Browsing by Subject "data security and confidentiality"

Objective of this article was to analyze whether the reporting of the 3rd and 4th degree obstetric anal sphincter injuries differ between the patient data recording systems. The study was retrospective. The setting included all six delivery units in the Hospital District of Helsinki and Uusimaa (HUS) comprising one third of all deliveries in Finland. Population was all deliveries in HUS in 2012 (n=18099). The incidence of the sphincter injury was extracted from three electronic medical record (EMR) systems (Obstetrix, Opera and Oberon), using the national versions of International Classification of Diseases 10th revision (ICD10) and the Nordic Classification of Surgical Procedures (NOMESCO). All observed cases were studied carefully from the patient records and the reliability of different systems was analyzed and compared to the data reported to national registers (MBR Medical Birth Register and HDR Hospital Discharge Register). Main outcome measure was sphincter injury rate in delivery units. We found that the actual rate of sphincter injury in all the EMRs combined in HUS was higher (1.8%) than the rate delivered from any single reporting system (from 1.5% to 1.7%) and varied even more among single delivery units. The coverage in the MBR (88%) was much higher than in the HDR (3%). In conclusion the simultaneous use of several patient data recording systems is confusing and prone for systematic errors. One common database – preferably an EMR with a structured format - would clarify the registering and enable reliable quality reports creating a sustainable base for quality improvements.