Abstract: We recently admitted to our service a 13 year old girl with disease complications such that we were unable to find relevant studies pertaining to the management of her unique medical situation. Without clear evidence to guide us and needing to make a decision swiftly, we turned to a unique approach utilizing the data captured in our institution’s electronic medical record (EMR). This patient-centered clinical research project, which took 4 hours to execute, gave us a better understanding of her risk of thrombosis and guided our decision to anticoagulate her within 24 hours of admission.
Our case is but one example where the existing literature is insufficient to guide the clinical management of a patient. It is, however, an exceptional illustration of a novel process that is likely to become much more standard with the adoption of EMRs and more sophisticated informatics tools. Although many previous groups have highlighted the secondary use of EMR data for clinical research, our case highlights how this same approach can be used to guide real-time clinical decisions. This rapid electronic chart review and analysis was not only feasible, but more helpful and accurate then physician recollection and pooled colleague opinion.
This real-time availability of data to guide decision-making has already transformed other industries. The growing prevalence of EMRs along with the development of sophisticated tools for real-time analysis of de-identified data sets will further catalyze this data-driven approach in healthcare delivery.