Building a framework for the ideal emergency department electronic health record. (Preprint)

UNSTRUCTURED Electronic Health Records (EHRs) have long been touted as a revolutionary step in healthcare by allowing for structured data entry and improved access to information. As the applications of EHRs become more advanced, healthcare providers and other stakeholders seek to leverage these platforms to improve patient outcomes and clinical workflow. Despite the potential of EHRs, evidence suggests that there is a large discrepancy between the potential and empirically demonstrated benefits of EHR systems. The emergency department (ED) provides a rich environment through which to critically examine EHR systems by virtue of its unique challenges: the case load is a mix of high acuity, high complexity presentations as well as a high volume of ambulatory patients, and each care journey can involve multiple care transitions. Moreover, there is a need for a high degree of situational awareness and emphasis on patient safety while balancing departmental flow. For these reasons, there is a growing reliance on digital health solutions and integrated clinical support tools. Additionally, as the gateway into the hospital, it is important that the system needs of an ED are captured in literature. This paper seeks to identify key areas for optimization in EHRs and suggest improvements.