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Am J Emerg Med. 2015 May;33(5):663-6. doi: 10.1016/j.ajem.2015.02.022. Epub 2015 Feb 19.

Minimal impact of an electronic medical records system.

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Department of Biological Sciences, Youngstown State University, Youngstown, OH. Electronic address:
Department of Emergency Medicine, St. Joseph Health Center, Warren, OH.



Electronic medical records (EMRs) implementation in hospitals and emergency departments (EDs) is becoming increasingly more common. The purpose of this study was to determine the impact of an EMR system on patient-related factors that correlate to ED workflow efficiency.


A retrospective chart review assessed monthly census reports of all patients who registered and were treated to disposition during conversion from paper charts to an EMR system. The primary outcome measurement was an analysis of the time of registration to discharge or total ED length of stay as well as rate of those who left without being seen, eloped, or left against medical advice. These data were recorded from 3 periods, for 18 months: before installation of the EMR system (pre-EMR), during acclimation to the EMR, and post acclimation (post-EMR).


A total of 61626 individual patient records were collected and analyzed. The total ED length of stay across all patient subtypes was not significantly affected by the installation of the hospital-wide EMR system (P = .481); however, a significant decrease was found for patients who were admitted to the hospital from the ED (P < .00001). The percentage of patients who left without being seen between the pre-EMR and post-EMR periods was 1.8% and 2.7%, respectively, representing a significant increase (P < .0001). The number of patients who left against medical advice did not change across the periods of the present investigation (P > .25).


Installation of a hospital-wide EMR system had minimal impact on workflow efficiency parameters in an ED.

[Indexed for MEDLINE]

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