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Implementation of an electronic health record system during global surgical outreach: A prospective evaluation of success and sustainability.
Gatto, Andrew P; Atkin, David; Tapia, Juan Claude; Lowenberg, Michelle; Kamal, Robin N; Shapiro, Lauren M.
Afiliação
  • Gatto AP; College of Osteopathic Medicine, Touro University California, Vallejo, California, USA.
  • Atkin D; Operation Rainbow, Oakland, California, USA.
  • Tapia JC; Vicente Corral Hospital, University of Cuenca, Cuenca, Azuay, Ecuador.
  • Lowenberg M; Operation Rainbow, Oakland, California, USA.
  • Kamal RN; Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University, Redwood City, California, USA.
  • Shapiro LM; Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, California, USA.
World J Surg ; 48(7): 1593-1601, 2024 Jul.
Article em En | MEDLINE | ID: mdl-38730536
ABSTRACT

BACKGROUND:

The burden of musculoskeletal conditions continues to grow in low- and middle-income countries. Among thousands of surgical outreach trips each year, few organizations electronically track patient data to inform real-time care decisions and assess trip impact. We report the implementation of an electronic health record (EHR) system utilized at point of care during an orthopedic surgical outreach trip.

METHODS:

In March 2023, we implemented an EHR on an orthopedic outreach trip to guide real-time care decisions. We utilized an effectiveness-implementation hybrid type 3 design to evaluate implementation success. Success was measured using outcomes adopted by the World Health Organization, including acceptability, appropriateness, feasibility, adoption, fidelity, and sustainability. Clinical outcome measures included adherence to essential quality measures and follow-up numerical rating system (NRS) pain scores.

RESULTS:

During the 5-day outreach trip, 76 patients were evaluated, 25 of which underwent surgery beforehand. The EHR implementation was successful as defined by mean questionnaire ratings of acceptability (4.26), appropriateness (4.12), feasibility (4.19), and adoption (4.33) at least 4.00, WHO behaviorally anchored rating scale ratings of fidelity (6.8) at least 5.00, and sustainability (80%) at least 60% follow-up at 6 months. All clinical quality measures were reported in greater than 80% of cases with all measures reported in 92% of cases. NRS pain scores improved by an average of 2.4 points.

CONCLUSIONS:

We demonstrate successful implementation of an EHR for real-time clinical use on a surgical outreach trip. Benefits of EHR utilization on surgical outreach trips may include improved documentation, minimization of medical errors, and ultimately improved quality of care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Registros Eletrônicos de Saúde Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Registros Eletrônicos de Saúde Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article