Effect of computerized physician order entry inactivation to order complementary studies in an emergency department
Introduction. The computerized provider order entry (CPOE) is a computing tool that could lead to unintended consequences despite its myriad benefits. We aimed to explore the effect of its inactivation on requests for complementary studies and the associated costs. Methods. Cross sectional study at...
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| Formato: | Artículo revista |
| Lenguaje: | Inglés Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/36760 |
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I10-R327-article-36760 |
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Universidad Nacional de Córdoba |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Inglés Español |
| format |
Artículo revista |
| topic |
medical order entry systems medical informatics health care costs emergency service hospital sistemas de entrada de órdenes médicas informática médica costos de la atención en salud servicio de urgencia en hospital sistemas de registro de ordens médicas informática médica custos de cuidados de saúde serviço hospitalar de emergência |
| spellingShingle |
medical order entry systems medical informatics health care costs emergency service hospital sistemas de entrada de órdenes médicas informática médica costos de la atención en salud servicio de urgencia en hospital sistemas de registro de ordens médicas informática médica custos de cuidados de saúde serviço hospitalar de emergência Muñoz, Agustin Matias Frutos, Eliana Ludmila Pedretti, Ana Soledad Pollan, Javier Alberto Luna, Daniel Roberto Martínez, Bernardo Julio Grande Ratti, María Florencia Effect of computerized physician order entry inactivation to order complementary studies in an emergency department |
| topic_facet |
medical order entry systems medical informatics health care costs emergency service hospital sistemas de entrada de órdenes médicas informática médica costos de la atención en salud servicio de urgencia en hospital sistemas de registro de ordens médicas informática médica custos de cuidados de saúde serviço hospitalar de emergência |
| author |
Muñoz, Agustin Matias Frutos, Eliana Ludmila Pedretti, Ana Soledad Pollan, Javier Alberto Luna, Daniel Roberto Martínez, Bernardo Julio Grande Ratti, María Florencia |
| author_facet |
Muñoz, Agustin Matias Frutos, Eliana Ludmila Pedretti, Ana Soledad Pollan, Javier Alberto Luna, Daniel Roberto Martínez, Bernardo Julio Grande Ratti, María Florencia |
| author_sort |
Muñoz, Agustin Matias |
| title |
Effect of computerized physician order entry inactivation to order complementary studies in an emergency department |
| title_short |
Effect of computerized physician order entry inactivation to order complementary studies in an emergency department |
| title_full |
Effect of computerized physician order entry inactivation to order complementary studies in an emergency department |
| title_fullStr |
Effect of computerized physician order entry inactivation to order complementary studies in an emergency department |
| title_full_unstemmed |
Effect of computerized physician order entry inactivation to order complementary studies in an emergency department |
| title_sort |
effect of computerized physician order entry inactivation to order complementary studies in an emergency department |
| description |
Introduction. The computerized provider order entry (CPOE) is a computing tool that could lead to unintended consequences despite its myriad benefits. We aimed to explore the effect of its inactivation on requests for complementary studies and the associated costs.
Methods. Cross sectional study at the Emergency Department of Hospital Italiano de Buenos Aires, which included a consecutive sample of pre-intervention (January-February 2020) and post-intervention (2021) consultations. Using secondary bases, the variables included were administrative debits and their respective billing prices.
Results. There were 27,671 consultations in 2020 with a total median value of $474, and 20,819 with $1,639 in 2021. After the analysis restricted to the area of moderately complex clinics (excluding COVID-19 consultations), the following was found: a decrease in the median number of practices per consultation (median of 11 vs. 10, p=0.001), a decrease in the request for at least one laboratory practice (45% vs. 39%, p=0.001), without finding significant changes in global costs (median $1,419 vs. $1,081; p=0.122) or in specific laboratory costs (median $1,071 vs. $1,089, p=0.710).
