Enhancing electronic health records with real-time dashboards to improve patient care and service efficiency: a protocol

Lorenzo Porta¹Franco Aprà²Andrea Caccioppo²Felice Catania³Cinzia Colombo⁴David Fluck⁵Giulia Irene Ghilardi⁴Katarina Hricova⁶Isaac John⁵Zora Lazúrová⁷Jonah Lynch³Giovanni Nattino⁴George Notas⁸Chiara Pandolfini^4*Giovanni Porta⁹Vicky Rubini¹⁰Pankaj Sharma⁵Lok Thapa⁵Guido Bertolini⁴

• ¹ASST Fatebenefratelli Sacco, Milan, Lombardy, Italy
• ²Ospedale San Giovanni Bosco, Turin, Piedmont, Italy
• ³Astir Srl, Milan, Lombardy, Italy
• ⁴Mario Negri Institute for Pharmacological Research (IRCCS), Milano, Lombardy, Italy
• ⁵Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, United Kingdom
• ⁶Nemocnica AGEL Košice-Šaca, Kosice-Saca, Slovakia
• ⁷University of Pavol Jozef Šafárik, Košice, Slovakia
• ⁸University of Crete School of Medicine and 7th Health Region of Crete, Heraklion, Greece
• ⁹Ospedale Santa Maria delle Grazie, Naples, Campania, Italy
• ¹⁰Università Statale di Milano, Milan, Lombardy, Italy

Emergency Departments (EDs) are critical healthcare settings that often face challenges related to patient overcrowding and sub-optimal resource use, and these issues have been linked to reduced effectiveness of care and increased patient mortality. This protocol describes a study to enhance Electronic Health Records (EHR) with real-time dashboards developed for healthcare staff, administrators, and other stakeholders in order to address these issues. These dashboards will be analytic tools, fed with data directly from the electronic health records, allowing healthcare indicators to be monitored dynamically and interactively. The indicators will provide a comprehensive overview of patient flow, crowding levels, waiting times, and other key operational metrics to support healthcare providers by enabling real-time monitoring and decision-making. Administrators will also benefit from the dashboards by gaining insight into system bottlenecks and overall ED performance, facilitating more effective management of resources. This study is part of the eCREAM (enabling Clinical Research in Emergency and Acute care Medicine through automated data extraction) project, and 32 EDs from 6 different European countries will be involved in this 36-month study. A panel of experts will test the usefulness of the dashboards, set up for each end-user type, using questionnaires and semi-structured interviews. The EHRs, integrated with these ad-hoc dashboards, will empower clinical teams and policymakers to understand department operations dynamics better, ultimately contributing to improved patient outcomes and reduced crowding in emergency settings.