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Research article overview in layman's terms.
This study looked at the effects of using an electronic patient record in dialysis units across the United States. They studied 1790 patients with many different underlying diseases over a period of 9 years. They found that mortality decreased significantly and there was a decrease in the amount of clinical staff needed, which would lead to lower costs. This is the first time this has been demonstrated and suggests that this type of electronic patient record system could be used in many different fields of medical practice.
Effect of electronic patient record use on mortality in End Stage Renal Disease, a model chronic disease: retrospective analysis of 9 years of prospectively collected data
Abstract
Electronic Patient Record Use
In chronic disease, health information technology promises but has yet to demonstrate improved outcomes and decreased costs. The main aim of the study was to determine the effects on mortality and cost of an electronic patient record used in daily patient care in a model chronic disease, End Stage Renal Disease, treated by chronic maintenance hemodialysis. Dialysis treatment is highly regulated, and near uniform in treatment modalities and drugs used.
Methods
The particular electronic patient record, patient-centered and extensively coded, was used first in patient care in 3 dialysis units in New York, NY in 1998, 1999, and 2000. All data were stored "live"; none were archived. By December 31, 2006, the patients had been treated by maintenance hemodialysis for a total of 3924 years. A retrospective analysis was made using query tools embedded in the software. The United States Renal Data System dialysis population served as controls. In all there were 1790 patients, with many underlying primary diseases and multiple comorbid conditions affecting many organ systems. Year by year mortality, hospital admissions, and staffing were analyzed, and the data were compared with national data compiled by the United States Renal Data System.
Results
Analyzed by calendar year after electronic patient record implementation, mortality decreased strikingly. In years 39 mortality was lower than in years 12 by 23%, 48%, and 34% in the 3 units, and was 37%, 37%, and 35% less than that reported by the United States Renal Data System. Clinical staffing was 25% fewer per 100 patients than the national average, thereby lowering costs.
Conclusion
To our knowledge, this is the first demonstration that an electronic patient record, albeit of particular design, can have a favorable effect on outcomes and cost in chronic disease. That the population studied has many underlying diseases affecting all organ systems suggests that the electronic patient record design may enable application to many fields of medical practice.
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