Comparison of Template-Based Electronic Patient Record and Conventional System in Out Patient Department

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  • 外来診療におけるテンプレート入力電子カルテと紙カルテとの比較評価

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<p> To evaluate the effectiveness of a template-based electronic patient record (EPR) system, we developed a standalone prototype EPR System. Each template contains specific items for physical examination results and lab data concerning each problem (disease). Input of data in the form of free-format sentences, arranged in SOAP classification, is also available. Doctors can display any temporal lab data combined with prescription and physical examination data graphically in relation to time; the system is thus useful for explanation for patients as well as diagnoses. Twenty templates are provided to cover mainly for common diseases. The EPR prototype system was used 920 times for 292 patients. We evaluated the time required to operate the system for each patient and the inputted data volume. The results indicated that the volume of contents of the EPR system was almost double compared to conventional paper records, while the operation time for consulting one patient increased by one minute. Thus they imply the EPR system has a lot of advantages that make the extra effort involved in its operation worth while. This trial highlighted the advantages of the EPR system in regard to diagnosis and patients’ comprehension. On the other hand, it must be noted that the EPR system also has disadvantages; for example, face-to-face consultation is more difficult because PC operation is required at the same time.</p>

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