Electronic medical record error in reported time of discharge: A prospective analysis at a tertiary care hospital

Abstract

Objective: The aim of the study is to evaluate the accuracy of electronic medical record reporting related to patients’ length-of-stay in an emergency department. Methods: This was a prospective non-interventional study that entailed research associates observing Time of Discharge (TODRA) in the emergency department. We used the electronic medical record to collect data in real time. The TODRA was provided by two research associates while electronic medical record served as the source for the routinely reported length of stay data including the time of discharge in the EMR (TODEMR). Results: A total of 184 cases for which TODEMR and TODRA were compared during a total of six study timing sessions. A difference of less than 5 minutes between TODRA and TODEMR was observed in 42.9% (79, 35.7–50.4%) and more than 5 minutes in 57.1% (105, 50.0–64.3%) of the cases. When analysis was restricted to the 105 cases where there was operationally significant (at least 5 minutes’) TODEMR error, the error direction was strongly biased toward TODEMR’s lagging behind TODRA. EMR-reported discharge times were usually (57% of cases) more than 5 minutes in error, and towards overestimation of the length of stay. The difference observed was clinically and operationally significant. Conclusions: In the study center, there were substantial errors in discharge time reported in the hospital’s electronic medical record-sourced database. Further study is warranted to assure that the precision of EMR-reported times is matched by acceptable accuracy.