Examining the value of electronic health records on labor and delivery

Karen B. Eden, Rosalia Messina, Hong Li, Patricia Osterweil, Carrie R. Henderson, Jeanne Marie Guise

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Objective: The objective of the study was to evaluate the impact of an electronic health record (EHR) on documentation completeness and patient care in a labor and delivery unit. Study Design: We conducted a pre- and postintervention study to compare documentation quality and workflow before and after EHR implementation. Documentation was compared using χ2 and Fisher's exact tests. Objective observers measured workflow activities across all shifts before and after EHR implementation and activities were compared using Kruskal-Wallis tests and analysis of covariance. Results: Paper admission records were significantly more likely to miss key clinical information such as chief complaints (contractions, membrane status, bleeding, fetal movement, 10-64% vs 2-5%; P < .0001) and prenatal laboratory results and history (Varicella, group B Streptococcus, human immunodeficiency virus, 26-66% vs 1-16%, P < .0001). Both direct patient care and computer activities increased after EHR implementation (2 vs 12 and 12 vs 17 activities/shift, respectively, P < .0001). Conclusion: The introduction of an obstetric EHR improved documentation completeness without reducing direct patient care.

Original languageEnglish (US)
Pages (from-to)307.e1-307.e9
JournalAmerican journal of obstetrics and gynecology
Issue number3
StatePublished - Sep 2008


  • health record systems
  • obstetrics
  • quality assurance
  • quality of health care
  • safety

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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