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The Meaningful Use of EMR in Chinese Hospitals: A Case Study on Curbing Antibiotic Abuse

Journal of Medical Systems volume 37, Article number: 9937 (2013) Cite this article

Abstract

Comprehensive electronic medical records (EMR) have proven to be an effective tool for improving the safety and quality of healthcare. In particular, EMR has resulted in a significant reduction in antibiotic consumption and an improvement in rational antibiotic use. This study focused on evaluating the effectiveness of using a comprehensive EMR system to curb antibiotic abuse. A retrospective “before/after” investigation was conducted in an 850-bed nonprofit hospital. A comprehensive EMR was implemented to improve the management of medical practices during treatment and to track antibiotic prescriptions. Patient records on antibiotic use were identified by searching the hospital database from April 1 to October 30, 2011 (post-implementation) and compared with those of patients from April 1 to October 30, 2010 (pre-implementation). Outcome measures were defined daily doses (DDDs) of antibiotics per 1,000 patient-days and factors that influenced antibiotic consumption. Antibiotic consumption during the seven months with EMR management decreased from 727 DDDs to 480 DDDs per 1,000 patient-days (p < 0.001). The decreases in cefminox, cefoperazone combinations, cefixime, and gentamicin were notably significant. The type of medical insurance, patient age, and ordering department (importance coefficients of 0.1935, 0.1818 and 0.1756, respectively) were the most significant factors that influenced antibiotic consumption. An improvement in the rational antibiotic use was also observed in the length of antibiotic therapy, selection of appropriate antibiotic level, route of administration, and so on. Rational antibiotic use resulted in a lower mortality of 0.0644 % during the post-implementation period compared to 0.179 % during the pre-implementation period (p = 0.018). The comprehensive EMR system contributed to a significant reduction in antibiotic consumption and an improvement in rational antibiotic use.

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Acknowledgments

This work was supported by the National Natural Science Foundation (Grant No. 61173127) and the National Science and Technology Infrastructure Program (Grant No 2011BAH15B08) of China.

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Affiliations

  1. Healthcare Informatics Engineering Research Center, Zhejiang University, Hangzhou, 310027, China

    Jing-Song Li, Xiao-Guang Zhang, Hua-Qiong Wang & Yu Wang

  2. Chang An Hospital, Xi’an, China

    Jing-Ming Wang & Qing-Dong Shao

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  1. Jing-Song Li
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  2. Xiao-Guang Zhang
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Correspondence to Jing-Song Li.

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Li, JS., Zhang, XG., Wang, HQ. et al. The Meaningful Use of EMR in Chinese Hospitals: A Case Study on Curbing Antibiotic Abuse. J Med Syst 37, 9937 (2013). https://doi.org/10.1007/s10916-013-9937-4

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  • DOI: https://doi.org/10.1007/s10916-013-9937-4

Keywords

  • Electronic medical records (EMR)
  • Meaningful use
  • Curbing antibiotic abuse
  • Effectiveness evaluation
  • Rational antibiotic use