title: Use of mobile tablet devices and reduction in time to perioperative transesophageal echocardiography reporting: a historical cohort study.
abstract: OBJECTIVE
  Timely communication of intraoperative transesophageal echocardiography (TEE) findings to the postoperative care team is critical to optimizing patient care. We compared the use of a personal computer (PC) system with the use of a mobile tablet device (MTD) system for point-of-care TEE data entry and hypothesized that the MTD-based system would reduce the time to preliminary TEE reporting and decrease the incidence of delinquent reporting by 50%.
  
  
  METHODS
  In this historical cohort study, we reviewed 508 perioperative TEE reports entered by cardiothoracic anesthesia fellows. Reports were grouped based on whether data were entered on a PC (PC group) or a MTD (MTD group). Time to TEE reporting was defined as the time from the patient leaving the operating room to the time the TEE report was generated. Delinquent reports were defined as those generated >24 hr after the initial exam. Time to TEE reporting and incidence of delinquent reports were compared between the two groups.
  
  
  RESULTS
  Mean (SD) time to TEE reporting was significantly improved with MTD data entry vs PC data entry [233 (676) min vs 1,103 (3,830) min, respectively; mean difference 870 min; 95% confidence interval (CI) 293 to 1,448; P = 0.003], and median (IQR) time was also significantly improved [46 (163) min vs 126 (1,000) min, respectively; median difference 80 min; P = 0.0002]. The incidence of report delinquency with MTD data entry vs PC data entry was also significantly reduced [2.1% vs 6.8%, respectively; mean difference 2.2%; 95% CI 0.5 to 9.0; P = 0.02].
  
  
  CONCLUSIONS
  Implementation of a MTD system for data entry leads to improved TEE reporting time and reduces TEE reporting delinquency. Further studies are required to determine whether this strategy enhances quality of reporting, optimizes communication between care teams, and improves outcomes without increasing costs.
authors.affiliation: Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Box 3094 DUMC, Durham, NC, 27710, USA, brandi.bottiger@dm.duke.edu.
authors.forename: Brandi
authors.initials: B
authors.lastname: Bottiger
authors.forename: Sharon
authors.initials: S
authors.lastname: McCartney
authors.forename: Igor
authors.initials: I
authors.lastname: Akushevich
authors.forename: Alina
authors.initials: A
authors.lastname: Nicoara
authors.forename: Mamata
authors.initials: M
authors.lastname: Yanamadala
authors.forename: Madhav
authors.initials: M
authors.lastname: Swaminathan
mesh_terms: D015331:Cohort Studies; D003142:Communication; D034201:Computers, Handheld; D017548:Echocardiography, Transesophageal / Q000379:methods*; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D010348:Patient Care Team / Q000458:organization & administration; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors