Antiquated paperwork processes in hospitals: the problems and solutions with health information technology systems

BACKGROUND. The United States healthcare system is one of the most expensive in the world, equaling approximately one trillion dollars. However, the quality of healthcare is low, as indicated by mortality rates, prevalence of diseases, rates of readmission to hospitals, dissatisfaction rates, and much more. One of the inefficiencies in the healthcare system that is causing errors and a decline in patient care to occur is the current paperwork system. Physicians and nurses spend much more time taking care of patient paperwork rather than giving direct treatment to patients themselves, and it's been shown that patient dissatisfaction levels rise and errors occur more frequently as a result of current physician/nurse workload. In order to change from paperwork to electronic files, hospitals must invest the time and money to look for alternative mechanisms that would decrease turn-around time of paperwork completion by leveraging digital solutions. A study was carried out to observe log back of paperwork by counting the amount of papers for each physician before and after an electronic email message intervention. RESULTS. The results were as expected: a simple email message did not drastically affect the amount of paperwork back log by residents, and numbers stayed consistent throughout. More than 50% of patient paperwork for residents in year 1 and 3 was more than 28 days old, which signifies the lack of paperwork availability and accessibility to the residents while off-site. CONCLUSION. Addressing the problem of paperwork burden to residents requires alternative solutions that include changing the entire paperwork system to a paperless, electronic system. Other solutions that require less effort, time and cost are possible, such as an email reminder as was done in this study, but will most likely not be as effective as switching to a paperless system that allows for physician-patient communication on a more consistent basis even though they may be off site. These changes would significantly improve quality of patient care as well as decrease administrative costs and waste

Automating Electronic Health Record Data Quality Assessment

Information systems such as Electronic Health Record (EHR) systems are susceptible to data quality (DQ) issues. Given the growing importance of EHR data, there is an increasing demand for strategies and tools to help ensure that available data are fit for use. However, developing reliable data quality assessment (DQA) tools necessary for guiding and evaluating improvement efforts has remained a fundamental challenge. This review examines the state of research on operationalising EHR DQA, mainly automated tooling, and highlights necessary considerations for future implementations. We reviewed 1841 articles from PubMed, Web of Science, and Scopus published between 2011 and 2021. 23 DQA programs deployed in real-world settings to assess EHR data quality (n = 14), and a few experimental prototypes (n = 9), were identified. Many of these programs investigate completeness (n = 15) and value conformance (n = 12) quality dimensions and are backed by knowledge items gathered from domain experts (n = 9), literature reviews and existing DQ measurements (n = 3). A few DQA programs also explore the feasibility of using data-driven techniques to assess EHR data quality automatically. Overall, the automation of EHR DQA is gaining traction, but current efforts are fragmented and not backed by relevant theory. Existing programs also vary in scope, type of data supported, and how measurements are sourced. There is a need to standardise programs for assessing EHR data quality, as current evidence suggests their quality may be unknown