Electronic Health Record Research in Critical Care: The End of the Randomized Controlled Trial?
We believe it is the duty of every hospital to establish a follow‐up system, so that as far as possible the result of every case will be available at all times for investigation by members of the staff, the trustees, or administration, or by other authorized investigators or statisticians (Ernest Amory Codman).
Codman was a surgeon from Boston, practicing at the beginning of the 20th century. He instituted the practice of morbidity and mortality conferences, and personally tracked all his patients using ‘End Result Cards’. Upon these he recorded demographics, diagnosis, treatment and outcomes. He argued that we should follow‐up all cases to improve the quality of care. We wish to argue here that we should capture all healthcare information to benefit the science of clinical medicine. This is indeed the promise of the electronic health record (EHR) – healthcare’s own ‘big data’1.
However, big data alone will not be a panacea. It has all the same fallibilities that we have...
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