title: An objective study of the impact of the electronic medical record on outcomes in trauma patients.
abstract: It is commonly believed that the electronic medical record (EMR) will improve patient outcomes. However, there is scant published literature to support this claim and no studies in any surgical population. Our hypothesis was that the EMR would not improve objective outcome measures  in patients with traumatic injury. Prospectively collected data from our university-based Level I trauma center was retrospectively reviewed. Demographic, injury severity as well as outcomes and complications data were compared for all patients admitted over a 20-month period before introduction  of the EMR and a 20-month period after full, hospital-wide use of the EMR. Implementation of the EMR was associated with a decreased hospital length of stay, P = 0.02; intensive care unit length of stay, P = 0.001; ventilator days, P = 0.002; acute respiratory distress  syndrome, P = 0.006, pneumonia, P = 0.008; myocardial infarction, P = 0.001; line infection, P = 0.03; septicemia, P = 0.000; renal failure, P = 0.000; drug complication, P = 0.001; and delay in diagnosis, P = 0.04. There was no difference  in mortality, unexpected cardiac arrest, missed injury, pulmonary embolism/deep vein thrombosis, or late urinary tract infection. This is the first study to investigate the impact of the EMR in surgical patients. Although there was an improvement in some complications, the overall impact was  inconsistent.
authors.affiliation: Division of Trauma Surgery & Surgical Critical Care, Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA. pschenar@pcmh.com
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Schenarts
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Goettler
authors.forename: Michael A
authors.initials: MA
authors.lastname: White
authors.forename: Brett H
authors.initials: BH
authors.lastname: Waibel
mesh_terms: D000328:Adult; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000628:therapy*