Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review

Objectives Review available evidence for impact of electronic health records (EHRs) on predefined patient safety outcomes in interventional studies to identify gaps in current knowledge and design interventions for future research.Design Scoping review to map existing evidence and identify gaps for...

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Autores principales:	paul Barach, Christian Peter Subbe, Genevieve Tellier
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/4e1f582f72a34f749267beb89273abb9
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spelling	oai:doaj.org-article:4e1f582f72a34f749267beb89273abb92021-11-12T00:30:07ZImpact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review10.1136/bmjopen-2020-0474462044-6055https://doaj.org/article/4e1f582f72a34f749267beb89273abb92021-01-01T00:00:00Zhttps://bmjopen.bmj.com/content/11/1/e047446.fullhttps://doaj.org/toc/2044-6055Objectives Review available evidence for impact of electronic health records (EHRs) on predefined patient safety outcomes in interventional studies to identify gaps in current knowledge and design interventions for future research.Design Scoping review to map existing evidence and identify gaps for future research.Data sources PubMed, the Cochrane Library, EMBASE, Trial registers.Study selection Eligibility criteria: We conducted a scoping review of bibliographic databases and the grey literature of randomised and non-randomised trials describing interventions targeting a list of fourteen predefined areas of safety. The search was limited to manuscripts published between January 2008 and December 2018 of studies in adult inpatient settings and complemented by a targeted search for studies using a sample of EHR vendors. Studies were categorised according to methodology, intervention characteristics and safety outcome.Results from identified studies were grouped around common themes of safety measures.Results The search yielded 583 articles of which 24 articles were included. The identified studies were largely from US academic medical centres, heterogeneous in study conduct, definitions, treatment protocols and study outcome reporting. Of the 24 included studies effective safety themes included medication reconciliation, decision support for prescribing medications, communication between teams, infection prevention and measures of EHR-specific harm. Heterogeneity of the interventions and study characteristics precluded a systematic meta-analysis. Most studies reported process measures and not patient-level safety outcomes: We found no or limited evidence in 13 of 14 predefined safety areas, with good evidence limited to medication safety.Conclusions Published evidence for EHR impact on safety outcomes from interventional studies is limited and does not permit firm conclusions regarding the full safety impact of EHRs or support recommendations about ideal design features. The review highlights the need for greater transparency in quality assurance of existing EHRs and further research into suitable metrics and study designs.paul BarachChristian Peter SubbeGenevieve TellierBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 11, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R paul Barach Christian Peter Subbe Genevieve Tellier Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review
description	Objectives Review available evidence for impact of electronic health records (EHRs) on predefined patient safety outcomes in interventional studies to identify gaps in current knowledge and design interventions for future research.Design Scoping review to map existing evidence and identify gaps for future research.Data sources PubMed, the Cochrane Library, EMBASE, Trial registers.Study selection Eligibility criteria: We conducted a scoping review of bibliographic databases and the grey literature of randomised and non-randomised trials describing interventions targeting a list of fourteen predefined areas of safety. The search was limited to manuscripts published between January 2008 and December 2018 of studies in adult inpatient settings and complemented by a targeted search for studies using a sample of EHR vendors. Studies were categorised according to methodology, intervention characteristics and safety outcome.Results from identified studies were grouped around common themes of safety measures.Results The search yielded 583 articles of which 24 articles were included. The identified studies were largely from US academic medical centres, heterogeneous in study conduct, definitions, treatment protocols and study outcome reporting. Of the 24 included studies effective safety themes included medication reconciliation, decision support for prescribing medications, communication between teams, infection prevention and measures of EHR-specific harm. Heterogeneity of the interventions and study characteristics precluded a systematic meta-analysis. Most studies reported process measures and not patient-level safety outcomes: We found no or limited evidence in 13 of 14 predefined safety areas, with good evidence limited to medication safety.Conclusions Published evidence for EHR impact on safety outcomes from interventional studies is limited and does not permit firm conclusions regarding the full safety impact of EHRs or support recommendations about ideal design features. The review highlights the need for greater transparency in quality assurance of existing EHRs and further research into suitable metrics and study designs.
format	article
author	paul Barach Christian Peter Subbe Genevieve Tellier
author_facet	paul Barach Christian Peter Subbe Genevieve Tellier
author_sort	paul Barach
title	Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review
title_short	Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review
title_full	Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review
title_fullStr	Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review
title_full_unstemmed	Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review
title_sort	impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/4e1f582f72a34f749267beb89273abb9
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Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review

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