Information resource management in emergency room medicine: A case study

The emergency room is one of the fastest-paced, intense places a person can find. Because many of the cases in the ER involve life-or-death decisions, accurate data in a useful format is critical for immediate access of necessary information. Over the last several years, this simple fact has sparked major interest in emergency room information resource management. While traditional paper methods are still widely used, the electronic capabilities provided by information technology are revolutionizing the way emergency rooms and trauma centers function.An ideal state-of-the-art emergency department is integrated with the rest of the healthcare enterprise for access to all patient information via electronic media. This means doctors offices, remote clinics, and hospitals will all be linked by fiber optics or some other means of communication technology, eliminating "islands of automation" in which information is unable to be shared. Instead, all authorized medical personnel can access and share patient information at any wired location. This shared information includes all information gathered at the primary care physician's office as well as all information gathered at all treatment facilities. Additionally, all software and hardware used in the ER will be fully integrated and designed to support the medical decisions made by the ER staff This integration will allow medical information to be available to medical staff at the touch of a button. As a result, the quality of patient treatment is increasing as is the probability of patient survival.A case study of Covenant Medical Center (CMC) will allow an assessment of one hospital's ER compared to a state-of-the-art ER facility. Covenant Medical Center is a 366-bed health facility, employing approximately 270 physicians and 608 nurses, as well as 28 information technology professionals. Located in Waterloo, Iowa, CMC offers many services including a Cancer Treatment Center, Dialysis Center, Sports Injury Center, Rehabilitation Center, Mental Health Services, and the 24-hour Emergency Trauma and Treatment Center (ETTC). Each year, this healthcare organization has approximately 12,000 inpatient hospitalizations and performs about 400,000 outpatient procedures. 1CMC's Emergency Trauma and Treatment Center is classified as a Level 2 trauma center, meaning all types of emergency cases are handled, with a few exceptions. CMC's ETTC does not treat patients for open-heart procedures, limb reattachments, or major burns. However, all other types of medical emergencies are treated at this facility. The emergency department is staffed with 7 full-time and 4 part-time physicians, 30-35 nurses, and 6 technicians. Physicians work 12- hour shifts, with 2 working the noon to midnight shift and 1 working from midnight to noon. Nurses work either 8- or 12-hour shifts, depending on individual circumstances and schedules. CMC's Emergency Trauma and Treatment Center sees 30,000 patients annually. Over 50% of hospitalized patients come from the emergency room (ER), and 24% of patients seen in the ER are admitted directly to the hospital.A comparison will be made between the latest modern technology available and the technology used by Covenant in its emergency department. Specific comparisons will be made in the following areas: strategic management, technical equipment, electronic medical records, and patient tracking (tracking and logging, vital signs, pharmacy, clinical documentation, discharge, planning, and scheduling). Within each of these major areas, two elements will be addressed. First, some of the latest technological information systems and processes and their uses in an emergency department are explained. Then, I discuss how Covenant Medical Center's Emergency Trauma and Treatment Center is progressing in the modernization of its ER department and utilizing some of these latest technological innovations to improve patient treatment. The need for information anytime and anywhere in critical situations has prompted researchers to examine how medical information is being used in emergency rooms.