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. 2020 Feb 14;8(2):e14487.
doi: 10.2196/14487.

Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

Kwang Yul Jung #  1   2 , SuJin Kim #  2 , Kihyung Kim  2 , Eun Ju Lee  3 , Kyunga Kim  2   4 , Jeanhyoung Lee  5 , Jong Soo Choi  2   5 , Mira Kang  2   5   6 , Dong Kyung Chang  2   5   7 , Won Chul Cha  2   5   8
Affiliations

Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

Kwang Yul Jung et al. JMIR Mhealth Uhealth. .

Erratum in

Abstract

Background: Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios.

Objective: For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use.

Methods: This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors' log frequencies were obtained from the mobile EMR, and we merged data using doctors' deidentification numbers. Pearson's product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors' mobile EMR usage and the response time to consultation requests.

Results: A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=-0.19; 95% CI -0.32 to -0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors' mobile EMR usage and the response time to consultation requests (coefficient=-0.18; 95% CI -0.30 to -0.04; P=.009).

Conclusions: Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

Keywords: electronic medical record; emergency department; mobile health; time efficiency.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
The specialty consultation process flow and outcome measurement of the study. The primary outcome was a measurement of the interval between consultation request and draft consultation note, while the secondary outcome used the interval between consultation request and response. ED: emergency department; EMR: electronic medical record.
Figure 2
Figure 2
Screenshots of a consultation request made via mobile electronic medical record popup (left, middle) or text message (right).
Figure 3
Figure 3
Flowchart of patient inclusion in the specialty consultation process. ED: emergency department; NA: No information about consultation department.
Figure 4
Figure 4
Median consultation completion interval and log frequency of doctors who used mobile electronic medical records in specialty consultation.
Figure 5
Figure 5
The correlation between consultation completion interval and mobile electronic medical record frequency. EMR: electronic medical record.
Figure 6
Figure 6
The correlation between consultation response interval and mobile electronic medical record frequency. EMR: electronic medical record.
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