title: A review of the documentation in the British Armed Forces electronic patient record following discharge from the Role 3 Hospital in Camp Bastion.
abstract: BACKGROUND
  The British Role 3 Hospital in Camp Bastion, Afghanistan, uses a different electronic patient record (EPR) to Defence Primary Health Care and the two cannot directly communicate. Consequently, hospital discharge information is transferred by printed letter to primary care, introducing a step where information can be lost. This study was designed to test the hypothesis that the primary care EPR contained an accurate summary of the secondary care admission.
  
  
  METHODS
  Cross-sectional information on consecutive General Internal Medicine patients at the hospital was collected and compared with the primary care EPR.
  
  
  RESULTS
  From April 2011 the hospital records of 270 patients were reviewed. 239 primary care records were available for comparison. Of 185 patients discharged back to their unit the EPR of 43.8% contained a comprehensive summary, 23.2% contained the scanned discharge letter and 50.8% contained an account of their hospital admission but not necessarily a comprehensive summary. Of the 54 patients evacuated to the UK, the EPRs of 48.1% contained a summary, 68.1% contained the scanned discharge letter and 75.9% contained some account of their hospital admission. More of the evacuated group had their admission documented in the primary care EPR (p=0.001). Only 56.5% of all primary care records contained some account of the hospital admission.
  
  
  CONCLUSIONS
  The primary care record is not a reliable record of operational hospital admission and presents an unrecognised potential patient safety issue. The systems responsible for the transfer of discharge summary data need to be appraised to prevent it continuing. Retrospective action should be considered to rectify this problem in former hospital patients.
authors.affiliation: Department of Military Medicine, Royal Centre of Defence Medicine, Birmingham, UK Department of Military Medicine, Royal Centre of Defence Medicine, Birmingham, UK.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Cox
authors.affiliation: Department of Military Medicine, Royal Centre of Defence Medicine, Birmingham, UK.
authors.forename: T
authors.initials: T
authors.lastname: Linton
authors.affiliation: Department of Military Medicine, Royal Centre of Defence Medicine, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Lentaigne
authors.affiliation: Department of Military Medicine, Royal Centre of Defence Medicine, Birmingham, UK.
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Military Medicine, Royal Centre of Defence Medicine, Birmingham, UK.
authors.forename: D
authors.initials: D
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D003430:Cross-Sectional Studies; D004282:Documentation; D057286:Electronic Health Records; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008875:Middle Aged; D008887:Military Medicine; D008889:Military Personnel; D010351:Patient Discharge; D006113:United Kingdom; D055815:Young Adult
keywords: GENERAL MEDICINE (see Internal Medicine); PRIMARY CARE