[QR-Code based patient tracking: a cost-effective option to improve patient safety]. / QR-Code Patienten-Tracking: eine kostengünstige Möglichkeit zur Verbesserung der Patientensicherheit.

BACKGROUND: Hospitals are implementing a risk management system to avoid patient or surgery mix-ups. The trend is to use preoperative checklists. This work deals specifically with a type of patient identification, which is realized by storing patient data on a patient-fixed medium. MATERIAL AND METHODS: In 127 ENT surgeries data relevant for patient identification were encrypted in a 2D-QR-Code. The code, as a separate document coming with the patient chart or as a patient wristband, has been decrypted in the OR and the patient data were presented visible for all persons. The decoding time, the compliance of the patient data, as well as the duration of the patient identification was compared with the traditional patient identification by inspection of the patient chart. RESULTS: A total of 125 QR codes were read. The time for the decrypting of QR-Code was 5.6 s, the time for the screen view for patient identification was 7.9 s, and for a comparison group of 75 operations traditional patient identification was 27.3 s. Overall, there were 6 relevant information errors in the two parts of the experiment. This represents a ratio of 0.6% for 8 relevant classes per each encrypted QR code. CONCLUSION: This work allows a cost effective way to technically support patient identification based on electronic patient data. It was shown that the use in the clinical routine is possible. The disadvantage is a potential misinformation from incorrect or missing information in the HIS, or due to changes of the data after the code was created. The QR-code-based patient tracking is seen as a useful complement to the already widely used identification wristband.

[Evaluation of a context sensitive system for intra-operative usage of the electronic patient record]. / Bewertung eines kontextsensitiven Systems zur intraoperativen Nutzung der E-Patientenakte.

This article analyzes the usage of an electronic patient record (EPR), which may be accessed intra-operatively by the surgeon. The focus lies on the automatic prioritization of documents to dramatically reduce the surgeon's interaction with the EPR system. An EPR system has been developed, which displays documents in accordance to the current procedure. The system is controlled by a foot switch and the documents are displayed on a large-scale screen in the operating room. The usage of the system by 2 surgeons has been recorded in clinical routine. 55 surgical procedures have been recorded. The EPR system has been used 2 times per procedure in average for surgeries at the middle ear, for surgeries of the paranasal sinuses, it has been used 1.3 times per procedure. The EPR-system has been used pre-operatively in 58% of cases. The surgeons did not have to interact with the EPR system for more than the half of the procedures to view the desired document. The existence of digitized documents in a clinic does not automatically lead to improved workflows. The evaluated EPR system presented the patient data in a simple and comfortable way. The extensive pre-operative usage had not been expected. Because of the low barrier to view patient data, higher patient safety may be assumed. On the other hand, the surgeon could be encouraged to skip the important preparation before the procedure. Due to the low pervasiveness of medical communication standards at this time, the integrated connection between clinic IT and an EPR system would nowadays only be possible by great efforts.

[Intraoperative use of electronic patient records by the surgeon. An evaluation of the "MI Report" in ENT surgery]. / Intraoperative Bedienung einer elektronischen Patientenakte durch den Operateur. Einsatzbeurteilung des MI-Reports in der HNO-Chirurgie.

MOTIVATION: Surgeons often wish to view patient data during surgical procedures. To achieve this, the surgeon normally has to get unsterile to view the record himself, or request a nurse to do so. This procedure results in a time delay, longer anesthesia and higher treatment costs. MATERIAL AND METHODS: The "MI Report" (Karl Storz, Tuttlingen, Germany) was evaluated for its impact in ENT surgery in daily routine. The system consists of a sensor for gesture recognition and a large 52-in. display positioned centrally in the operating room. Usage of the system by the surgeon was recorded in 51 surgical procedures. RESULTS: Information was retrieved from the display on average 1.2 times per procedure. The system was not used at all in 20% of operations. The operation with the highest usage rate was tympanoplasty (1.6 views per operation). In 86% of cases, the system was used to confirm the therapy underway or make a decision on how to proceed with therapy. When trying to activate the system by making a particular hand gesture, the surgeon cancelled activation in 31% of attempts. CONCLUSION: A relation between the type of operation and information viewed could be shown. A benefit for the patient may be assumed on the basis of the reduced effort required to retrieve patient data as well as increased intraoperative consultation of patient records. The system provides the surgeon with greater flexibility and may reduce operating time.