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      Mapping progress in intravascular catheter quality surveillance: An Australian case study of electronic medical record data linkage

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          Abstract

          Background and significance

          Intravascular (IV) catheters are the most invasive medical device in healthcare. Localized priority-setting related to IV catheter quality surveillance is a key objective of recent healthcare reform in Australia. We sought to determine the plausibility of using electronic health record (EHR) data for catheter surveillance by mapping currently available data across state-wide platforms. This work has identified barriers and facilitators to a state-wide EHR surveillance initiative.

          Materials and methods

          Data variables were generated and mapped from routinely used EHR sources across Queensland, Australia through a systematic search of gray literature and expert consultation with clinical information specialists. EHR systems were eligible for inclusion if they collected data related to IV catheter insertion, care, or outcomes of hospitalized patients. Generated variables were mapped against international recommendations for IV catheter surveillance, with data linkage and data export capacity narratively summarized.

          Results

          We identified five EHR systems, namely, iEMR, MetaVision ICU ®, Multiprac, RiskMan, and the Nephrology Registry. Systems were used across jurisdictions and hospital wards. Data linkage was not evident across systems. Extraction processes for catheter data were not standardized, lacking clear and reliable extraction techniques. In combination, EHR systems collected 43/50 international variables recommended for catheter surveillance, however, individual systems collected a median of 24/50 (IQR 22, 30) variables. We did not identify integrated clinical analytic systems (incorporating machine learning) to support clinical decision making or for risk stratification (e.g., catheter-related infection).

          Conclusion

          Current data linkage across EHR systems limits the development of an IV catheter quality surveillance system to provide timely data related to catheter complications and harm. To facilitate reliable and timely surveillance of catheter outcomes using clinical informatics, substantial work is needed to overcome existing barriers and transform health surveillance.

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          Most cited references45

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          Scoping studies: towards a methodological framework

          Lisa O'Malley, Hilary Arksey (2005)
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            An overview of clinical decision support systems: benefits, risks, and strategies for success

            Reed Sutton, David Pincock, Daniel Baumgart … (2020)
            Computerized clinical decision support systems, or CDSS, represent a paradigm shift in healthcare today. CDSS are used to augment clinicians in their complex decision-making processes. Since their first use in the 1980s, CDSS have seen a rapid evolution. They are now commonly administered through electronic medical records and other computerized clinical workflows, which has been facilitated by increasing global adoption of electronic medical records with advanced capabilities. Despite these advances, there remain unknowns regarding the effect CDSS have on the providers who use them, patient outcomes, and costs. There have been numerous published examples in the past decade(s) of CDSS success stories, but notable setbacks have also shown us that CDSS are not without risks. In this paper, we provide a state-of-the-art overview on the use of clinical decision support systems in medicine, including the different types, current use cases with proven efficacy, common pitfalls, and potential harms. We conclude with evidence-based recommendations for minimizing risk in CDSS design, implementation, evaluation, and maintenance.
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              Guidelines for conducting systematic mapping studies in software engineering: An update

              Kai Petersen, Ludwik Kuzniarz, Sairam Vakkalanka (2015)
              Article 0 comments Cited 228 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Med (Lausanne)
                Journal ID (iso-abbrev): Front Med (Lausanne)
                Journal ID (publisher-id): Front. Med.
                Title: Frontiers in Medicine
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-858X
                Publication date (Electronic): 11 August 2022
                Publication date Collection: 2022
                Volume: 9
                Electronic Location Identifier: 962130
                Affiliations
                [1] 1Alliance for Vascular Access Teaching and Research Group , Nathan, QLD, Australia
                [2] 2School of Nursing, Midwifery and Social Work, The University of Queensland , St Lucia, QLD, Australia
                [3] 3Metro North Health, Herston Infectious Disease Institute , Herston, QLD, Australia
                [4] 4School of Information and Communication Technology, Griffith University , Nathan, QLD, Australia
                [5] 5Digital Metro North, Metro North Hospital and Health Service , Herston, QLD, Australia
                [6] 6Centre for Health Services Research, Faculty of Medicine, University of Queensland , Herston, QLD, Australia
                [7] 7Digital Solutions, Griffith University , Nathan, QLD, Australia
                [8] 8School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University , Nathan, QLD, Australia
                [9] 9Division of Surgery, Princess Alexandra Hospital , Brisbane, QLD, Australia
                [10] 10Nursing and Midwifery Research Centre, Royal Brisbane and Women’s Hospital , Brisbane, QLD, Australia
                Author notes

                Edited by: Ata Murat Kaynar, University of Pittsburgh, United States

                Reviewed by: Masaaki Sakuraya, Hiroshima General Hospital, Japan; Yuki Kotani, Kameda Medical Center, Japan

                *Correspondence: Jessica A. Schults, j.schults@ 123456uq.edu.au

                This article was submitted to Intensive Care Medicine and Anesthesiology, a section of the journal Frontiers in Medicine

                Article
                DOI: 10.3389/fmed.2022.962130
                PMC ID: 9403736
                SO-VID: 71b51bcc-dc09-44b5-8dc7-d04f7a5a27ca
                Copyright © Copyright © 2022 Schults, Ball, Sullivan, Rossow, Ray-Barruel, Walker, Stantic and Rickard.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 06 June 2022
                Date accepted : 18 July 2022
                Page count
                Figures: 3, Tables: 1, Equations: 0, References: 48, Pages: 10, Words: 5682
                Categories
                Subject: Medicine
                Subject: Original Research

                Keywords: intravascular catheter,quality surveillance,electronic health record,clinical informatics,patient – centered care
                Data availability:
                Keywords: intravascular catheter, quality surveillance, electronic health record, clinical informatics, patient – centered care

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