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Electronic Medical Record Reporting Enhances Proactive Psychiatric Consultation

机译：电子医疗记录报告增强了积极主动精神咨询

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Background: Numerous studies have demonstrated that psychiatric and substance use issues in general hospital inpatients result in increased length of stay and associated costs. Additional studies have demonstrated that proactive consultation models in psychiatry can effectively address these problems. Selecting patients for proactive interventions is less well studied. Objective: We sought to develop an automated, electronic medical record-based screening tool to select patients who might benefit from proactive psychiatric consultation. Methods: An automated daily report was developed using information stored in electronic medical record and billing systems. Discrete data fields populating the report included diagnoses, orders, and nursing care plans. Results: Over a 9-month period, the report identified 2177 patients (19% of the total nonpsychiatric adult admissions) as potentially benefitting from proactive psychiatric interventions. Of these, 367 were confirmed as likely to benefit from intervention; 139 (38%) were randomized to the proactive psychiatric consultation group. Of those patients randomized to "treatment as usual," a subset later required psychiatric consultation, which was requested an average of 4 days after the time they were flagged by the report. Conclusions: The use of an electronic medical record-based automated report is feasible to select patients for proactive psychiatric interventions on admission and throughout the hospital stay. Early identification of patients may decrease length of stay and improve patient outcomes.
机译：背景：众多研究表明，一般医院住院患者的精神病和物质使用问题导致了增加的住宿时间和相关成本。另外的研究表明，精神病学中的主动咨询模型可以有效解决这些问题。选择患者的主动干预措施较少。目的：我们试图开发一个自动化的电子医疗记录的筛选工具，以选择可能受益于主动精神咨询的患者。方法：使用存储在电子医疗记录和计费系统中的信息开发了自动日报。填充报告的离散数据字段包括诊断，订单和护理计划。结果：在9个月内，报告确定了2177名患者（占总精神学成人入学总数的19％），可能受益于积极的精神病学干预措施。其中，367人被证实，可能受益于干预; 139（38％）被随机分为主动精神咨询组。在那些患者随机化为“像往常一样”的患者，稍后需要精神病学咨询，该咨询平均4天在报告中预计后4天。结论：使用基于电子医疗记录的自动报告是可行的，可在入院和整个住院入住的患者中选择患者。早期鉴定患者可能会降低入住时间和改善患者结果。

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