Creare valore in sanità attraverso la cartella clinica elettronica: revisione sistematica della letteratura e metanalisi degli studi

Translated title of the contribution: [Autom. eng. transl.] Creating value in healthcare through the electronic medical record: systematic review of the literature and meta-analysis of studies

Maria Lucia Specchia, Gualtiero Ricciardi, Paolo Campanella, Agostino Mancuso, C Marone, L Fallacara, E Lovato

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

[Autom. eng. transl.] INTRODUCTION: The electronic medical record (CCE) is the tool that systematically collects health information on patients and automates the prescription of drugs and diagnostic tests guaranteeing standardized, legible and complete orders. It may also include a decision support system that, through reminders or other actions, helps health professionals in the decision-making process. Although there are several published studies on the effects of the implementation of the EHR, the evidence on this topic is not fully defined. To assess the impact of the ECA on the quality of health care, we therefore carried out a systematic review and meta-analysis of the studies published on this topic. MATERIALS AND METHODS: In order to identify studies assessing the association between the CCE implementation and process or outcome indicators, a search was performed on the PubMed, Web of Knowledge, Scopus and Cochrane Library databases. Two reviewers analyzed the citations identified and extracted the data according to the PRISMA guidelines and for each indicator a meta-analysis was performed using the random-effects model. Heterogeneity was quantified using the Cochran Q test and I2 statistic, while the publication bias was evaluated by the Egger test. RESULTS: Out of 23398 identified citations, 47 articles were included in the analysis. The meta-analysis showed an association between the use of CCE and a reduced documentation time with an average difference of -22.4% (95% CI = -38.8% - 6.0%, p < 0.007). CCE was also associated with greater compliance with the guidelines with an RR of 1.33 (95% CI = 1.01-1.76, p = 0.049) and fewer therapeutic errors with an RR of 0, 46 (95% CI = 0.38-, 55; p <0.001) and adverse drug events with an RR of 0.66 (95% CI = 0.44-0.99, p = 0.045). No association was found with mortality (p = 0.936). The heterogeneity between the studies was high while the presence of publication bias was not highlighted. CONCLUSIONS: The implementation of the CEC can improve the quality of health care by increasing adherence to guidelines and reducing time, medication errors and adverse drug effects. The adoption of this instrument is therefore able to create value in the assistance provided and, as such, it is desirable as a tool of clinical governance within health facilities.
Translated title of the contribution[Autom. eng. transl.] Creating value in healthcare through the electronic medical record: systematic review of the literature and meta-analysis of studies
Original languageItalian
Title of host publicationAtti del 47° Congresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI)-Comunicazioni brevi
Pages80
Number of pages1
Publication statusPublished - 2014
Event47° Congresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI) - Riccione
Duration: 1 Oct 20144 Oct 2014

Conference

Conference47° Congresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI)
CityRiccione
Period1/10/144/10/14

Keywords

  • Electronic Health Record
  • Health Value

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