E. O. Abara1,2, E. Abara1,2 1Northern Ontario School Of Medicine,Clinical Sciences,Sudbury/Thunder Bay, ONTARIO, Canada 2Richmond Hill Urology Practice & Prostate Institute,Richmond Hill, ONTARIO, Canada
Introduction:
Ureteroscopy is commonly used in the management of stone and other diseases of the ureter. The use of stent before and after ureteroscopic lithotripsy remains controversial. Electronic Health Records (EHR) , a software platform that contains data captured during patient encounter is useful for billing but other applications in research, data analysis, practice audit and quality improvement are gaining momentum. In 2013, we adopted the use of Electronic Health Record(EHR).
The purpose of this study is to understand the basic ways of manipulating EHR data to identify “hot spots” in ureteral stone management and describe the treatment outcomes in a community urology practice.
Methods:
Data recorded in the physician’s clinical notes, operative room records including details of procedure and fluoroscopy times and follow up were reviewed and extracted. Tracking of the procedures were verified using the Diagnostic and Billing codes. For question formation and sequencing, a literature search was completed through PUBMED, Medline, Cochrane Data base using such words and phrases as EHR Ureteroscopy Stent or No Stent, EHR Data analysis. Data collection was between 2001 and 2004 and included patient’s age, sex, stone features, stent or no stent, operating and fluoroscopy times, out-patient or in-patient. Data extracted were then transferred into a random number spread sheet function for analysis.
Results:
There were 192 procedures – 149 ‘Stent’ and 43 ‘No Stent’, ratio 3:1.These two groups were comparable regarding patients , stone features, stone free rates , infections and complications.The mean stone size was 8.5+/-2mm.Stone free rates at 6 weeks was 100% in each group. There was relief of renal colic in all patients immediately. After 2 days, lower urinary tract symptoms (LUTS) were ‘zero’ in ‘non stented’ compared to the ‘ stented’ patients. These results are similar to current literature.
Conclusion:
Data extraction and manipulation from the EHR was successful. In addition to billing purposes, EHR application in research, chronic disease management, quality improvement and practice audit is attractive and will grow.