title: Effect of introduction of a new electronic anesthesia record (Epic) system on the safety and efficiency of patient care in a gastrointestinal endoscopy suite-comparison with historical cohort.
abstract: BACKGROUND
  Use of electronic medical record systems has increased in the recent years. Epic is one such system gaining popularity in the USA. Epic is a private company, which invented the electronic documentation system adopted in our hospital. In spite of many presumed advantages, its use is not critically analyzed. Some of the perceived advantages are increased efficiency and protection against litigation as a result of accurate documentation.
  
  
  METHODS
  In this study, retrospective data of 305 patients who underwent endoscopic retrograde cholangiopancreatography (wherein electronic charting was used - "Epic group") were compared with 288 patients who underwent the same procedure with documentation saved on a paper chart ("paper group"). Time of various events involved in the procedure such as anesthesia start, endoscope insertion, endoscope removal, and transfer to the postanesthesia care unit were routinely documented. From this data, the various time durations were calculated.
  
  
  RESULTS
  Both "anesthesia start to scope insertion" times and "scope removal to transfer" times were significantly less in the Epic group compared to the paper group. Use of Epic system led to a saving of 4 min of procedure time per patient. However, the mean oxygen saturation was significantly less in the Epic group.
  
  
  CONCLUSIONS
  In spite of perceived advantages of Epic documentation system, significant hurdles remain with its use. Although the system allows seamless flow of patients, failure to remove all artifacts can lead to errors and become a source of potential litigation hazard.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, USA.
authors.forename: B
authors.initials: B
authors.lastname: Goudra
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, All India Institutes of Medical Sciences, New Delhi, India.
authors.forename: P M
authors.initials: PM
authors.lastname: Singh
authors.affiliation: Department of Anesthesia, All India Institutes of Medical Sciences, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Borle
authors.affiliation: Department of Biological Sciences, Drexel University, Philadelphia, PA 19104, USA.
authors.forename: G
authors.initials: G
authors.lastname: Gouda
keywords: Anesthesia documentation; Epic; electronic medical documentation; endoscopic retrograde cholangiopancreatography