title: Outcomes of effective transmission of electronic prenatal records from the office to the hospital.
abstract: OBJECTIVE
  To investigate the outcomes associated with improved transmission of prenatal test results between the outpatient and inpatient obstetric setting after implementation of an electronic prenatal record system.
  
  
  METHODS
  Admission paper charts of patients admitted to our labor and delivery unit were reviewed before and after implementation of an electronic prenatal record system. The availability of maternal hepatitis B and human immunodeficiency virus (HIV) serology on admission, the occurrence of repeat hepatitis B surface antigen and rapid HIV blood testing, and the occurrence of hepatitis B immunoglobulin administration to the newborns of mothers without available hepatitis B serology was recorded. Fisher's exact tests were performed to determine differences in availability of prenatal test results, the occurrence of repeat blood testing, and the occurrence of immunoglobulin administration before and after implementation.
  
  
  RESULTS
  A total of 460 admission charts were reviewed, 229 preimplementation and 231 postimplementation. Of the preimplementation charts, 78.2% contained maternal hepatitis B and HIV serology results, whereas all postimplementation charts contained such results (P<.001). Although repeat hepatitis B surface antigen testing was performed in 3.1% of patients preimplementation, no patients required repeat testing postimplementation (P=.007). Similarly, rapid HIV blood testing was performed in 3.5% of patients preimplementation, but no patients required repeat testing postimplementation (P=.003). Increased availability of testing results prevented unnecessary administration of hepatitis B immunoglobulin postimplementation.
  
  
  CONCLUSIONS
  Implementation of an electronic perinatal record system was associated with improved transmission of prenatal test results between the outpatient and inpatient obstetric setting and a decreased rate of unnecessary maternal testing and newborn interventions.
  
  
  METHODS
  III.
authors.affiliation: Departments of Obstetrics and Gynecology, Dublin Center, Palo Alto Medical Foundation, Dublin, California, Drexel University College of Medicine, Philadelphia, Pennsylvania, and Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Nancy
authors.initials: N
authors.lastname: Pham-Thomas
authors.forename: Nigel
authors.initials: N
authors.lastname: Pereira
authors.forename: Anna M
authors.initials: AM
authors.lastname: Powell
authors.forename: Damien J
authors.initials: DJ
authors.lastname: Croft
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Guilfoil
authors.forename: Owen C
authors.initials: OC
authors.lastname: Montgomery
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D057286:Electronic Health Records; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D006679:HIV Seropositivity / Q000175:diagnosis; D006509:Hepatitis B / Q000175:diagnosis; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006760:Hospitalization; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D033181:Information Dissemination; D011247:Pregnancy; D011295:Prenatal Care; D012189:Retrospective Studies; D012698:Serologic Tests / Q000706:statistics & numerical data*; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D015483:HIV Antibodies; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D007136:Immunoglobulins