Monday, October 26, 2015

Dilemma of Accurate Data Collection

In the article How your hospital can make you sick, Consumer Reports paints a pretty negative picture of hospital acquired infections.  The data is disturbing, but without context can lead to reaching conclusions and action plans that may or may not work.

The electronic health record contains endless amounts of information, but may or may not provide the precise data researchers seek in an easily accessible form.  Optimally, the EHR collects the data automatically, without need for provider input.  However all too frequently, data is incomplete or inappropriately classified; unless an answer to a specifically requested question is input, the data may become difficult to retrieve.

Most commonly the providers do not know the questions that are needed, and do not therefore record whether they have or not done performed some action.  A good example is not recording that the patient is a MRSA carrier who then leaves the hospital with MRSA cellulitis and dehydration.  Did the patient acquire the infection prior to entering the institution or after hospital exposure?

An EHR can be used as a tool to capture this data.  The providers must know the questions and the  organization must create buy-in to collect the data.  There are various methods.  The easiest is a checklist prior to discharge that answers the questions easily with the ability to provide context.  This context can explain a behavior that may seem inappropriate.  Moreover, it can be entered into the EHR by a non-provider at a latter time.

The bottom line is the EHR can be formatted to help the clinicians answer the tough questions.  This may help various institutions avoid the dreaded headlines in the morning paper(if anyone still reads it).

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