Using Electronic Medical Records to Identify Enhanced Recovery After Surgery Cases

EGEMS
Nikki L B FreemanPeter J Leese

Abstract

Enhanced recovery after surgery (ERAS) aims to improve surgical outcomes by integrating evidence-based practices across preoperative, intraoperative, and postoperative care. Data in electronic medical records (EMRs) provide insight on how ERAS is implemented and its impact on surgical outcomes. Because ERAS is a multimodal pathway provided by multiple physicians and health care providers over time, identifying ERAS cases in EMRs is not a trivial task. To better understand how EMRs can be used to study ERAS, we describe our experience with using current methodologies and the development and rationale of a new method for retrospectively identifying ERAS cases in EMRs. Using EMR data from surgical departments at the University of North Carolina at Chapel Hill, we first identified ERAS cases using a protocol-based method, using basic information including the date of ERAS implementation, surgical procedure and date, and primary surgeon. We further examined two operational flags in the EMRs, a nursing order and a case request for OR order. Wide variation between the methods compelled us to consult with ERAS surgical staff and explore the EMRs to develop a more refined method for identifying ERAS cases. We developed a two-step method...Continue Reading

References

May 1, 1997·British Journal of Anaesthesia·H Kehlet
Jun 9, 2016·Obstetrics and Gynecology·Jocelyn S ChapmanLee-May Chen
Jan 18, 2017·JAMA Surgery·Olle LjungqvistKenneth C Fearon
Mar 14, 2018·The Annals of Thoracic Surgery·Robert M Van HarenDavid C Rice
Jul 12, 2018·Diseases of the Colon and Rectum·Taryn E HassingerTraci L Hedrick

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