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Emergency Department Access to a Longitudinal Medical Record

^a Department of Biomedical Informatics, Columbia University, New York, NY
^b Department of Emergency Medicine, NewYork-Presbyterian Hospital & Columbia University, New York, NY.

^_* Correspondence and reprints: George Hripcsak, MD, MS, 622 W 168 Street, VC5, New York, NY 10032. (Email: hripcsak{at}columbia.edu).

Received for publication: 07/12/06; accepted for publication: 12/12/06.

Our goal is to assess how clinical information from previous visits is used in the emergency department. We used detailed user audit logs to measure access to different data types. We found that clinician-authored notes and laboratory and radiology data were used most often (common data types were used up to 5% to 20% of the time). Data were accessed less than half the time (up to 20% to 50%) even when the user was alerted to the presence of data. Our access rate indicates that health information exchange projects should be conservative in estimating how often shared data will be used and the wide breadth of data accessed indicates that although a clinical summary is likely to be useful, an ideal solution will supply a broad variety of data.

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