Review of information technology for surgical patient care

Jamie R Robinson; Hannah Huth; Gretchen P Jackson

doi:10.1016/j.jss.2016.03.053

Review of information technology for surgical patient care

J Surg Res. 2016 Jun 1;203(1):121-39. doi: 10.1016/j.jss.2016.03.053. Epub 2016 Mar 29.

Authors

Jamie R Robinson¹, Hannah Huth², Gretchen P Jackson³

Affiliations

¹ Department of Pediatric Surgery, Vanderbilt Children's Medical Center, Nashville, Tennessee; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: jamie.r.robinson@vanderbilt.edu.
² Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.
³ Department of Pediatric Surgery, Vanderbilt Children's Medical Center, Nashville, Tennessee; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.

Abstract

Background: Electronic health records (EHRs), computerized provider order entry (CPOE), and patient portals have experienced increased adoption by health care 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, nonsurvey 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: A total of 2890 citations were identified. Of them, 32 observational studies and two randomized controlled trials met eligibility criteria. EHR or CPOE improved appropriate antibiotic administration for surgical procedures in 13 comparative observational studies. Five comparative observational studies indicated that 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 inperson outpatient surgical encounters.

Conclusions: 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.

Keywords: Computerized provider order entry; Electronic medical record; Electronic operative note; Health information technology; Internet; Patient portal.

Publication types

Review
Research Support, N.I.H., Extramural

MeSH terms

Consumer Health Information*
Electronic Health Records*
Humans
Internet*
Medical Order Entry Systems*
Patient Acceptance of Health Care
Perioperative Care*

Abstract

Publication types

MeSH terms

Grants and funding