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Mapping of Clinical Outcome Improvements in a Trauma Intensive Care Unit after Introduction of an EHR System Smartphone Intervention
With growing attention in the U.S. healthcare system on quality of care, many recent technology interventions are focused on improving clinical outcomes. This paper describes the retrospective capture of a trauma intensive care unit’s (TICU’s) clinical outcomes over the span of three and a half years. The study period included a baseline capture of clinical outcomes at Ryder Trauma Center’s ICU as well as two iterations of an smartphone based EHR system designed to improve care quality in the TICU. This intervention is an innovative smartphone based EHR application that permits clinicians to document and reference medical records directly from their mobile phone.
Methods
Data on clinical variables was collected retrospectively from de-identified medical records at three time periods from 2010-2014: pre-intervention (Period 1) and two subsequent iterations of a smartphone based EHR system (Period 2 and 3). All records were drawn from the Ryder Trauma Center of Jackson Memorial Hospital.
Results/Outcomes
Period 1, the time range without intervention, showed a TICU length of stay (LOS) of 12.71 days, TICU Mortality rate of 8%, Readmission Rate of 5% and Post-TICU Mortality of 1%. The second period, which represents the introduction of the first iteration of the smartphone intervention, showed little change except for a slight increase in TICU LOS to 12.89 days. Period 3, which marked the introduction of the second iteration of the smartphone intervention, showed a decrease of TICU LOS to 10.98 days and a TICU Mortality rate of 6%, Readmission Rate of 3%, and Post-TICU Mortality of 0%.
Conclusions
Notable benefits in clinical outcomes were exhibited for TICU LOS, mortality rate, readmission rate, and post-TICU mortality rates following the implementation of the intervention. Average length of stay decreased by 1.73 days from the pre-intervention period to Period 3. TICU Mortality rates decreased by 2% over the same study period. Readmission rates decreased by 2% over the study period, and post-TICU mortality decreased by 1% over the study period. These represent significant benefits in clinical outcomes and indicate an improvement in care over time. This study encourages further investigation of this intervention’s impact on quality of care.
Learning Areas:
Administration, management, leadershipConduct evaluation related to programs, research, and other areas of practice
Epidemiology
Learning Objectives:
Discuss the clinical outcomes of a Trauma Intensive Care Unit (TICU) through a retrospective capture of patient health outcomes over three and a half years.
Compare the readmission and mortality rates before and after the implementation of a smartphone based EHR system in the TICU.
Keyword(s): Hospitals, Telehealth
Qualified on the content I am responsible for because: I am currently the manager of innovations research of HITLAB (Healthcare Innovation and Technology Lab) and I lead the mHealth and digital health research efforts. My background includes experience in qualitative research, strategic consulting, and a Masterâs in Public Health from Boston University.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.