Paperless anesthesia: uses and abuses of these data

Abstract

Demonstrably accurate records facilitate clinical decision making, improve patient safety, provide better defense against frivolous lawsuits, and enable better medical policy decisions. Anesthesia Information Management Systems (AIMS) have the potential to improve on the accuracy and reliability of handwritten records. Interfaces with electronic recording systems within the hospital or wider community allow correlation of anesthesia relevant data with biochemistry laboratory results, billing sections, radiological units, pharmacy, earlier patient records, and other systems. Electronic storage of large and accurate datasets has lent itself to quality assurance, enhancement of patient safety, research, cost containment, scheduling, anesthesia training initiatives, and has even stimulated organizational change. The time for record making may be increased by AIMS, but in some cases has been reduced. The question of impact on vigilance is not entirely settled, but substantial negative effects seem to be unlikely. The usefulness of these large databases depends on the accuracy of data and they may be incorrect or incomplete. Consequent biases are threats to the validity of research results. Data mining of biomedical databases makes it easier for individuals with political, social, or economic agendas to generate misleading research findings for the purpose of manipulating public opinion and swaying policymakers. There remains a fear that accessibility of data may have undesirable regulatory or legal consequences. Increasing regulation of treatment options during the perioperative period through regulated policies could reduce autonomy for clinicians. These fears are as yet unsubstantiated.

Blood pressure and heart rates in neonates and preschool children: an analysis from 10 years of electronic recording

“…One pitfall of using data collected into Anesthesia Information Management Systems (AIMS) is the possible inaccuracy or incompleteness of those data collected . We were disappointed to note that although heart rate was recorded in more than 90% of records, intraoperative blood pressure was only available in 55%.…”

“…We wished to determine the usual heart rate and blood pressure values during anesthesia in our hospital. We have been using electronic records for the past 10 years and sought to use these records to define the 5%, 50%, and 95% centiles for heart rate (HR), systolic and mean, and diastolic blood pressure.…”

Compliance with perioperative prophylaxis guidelines and the use of novel outcome measures

“…Computerized voice prompts have shown to reduce the errors in recording and administration of drugs in anesthesia . The anesthetic information management system (AIMS) is a useful tool to improve compliance with antibiotic dosing . These AIMS can issues prompts to the anesthetic practitioner if antibiotics have not been recorded in the anesthetic record at the appropriate time of the anesthetic management.…”

“…27 The anesthetic information management system (AIMS) is a useful tool to improve compliance with antibiotic dosing. 28…”

A low cost, customised anaesthesia information management system: An evolving process

“…Traditional techniques of record keeping in most hospitals include manual entry in case sheets and then adding to piles of paper files. [ 1 ] Although gradual transition towards automated and computerized record systems is in place, it is still a distant prospect in many peripheral institutes and low resource hospitals. An anaesthesia information management system (AIMS) is an electronic record system that allows collection, storage and presentation of patient data during the peri-operative course.…”