TY - JOUR
T1 - Acquisition of patients’ EHR information under ED congestion–an empirical investigation
AU - Ben-Assuli, Ofir
AU - Gefen, David
AU - Shamir, Noam
N1 - Publisher Copyright:
© 2024 The Operational Research Society.
PY - 2024
Y1 - 2024
N2 - We examine the information acquisition process regarding a patient’s status under emergency department (ED) congestion conditions. We focus on two key information channels: 1) Electronic Health Record (EHR) that provide the patient’s medical history and 2) Medical tests conducted in real-time. Whereas the EHR provides the physician with easily accessible information with little delay, real-time medical tests can provide more current information, but are time-consuming. We examine physicians’ decisions in cases of ED congestion, using a dataset that includes more than 1.4 million visits. When congestion is low, the information channels are complementary–acquiring information from the EHR is positively correlated with information acquisition from the medical tests channel, representing an incentive for the physician to acquire all possible information before providing diagnosis. However, as the congestion increases, there is less reliance on medical tests; this effect is amplified when EHR information is used. To avoid excessive congestion, physicians apparently refrain from sending patients for medical tests, and compensate for loss of information using EHR information. The impact of high system workload on the quality of medical service is an essential concern for managers; we show the indirect benefit of investment in EHRs through reduced blood-tests without increasing revisit rates.
AB - We examine the information acquisition process regarding a patient’s status under emergency department (ED) congestion conditions. We focus on two key information channels: 1) Electronic Health Record (EHR) that provide the patient’s medical history and 2) Medical tests conducted in real-time. Whereas the EHR provides the physician with easily accessible information with little delay, real-time medical tests can provide more current information, but are time-consuming. We examine physicians’ decisions in cases of ED congestion, using a dataset that includes more than 1.4 million visits. When congestion is low, the information channels are complementary–acquiring information from the EHR is positively correlated with information acquisition from the medical tests channel, representing an incentive for the physician to acquire all possible information before providing diagnosis. However, as the congestion increases, there is less reliance on medical tests; this effect is amplified when EHR information is used. To avoid excessive congestion, physicians apparently refrain from sending patients for medical tests, and compensate for loss of information using EHR information. The impact of high system workload on the quality of medical service is an essential concern for managers; we show the indirect benefit of investment in EHRs through reduced blood-tests without increasing revisit rates.
KW - congestion
KW - Electronic health records
KW - emergency department
KW - medical tests
UR - http://www.scopus.com/inward/record.url?scp=85213795336&partnerID=8YFLogxK
U2 - 10.1080/20476965.2024.2444954
DO - 10.1080/20476965.2024.2444954
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AN - SCOPUS:85213795336
SN - 2047-6965
JO - Health Systems
JF - Health Systems
ER -