Monitoring health IT integration - the effect of an EMR on laboratory service timeliness across six Australian hospitals

The Electronic Medical Record (EMR) incorporates computerised provider order entry systems which allow clinicians to order diagnostic tests electronically, thus eliminating the need for cumbersome handwritten orders. In many situations the EMR relies on a manual transition of information across systems (e.g., integration with the Laboratory Information System). This study, based in a laboratory setting requiring such a transition across systems, aimed to compare the data entry time (from when a specimen arrives in the Central Specimen Reception [CSR] area of the laboratory, to when it is forwarded on for processing), along with a laboratory turnaround time (TAT) (from the time a specimen is received to the time a verified result is issued) for paper and EMR orders, for two high volume tests, across six hospitals. Results showed that the median data entry time for all hospitals combined, was three minutes shorter for EMR entered orders than paper orders. This difference was consistent and significant for Electrolytes, Urea, Creatinine (EUC) and Automated Differential (including full blood count) tests in 2010 and 2011. These decreases contributed to significantly lower median Laboratory TATs for EMR orders (for EUC tests the difference in medians was 12 minutes in 2010 and six minutes in 2011; for Automated Differential tests, the difference was four minutes in 2010 and two minutes in 2011).