Review of information technology for surgical patient care

Abstract

Introduction Electronic health records (EHRs), computerized order entry (CPOE), and patient portals have experienced increased adoption by healthcare systems. The objective of this study was to review evidence regarding the impact of such health information technologies (HIT) on surgical practice. Materials and Methods A search of Medline, EMBASE, CINAHL, and the Cochrane Library was performed to identify data-driven, non-survey studies about the effects of HIT on surgical care. Domain experts were queried for relevant articles. Two authors independently reviewed abstracts for inclusion criteria and analyzed full-text of eligible articles. Results 2890 citations were identified. 32 observational studies and 2 RCTs met eligibility criteria. EHR or CPOE improved appropriate antibiotic administration for surgical procedures in 13 comparative observational studies. 5 comparative observational studies indicated electronically generated operative notes had increased accuracy, completeness, and availability in the medical record. The Internet as an information resource about surgical procedures was generally inadequate. Surgical patients and providers demonstrated rapid adoption of patient portals, with increasing proportions of online versus in-person outpatient surgical encounters. Conclusion The overall quality of evidence about the effects of HIT in surgical practice was low. Current data suggest an improvement in appropriate perioperative antibiotic administration and accuracy of operative reports from CPOE and EHR applications. Online consumer health educational resources and patient portals are popular among patients and families, but their impact has not been studied well in surgical populations. With increasing adoption of HIT, further research is needed to optimize the efficacy of such tools in surgical care.

Implementation of electronic health records systems in surgical units and its impact on performance

“…Some studies suggest that there may be improvements in length of stay, mortality, inpatient rate of infections, adherence to guidelines, rate of medication errors, costs and utilization of physician time. [10][11][12][13][14][15][16] Other studies have reported that the introduction of EHR may result in less orders for unnecessary tests and imaging and can possibly influence confidence in diagnosis. 17,18 The difficulty in reaching a conclusion as to benefits of EHR is due to multiple factors, these include a wide spectrum of commercially available EHR systems, mixed taxonomy utilized by different studies, intrinsic site and utilization differences and an absence of standardized measure in the assessment of EHR performance.…”

“…International literature also remains equivocal as to the effects of EHR. Some studies suggest that there may be improvements in length of stay, mortality, inpatient rate of infections, adherence to guidelines, rate of medication errors, costs and utilization of physician time . Other studies have reported that the introduction of EHR may result in less orders for unnecessary tests and imaging and can possibly influence confidence in diagnosis …”

“Minimally invasive research?” Use of the electronic health record to facilitate research in pediatric urology

“…Providers and investigators may be unfamiliar with data extraction tools and may not utilize structured data elements even when available due to difficulty in changing existing clinic workflows [31]. Implementation of discrete data elements in the operative setting may also lead to delays in operative report generation, despite potential long-term improvements in data quality and accessibility [32].…”

The World's consumption of free web‐based Otolaryngology‐Head and Neck Surgery educational resources: A global assessment of video usage trends

“…3,4 Coinciding with advances in technology and web access alongside the COVID-19 pandemic, educators have sought to increase webbased information available to students, health care providers, and patients to promote and develop these resources. [5][6][7][8] However, there are disproportionately fewer open-access educational resources specifically targeted for global accessibility and consumption, such as free online videos and various surgical atlas texts. [9][10][11][12] Even with modern advances in technology improving access to medical information worldwide, the readability and quality can be variable.…”