Aim

The implementation of electronic health records (EHRs) in the aged care sector has been shown to improve efficiency and quality of care, administrative and funding processes. The aim of this study was to examine whether implementing EHRs and/or interventions leveraging EHRs in residential aged care facilities has any impact on health outcomes for residents and to review and summarise any published evidence.

Methods

Using the Joanna Briggs Institute guidelines for conducting scoping reviews, we searched PubMed, CINAHL, Embase, Cochrane and Scopus databases for articles describing the impact of EHRs and/or EHR-based interventions on health outcomes for residents in residential aged care. We included journal articles published in English between 2009 and 2019. After identifying articles meeting the inclusion criteria, we extracted individual findings and produced a narrative summary.

Results

Out of 6576 articles identified through database searches, seven met our inclusion criteria. The articles varied in study design, experimental methods, sample sizes and health outcomes assessed but there were no randomised controlled trials: four articles employed quantitative methods and three employed both quantitative and qualitative methods. The implementation of EHR-based interventions had positive impact on outcomes related to excessive weight loss, malnutrition, mobility, weighing of residents and use of antipsychotic medicines but had mixed impact (i.e., positive impact in some studies but non-significant or negative impact in others) on pressure ulcers, activities of daily living, behavioural symptoms, use of physical restraints and signs of depression. We also found that these interventions had no statistically significant impact on medication discrepancies, adverse drug events, falls or mortality.

Conclusion

In conclusion, research in this area is not yet comprehensive enough to reach a definitive conclusion on the impact of EHR-based interventions on health outcomes in residential aged care. As provider organisations increasingly implement EHRs, more research is needed to study their impact on resident health outcomes and examine how this impact eventuates.

中文翻译：

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实施电子健康记录以支持住院老年护理中的老年人护理对健康结果的影响：范围界定审查

目标

事实表明，在老年护理部门实施电子健康记录（EHR）可以提高护理，行政和筹资流程的效率和质量。这项研究的目的是检查在居民养老院中实施电子病历和/或利用电子病历的干预措施是否对居民的健康状况有影响，并审查和总结任何公开的证据。

方法

使用Joanna Briggs Institute指南进行范围界定审查，我们在PubMed，CINAHL，Embase，Cochrane和Scopus数据库中搜索了描述EHR和/或基于EHR的干预措施对住院老年护理患者健康结果的影响的文章。我们收录了2009年至2019年之间以英文发表的期刊文章。在确定了符合纳入标准的文章后，我们提取了个人发现并提供了叙述性摘要。

结果

通过数据库搜索确定的6576篇文章中，有7篇符合我们的纳入标准。文章的研究设计，实验方法，样本量和评估的健康结果各不相同，但没有随机对照试验：四篇文章采用定量方法，三篇采用定量和定性方法。基于EHR的干预措施的实施对与过度减肥，营养不良，行动不便，居民体重和使用抗精神病药有关的结局具有积极影响，但产生了不同的影响（即，在某些研究中产生积极影响，但在某些研究中则无显着或负面影响）其他）压疮，日常生活活动，行为症状，使用身体约束和沮丧迹象。

结论

总之，该领域的研究还不够全面，无法就基于电子病历的干预措施对住院老年护理的健康结果产生明确的结论。随着提供者组织越来越多地实施电子病历，需要更多的研究来研究其对居民健康结果的影响并研究这种影响如何发生。