American Burn Association

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CODBC Survey

The Committee on Organization and Delivery of Burn Care is assessing the features and functionality of the Electronic Medical Record (EMR) that are significant to burn centers operations. The intent of this survey is to inform ABA leadership of key issues affecting the successful transition of burn care practices from paper to the electronic medical record.

Thank you for your time and interest.

My discipline is: MD RN PT OT PhD RD PA-C RT LPN Social Worker
Other:

Identify your burn center/hospital:

Part 1: Current Electronic Applications
How does your institution perform the following functions?

INPATIENT

FEATURE OR FUNCTIONALITY	ELECTRONICALLY	MANUALLY	BOTH	NEITHER	DON'T KNOW
Admission, discharge, transfer (ADT)
Laboratory reporting
Physician order entry (POE)
Patient completed review of systems, past medical, family and social history
Nursing documentation (admission and progress notes, patient teaching)
Physician documentation (H and P, progress notes, procedure notes, Op reports)
Ancillary service documentation
Radiology image viewing
Radiology reporting
Patient flow sheet (vital signs, intake/output, drip rates, bedside glucose, etc.)
Medication administration record (nurse gives med)
OR scheduling
Discharge orders, patient instruction, follow-up scheduling

OUTPATIENT

FEATURE OR FUNCTIONALITY	ELECTRONICALLY	MANUALLY	BOTH	NEITHER	DON'T KNOW
Appointment scheduling
Physician documentation
Physician order entry (labs, x-ray)
Prescription writing

Part II: Future Electronic Applications
The items below are features that could be performed on the computer and at least theoretically could be part of an EMR, which you could access from a single work-station. We wish to know how important each one would be to you to help you provide optimal burn care.

FEATURE OR FUNCTIONALITY	Essential	Desirable	Optional/ Neutral	Not Important	Worthless
Patient flow sheet (vital signs, I&O, drip rates, glucose, etc.)
ADT
Physician order entry
Radiology image viewing
Radiology reports
Nursing notes (documentation)
Ancillary care documentation (PT, dietary)
Physician H and P progress notes
Specific order sets (admissions)
Templates for progress notes
Templates for bedside procedures
Access to record from office
Access to record from outside institution
Laboratory values
Access to old records
Incorporation of burn man diagram
Automated import of clinical data (VS, labs, I/O) into progress note
Preprinted patient instructions
Access to record by primary care physician
Generate "to do" list for bedside nurse each shift
Document task completion
Warn about drug interaction
Calculate maintenance fluid needs
Calculation of resuscitation fluid
Calculation of nutritional needs
Calculation of weight-based drip dosage
Drug-drug interaction warnings
Drug-nutrient interaction warnings
Coordinate multidisciplinary plan of care
Computer at each bedside
Pain scale (flow sheet)
ICD9 diagnosis code lists
Automatic determination of level of service
Computer generated discharge summary
Remote access
Wireless connectivity

Part III: Trade Offs
With the ongoing challenges inherent in developing the EMR, please indicate how willing you would be to accept the following limitations in an EMR which otherwise provided almost all of the features you think would be necessary and/or desirable.

FEATURE OR FUNCTIONALITY	Very Willing	Willing	Makes No Difference	Rather Not	Absolutely Not/No Way
Increased time needed for documentation by 10%
...by 25%
...by 50%
Two or more systems with limited linkage
Learning curve of 10 days, i.e. time needed to use system efficiently
Learning curve of 30 days
Learning curve of 60 days
Inaccessible outside of institution
Inaccessible outside of patient unit
Two or more systems with limited linkage for inpatient data/documentation (e.g. labs, clinical data on different systems)
Different systems with limited linkage for inpatient and outpatient care
Two or more systems to retrieve current health information and to retrieve information from prior admissions or visits
Transition time between windows (screens) of five seconds
Transition time between windows of 10 seconds each
Additional indirect charge of 1% to burn center's operating budget
Additional indirect charge of 1% to your professional revenues

1. What are the main advantages of the electronic medical record in your facility?

2. What are the main disadvantages of the electronic medical record in your facility?

3. What would you change about your medical record in your facility?

4. What do you need that you don't have in relationship to your medical record?

5. Additional Comments:

The American Burn Association Web site contains general information for burn care professionals. The ABA Web site is not intended to respond to requests for medical information, and the ABA is unable to respond to requests regarding personal medical concerns related to burn injuries. Your physician is the best source for information related to initial treatment, ongoing care, and follow-up issues for burn injuries. If you do not have a physician, please contact the physician referral service at your local burn center or hospital. © copyright 2005 American Burn Association