title: Design and evaluation of a wireless electronic health records system for field care in mass casualty settings.
abstract: BACKGROUND
  There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD).
  
  
  METHODS
  WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds.
  
  
  RESULTS
  WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, p<0.001). The total time of the field was nearly identical (38:20 vs 38:23, IQR 26:53-1:05:32 vs 18:55-57:22).
  
  
  CONCLUSIONS
  Overall, the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters.
authors.affiliation: Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA. leslie.lenert@hsc.utah.edu
authors.forename: L A
authors.initials: LA
authors.lastname: Lenert
authors.forename: D
authors.initials: D
authors.lastname: Kirsh
authors.forename: W G
authors.initials: WG
authors.lastname: Griswold
authors.forename: C
authors.initials: C
authors.lastname: Buono
authors.forename: J
authors.initials: J
authors.lastname: Lyon
authors.forename: R
authors.initials: R
authors.lastname: Rao
authors.forename: T C
authors.initials: TC
authors.lastname: Chan
mesh_terms: D057286:Electronic Health Records; D004631:Emergency Medical Service Communication Systems; D006801:Humans; D016247:Information Storage and Retrieval; D054527:Mass Casualty Incidents; D012984:Software; D013997:Time Factors; D059015:Wireless Technology