Efficacy of Electronic Discharge Summaries: A Case Study Demonstrating Early Results at Two Hospitals

Abstract

Paper objectives or hypothesis: Queensland Health is in the process of rolling out a web-based, electronic discharge summary to hospitals which request a move from the status quo (usually paper-based, triplicate forms). This paper aims to test whether the move to an electronic discharge summary can improve clinical outcomes through a demonstrable improvement in delivery, quality and speed. Methods: This paper focuses on two public hospitals of approximately the same size and clinical mix. One of the hospitals was interested in the electronic summary based on dissatisfaction with the paper-based summary and was used as a baseline case (Hospital A). The second hospital used the electronic discharge summary for approximately 18 months prior to the study, and the electronic summary was well ingrained into day-to-day business processes (Hospital B). Results and discussion of implications: • Delivery: The data indicate that for Hospital A only 39% of completed paper summaries were received by the GP, while 82% of summaries were received by the GP using the electronic summary. • Quality: Satisfaction with Hospital A summaries was 7% while Hospital B received a 93% satisfaction rating. • Speed: Qualitative feedback strongly suggested a marked improvement in speed. Hospital B sent 75% of summaries within 48 hours. Conclusion: This case highlights that the electronic discharge summary may contribute to improved clinical outcomes, however further research is required to establish this conclusively. The measures included did demonstrate measurable, quantifiable gains for both delivery and quality. Speed was strongly supported through qualitative evidence.