Patients with chest pain who are in the emergency department, and whose attending emergency physicians received lab results directly to their smartphones, got discharged faster than patients whose doctors didn’t get that data on their smartphones, according to new research.
The results of a randomized, controlled trial of a quality improvement initiative were recently published online in Annals of Emergency Medicine. Indeed, the findings revealed that those patients whose ED doctors received lab results delivered direct to their smartphones spent about 26 minutes less waiting to be discharged than patients whose lab results were delivered to the electronic patient record on the hospital computer system.
Patients who come to the emergency department with chest pain have blood drawn to test for troponin levels, which, if elevated, indicate a heart attack. In this study, the overall median interval from final troponin results to discharge decision was 79.7 minutes. For the control group (no smartphone), it was 94.3 minutes and for the intervention group (smartphone) it was 68.5 minutes. The difference of 25.8 minutes is “statistically significant,” according to the report’s authors. The total emergency department length of stay was 345 minutes in the control group and 328 minutes in the intervention group, which researchers did not consider statistically significant.
The study was conducted at Sunnybrook Health Sciences Centre over an eight-month span in 2014. Sunnybrook Health Sciences Centre is a tertiary care, academic center, fully affiliated with the University of Toronto, with an annual ED census of 58,500 patients. During the study’s timeframe, 1,554 patients were discharged from the ED with chest pain. There were 551 patients in the control group and 554 in the intervention group who met inclusion criteria.
“For patients waiting for lab results, 26 minutes is significant, even if the smartphone process did not shorten overall length of stay significantly,” study author Aikta Verma, M.D., of the University of Toronto in Ontario, Canada, said in a statement accompanying the findings. “For many patients, waiting for lab results that determine if they stay in the hospital or go home is the hardest part of the ER visit. Physicians who received troponin results on their smartphones made the decision to discharge their patients with chest pain a median of 26 minutes faster than physicians without troponin push-alert notifications.”
Dr. Verma added, “Our study demonstrated reduced time to discharge decision for chest pain patients by pushing troponin results to smartphones. There are many other results that could also be pushed: other critical lab results, radiology reports, vital signs, etc. For now, we recommend the use of the push-alert notification system to improve flow through the emergency department for chest pain patients.”
