Record Linkage - a Method to Generate an Enriched Dataset for the Study of CPOE Systems on Test Turnaround Time

Background: One of the major challenges facing health IT planners is accessing the right information for the evaluation of the impact of Computerised Provider Order Entry (CPOE) systems on the delivery of health care. This information usually resides in information systems that are not integrally linked. Record linkage is a method through which records from different but related databases are linked retrospectively. Objective: This paper describes the procedural steps used to link records from different data sources to generate information enriched dataset for the evaluation of the impact of CPOE systems on turn around time (TAT) for tests ordered in the Emergency Department. Methods: Data about patients admitted to a hospital from a NSW Area Health Service before and after the implementation of CPOE systems were extracted from two separate information systems. These were the Emergency Department Information System, and Hospital Laboratory Information System. We linked these datasets using the deterministic linkage method, where Medical Record Number and admission dates were used as linkage variables to identify each admission episode. To ensure the quality of the final dataset, data quality checks using data profiling techniques were performed prior to data linkage separately for each dataset, and validation tests were carried out post linkage. Results: In total 285595 data points with 37 variables were generated from the linkage. This dataset allowed analyses to be conducted to examine the impact of CPOE systems on health delivery indicators such as measures of efficiency (eg. turnaround times for pathology requests), and effectiveness (eg. test volumes and rate redundant tests). Conclusion: This study demonstrated the value of using a standardized record linkage technique in generating a quality dataset with enriched information. Analyses applied to these enriched datasets can provide valuable information to health system planners, clinicians and pathology managers for use in managing and evaluating new CPOE systems.