Conclusion. Despite inflation, a significant reduction in the number of practices was achieved and overall costs per consultation were maintained. These findings demonstrate the effectiveness of the intervention, but an educational intervention aimed at reminding the potential harm of overuse and the health costs of unnecessary studies will be necessary. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
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2023 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/36760 |
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I10-R327-article-367602024-04-08T21:22:09Z Effect of computerized physician order entry inactivation to order complementary studies in an emergency department Efecto de la inactivación de las órdenes múltiples para solicitud de estudios complementarios en una central de emergencias Efeito da inativação de entrada de pedidos do médico computadorizado para pedir estudos complementares em um departamento de emergência Muñoz, Agustin Matias Frutos, Eliana Ludmila Pedretti, Ana Soledad Pollan, Javier Alberto Luna, Daniel Roberto Martínez, Bernardo Julio Grande Ratti, María Florencia medical order entry systems medical informatics health care costs emergency service hospital sistemas de entrada de órdenes médicas informática médica costos de la atención en salud servicio de urgencia en hospital sistemas de registro de ordens médicas informática médica custos de cuidados de saúde serviço hospitalar de emergência Introduction. The computerized provider order entry (CPOE) is a computing tool that could lead to unintended consequences despite its myriad benefits. We aimed to explore the effect of its inactivation on requests for complementary studies and the associated costs. Methods. Cross sectional study at the Emergency Department of Hospital Italiano de Buenos Aires, which included a consecutive sample of pre-intervention (January-February 2020) and post-intervention (2021) consultations. Using secondary bases, the variables included were administrative debits and their respective billing prices. Results. There were 27,671 consultations in 2020 with a total median value of $474, and 20,819 with $1,639 in 2021. After the analysis restricted to the area of moderately complex clinics (excluding COVID-19 consultations), the following was found: a decrease in the median number of practices per consultation (median of 11 vs. 10, p=0.001), a decrease in the request for at least one laboratory practice (45% vs. 39%, p=0.001), without finding significant changes in global costs (median $1,419 vs. $1,081; p=0.122) or in specific laboratory costs (median $1,071 vs. $1,089, p=0.710). Conclusion. Despite inflation, a significant reduction in the number of practices was achieved and overall costs per consultation were maintained. These findings demonstrate the effectiveness of the intervention, but an educational intervention aimed at reminding the potential harm of overuse and the health costs of unnecessary studies will be necessary. Introducción. La plantilla de órdenes múltiples es una herramienta informática que podría producir consecuencias inadvertidas pese a sus innumerables beneficios. Nos propusimos explorar el efecto de su inactivación sobre las solicitudes de estudios complementarios y los costos asociados. Métodos. Corte transversal en la Central de Emergencias de Adultos del Hospital Italiano de Buenos Aires, que incluyó muestra consecutiva de consultas pre-intervención (Enero-Febrero 2020) y post-intervención (2021). Mediante el uso de bases secundarias, las variables incluidas fueron los débitos administrativos y sus respectivos precios de facturación. Resultados. Hubo 27.671 consultas en 2020 con una mediana de valor total de 474$, y 20.819 con 1.639$ en 2021. Tras el análisis restringido al área de consultorios de moderada complejidad (excluyendo consultas por COVID-19), se encontró: una disminución en la mediana del número de prácticas por consulta (mediana de 11 vs 10, p=0,001), una disminución en la solicitud de al menos una práctica de laboratorio (45% versus 39%, p=0,001), sin encontrar cambios significativos en costos globales (mediana 1.419$ vs 1.081$; p=0,122) ni en costos específicos de laboratorio (mediana 1.071$ vs 1.089$, p=0,710). Conclusión. Pese a la inflación interanual, se logró una reducción significativa en el número de prácticas y se mantuvieron los costos globales por consulta. Estos hallazgos demuestran la efectividad de la intervención, pero serán necesarias medidas educativas que apunten al recordatorio de los potenciales daños en la sobreutilización, y los costos sanitarios de los estudios innecesarios. Introdução: A entrada computadorizada de pedidos de fornecedores (CPOE) é uma ferramenta de computação que pode levar a consequências não intencionais, apesar de seus inúmeros benefícios. Procurou-se explorar o efeito de sua inativação nas solicitações de estudos complementares e os custos associados. Métodos. Estudo transversal no Serviço de Emergência do Hospital Italiano de Buenos Aires, que incluiu uma amostra consecutiva de consultas pré-intervenção (janeiro-fevereiro 2020) e pós-intervenção (2021). Utilizando bases secundárias, as variáveis incluídas foram débitos administrativos e seus respectivos preços de faturamento. Resultados. Foram 27.671 consultas em 2020 com valor médio total de $ 474, e 20.819 com $ 1.639 em 2021. Após a análise restrita à área de clínicas de complexidade moderada (excluindo consultas de COVID-19), foi constatado o seguinte: o número mediano de consultórios por consulta (mediana de 11 vs. 10, p=0,001), uma diminuição na solicitação de pelo menos um consultório de laboratório (45% vs. 39%, p=0,001), sem encontrar mudanças significativas no custos (mediana $ 1.419 vs. $ 1.081; p=0,122) ou em custos laboratoriais específicos (mediana $ 1.071 vs. $ 1.089, p=0,710). Conclusão. Apesar da inflação homóloga, conseguiu-se uma redução significativa do número de consultórios e mantiveram-se os custos globais por consulta. Esses achados demonstram a eficácia da intervenção, mas será necessária uma intervenção educativa destinada a lembrar os danos potenciais do uso excessivo e os custos de saúde de estudos desnecessários. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-03-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/36760 10.31053/1853.0605.v80.n1.36760 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 No. 1 (2023); 29-35 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 Núm. 1 (2023); 29-35 Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 n. 1 (2023); 29-35 1853-0605 0014-6722 10.31053/1853.0605.v80.n1 eng spa https://revistas.unc.edu.ar/index.php/med/article/view/36760/44854 https://revistas.unc.edu.ar/index.php/med/article/view/36760/41033 https://revistas.unc.edu.ar/index.php/med/article/view/36760/40945 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |