ON THE USE OF A HOSPITAL INFORMATION-SYSTEM IN EVALUATING CLINICAL CARE - A CASE-REPORT

In this paper we describe, as an example, how we obtained the informat ion needed to evaluate a newly introduced protocol for ordering X-rays for ankle trauma patients. Extensive use was made of available data a nd facilities of the hospital information system (HIS). Procedures for collecting the required additional data, which were not recorded in t he HIS but were needed to evaluate the protocol, were embedded in the current medical and administrative routine of the emergency room. Thes e additional data were also stored in the HIS. Periodically all data w ere downloaded to a personal computer to analyse the impact of using t he protocol on quality of care and costs. In total 1241 patients enter ed the study, and for 1149 patients a complete dataset was obtained. T he sensitivity and specificity of the protocol at the threshold value which was used during the initial study period was 0.77 and 0.80. The reduction in the number of ankle X-rays due to the protocol was signif icant when compared with a strategy of ordering an X-ray for every ank le trauma patient visiting the emergency room.