Abstract

Objective: To compare the effectiveness and efficiency of a cloud-bases system (CBS) versus traditional MS Excel® spreadsheets (MES) for data management in a Mexican private tertiary care hospital’s Intensive Care Unit (ICU).
Methods: A retrospective, before-after study was conducted in an 11-bed polyvalent ICU. Data was collected for two 7-month periods: MES (June 1, 2023 - December 31, 2023), using Excel, and CBS (January 1, 2024 - July 31, 2024), using the Epimed system ®. The study evaluated data completeness, SAPS III calibration (using Hosmer-Lemeshow, Brier score, and ROC analysis), data entry time, and physicians’ perception of simplicity (via a 5-point Likert scale survey). Statistical analyses included t-tests, Mann-Whitney U tests, Chi-square tests, Fisher’s exact tests, and DeLong’s test.
Results: A total of 409 patients were included (221 MES, 188 CBS). Missing data was prevalent in the MES period but absent in the CBS period. The Sanders-modified Brier score indicated a potential improvement in SAPS III calibration in the CBS period (0.0907 vs. 0.1514), although Hosmer-Lemeshow and DeLong tests showed no significant differences. First-year residents spent significantly less time on data entry with CBS (4.5 minutes vs. 8.9 minutes, p=0.02). Physicians perceived CBS as easier to use, with a clearer interface and better organization (p<0.05 for these three aspects).
Conclusion: The implementation of a CBS was associated with significant improvements in data completeness, potential improvement in SAPS III calibration, reduced data entry time for first-year residents, and positive perceptions of simplicity. These findings highlight the potential benefits of electronic data management systems in enhancing data quality and efficiency in critical care settings. Further research is needed to assess the long-term impact on clinical outcomes and cost-effectiveness.

Keywords

Intensive Care Unit (ICU), Electronic Health Records (EHR), Data Management, SAPS III, Epimed Monitor ICU®