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Can we understand population healthcare needs using electronic medical records?

Publication ,  Journal Article
Chong, JL; Low, LL; Chan, DYL; Shen, Y; Thin, TN; Ong, MEH; Matchar, DB
Published in: Singapore Med J
September 2019

INTRODUCTION: The identification of population-level healthcare needs using hospital electronic medical records (EMRs) is a promising approach for the evaluation and development of tailored healthcare services. Population segmentation based on healthcare needs may be possible using information on health and social service needs from EMRs. However, it is currently unknown if EMRs from restructured hospitals in Singapore provide information of sufficient quality for this purpose. We compared the inter-rater reliability between a population segment that was assigned prospectively and one that was assigned retrospectively based on EMR review. METHODS: 200 non-critical patients aged ≥ 55 years were prospectively evaluated by clinicians for their healthcare needs in the emergency department at Singapore General Hospital, Singapore. Trained clinician raters with no prior knowledge of these patients subsequently accessed the EMR up to the prospective rating date. A similar healthcare needs evaluation was conducted using the EMR. The inter-rater reliability between the two rating sets was evaluated using Cohen's Kappa and the incidence of missing information was tabulated. RESULTS: The inter-rater reliability for the medical 'global impression' rating was 0.37 for doctors and 0.35 for nurses. The inter-rater reliability for the same variable, retrospectively rated by two doctors, was 0.75. Variables with a higher incidence of missing EMR information such as 'social support in case of need' and 'patient activation' had poorer inter-rater reliability. CONCLUSION: Pre-existing EMR systems may not capture sufficient information for reliable determination of healthcare needs. Thus, we should consider integrating policy-relevant healthcare need variables into EMRs.

Duke Scholars

Published In

Singapore Med J

DOI

EISSN

2737-5935

Publication Date

September 2019

Volume

60

Issue

9

Start / End Page

446 / 453

Location

India

Related Subject Headings

  • Singapore
  • Retrospective Studies
  • Reproducibility of Results
  • Prospective Studies
  • Physicians
  • Patient-Centered Care
  • Nurses
  • Needs Assessment
  • Incidence
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chong, J. L., Low, L. L., Chan, D. Y. L., Shen, Y., Thin, T. N., Ong, M. E. H., & Matchar, D. B. (2019). Can we understand population healthcare needs using electronic medical records? Singapore Med J, 60(9), 446–453. https://doi.org/10.11622/smedj.2019012
Chong, Jia Loon, Lian Leng Low, Darren Yak Leong Chan, Yuzeng Shen, Thiri Naing Thin, Marcus Eng Hock Ong, and David Bruce Matchar. “Can we understand population healthcare needs using electronic medical records?Singapore Med J 60, no. 9 (September 2019): 446–53. https://doi.org/10.11622/smedj.2019012.
Chong JL, Low LL, Chan DYL, Shen Y, Thin TN, Ong MEH, et al. Can we understand population healthcare needs using electronic medical records? Singapore Med J. 2019 Sep;60(9):446–53.
Chong, Jia Loon, et al. “Can we understand population healthcare needs using electronic medical records?Singapore Med J, vol. 60, no. 9, Sept. 2019, pp. 446–53. Pubmed, doi:10.11622/smedj.2019012.
Chong JL, Low LL, Chan DYL, Shen Y, Thin TN, Ong MEH, Matchar DB. Can we understand population healthcare needs using electronic medical records? Singapore Med J. 2019 Sep;60(9):446–453.

Published In

Singapore Med J

DOI

EISSN

2737-5935

Publication Date

September 2019

Volume

60

Issue

9

Start / End Page

446 / 453

Location

India

Related Subject Headings

  • Singapore
  • Retrospective Studies
  • Reproducibility of Results
  • Prospective Studies
  • Physicians
  • Patient-Centered Care
  • Nurses
  • Needs Assessment
  • Incidence
  • Humans