J Emerg Med
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Observational Study
Observational Study and Estimate of Cost Savings from Use of a Health Information Exchange in an Academic Emergency Department.
Federal initiatives to improve health care information sharing have led to the development of a new type of regional electronic medical record known as a health information exchange (HIE). ⋯ According to clinician estimates, use of an HIE in this urban academic ED resulted in reduced use of hospital resources, noteworthy cost savings, decreased LOS, and improved quality of care. Limitations included the observational nature of the study, selection bias, the Hawthorne effect, and cost estimates being from a single institution. Allowance was not made for additional services used because of information obtained from the HIE.
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To measure emergency department (ED) crowding, the emergency department occupancy ratio (EDOR) was introduced. ⋯ The EDOR is associated with increased 1- to 3-day mortality even after controlling for potential confounders.
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Clinical outcomes in ST-segment elevation myocardial infarction (STEMI) are related to reperfusion times. Given the benefit of early recognition of STEMI and resulting ability to decrease reperfusion times and improve mortality, current prehospital recommendations are to obtain electrocardiograms (ECGs) in patients with concern for acute coronary syndrome. ⋯ Prehospital STEMI identification allows for prompt catheterization laboratory activation, leading to decreased reperfusion times.