The influence of EHR components on admission decisions

Medical organizations adopt electronic health record (EHR) and health information exchange (HIE) interoperable technologies in order to provide vital medical information needed for medical decision-making. The use of such interoperable information may lead to increased quality of care and reduced unnecessary costs. The goal of this study was to characterize the specific data components that improve the process of medical decision-making in an emergency department (ED). The outcome measures were the decision to admit/discharge a patient and differences in single-day admission rates with/without using an interoperable EHR. A database containing 3.2 million ED referrals from seven main Israeli hospitals was subjected to log-file analysis. We found that viewing medical history via the interoperable EHR significantly affects admission decisions. The data show a reduction in the number of avoidable single-day admissions, but also an increase in the rate of prolonged admissions. Previous admissions, laboratory tests, imaging and previous surgeries were the most influential information components.