Hospital blames EHR for doubled ED wait times

Patient wait and treatment times doubled at an Indiana emergency department during the hospital's recent transition to electronic health records, highlighting the challenges of training medical staff on new health IT systems.

The time acute-care patients spent in the emergency department at the Columbus (Ind.) Regional Hospital jumped from 2 hours 32 minutes to 4 hours 13 minutes the first week of the implementation in late June, the hospital's nursing director told The Republic newspaper.

Patients with less severe conditions spent 4 hours 41 minutes in the ED, up from 2 hours 25 minutes. Those with life-threatening conditions continued to be seen immediately, hospital officials said.

"When you are writing on a piece of paper that you've used for as long as you have been here, you can do it quickly. When you move to electronic, the staff had to be very careful to make sure they did things accurately," nursing director Carolyn O'Neal told the newspaper.

Average patient stays since have dropped to 3 hours 10 minutes for acute-care patients and 2 hours 39 minutes for others, according to the report. The hospital is adding staff to try to return to pre-EHR times, O'Neal said.

"We don't like the waits, the physicians don't like it, the patients don't like it," she said.

Meanwhile, the medical staff is examining the EHR and its work processes to see whether the problems run deeper than lack of familiarity with the new electronic records system, the hospital's information services director, Ron Latta, told the paper.

A 2010 study by researchers at Arizona State University found that the length of stay at emergency departments with robust EHRs was 22.4 percent lower than at those with basic or no EHR. The diagnosis and treatment time was 13.1 percent lower, according to the study, "Electronic Medical Records and the Efficiency of Hospital Emergency Departments."

EDs with basic EHRs were no more efficient on average than those with no EHR, the study found. The findings were reported in the journal Medical Care Research and Review, and based on a review of the 2006 National Hospital Ambulatory Medical Care Survey.

Meanwhile, HealthAlliance of the Hudson Valley last year reported that 87 percent of its ED patients were seen within 30 minutes of check-in, following implementation of a comprehensive EHR, up from 47 percent before the implementation. The previous average wait time had been 47 minutes, emergency services administrator Stuart Hirsch wrote in Hospital Impact.

Hirsch did not discuss how patient stays were affected at the beginning of the EHR transition.

To learn more:
- read the newspaper account
- see the ASU study abstract
- check out the column in Hospital Impact