Real-world implementation of an EMR-integrated mobile patient self-report system for injured patients in the emergency department: a retrospective observational study

Communication errors and information loss during history-taking are common in the emergency department (ED). Although digital patient self-report systems may mitigate these problems, prior studies often required hospital-owned devices or app installation, limiting scalability. We evaluated the real-world implementation of an electronic medical record (EMR)-integrated mobile web-based patient self-report system for injured patients delivered through a widely used messaging platform. We conducted a single-center retrospective study of injury-related ED visits at a tertiary academic hospital in Seoul, South Korea. From June 7 to December 31, 2023, eligible patients received a structured injury history questionnaire link via a mobile messaging platform during ED waiting time, and responses were automatically imported into the EMR. The primary outcome was questionnaire completion among message recipients; associated factors were evaluated using multivariable logistic regression. Documentation completeness of registry-mandated injury fields and agreement of patient-entered responses with the medical record were additionally assessed. Of 3,966 injury-related ED visits, 3,684 were eligible, 3,029 (82.2%) received the questionnaire message, and 962 (31.8%) of message recipients completed it. In adjusted analyses among message recipients, younger age groups had higher completion than patients aged ≥ 75 years, and completion was also higher with longer waiting times. Completion was higher among patients with lower-acuity visits, during daytime and evening visits than nighttime visits, and among patients arriving by other vehicle or other ambulance than by 119 ambulance. Sex was not associated with completion. Additionally, documentation completeness was higher among patients who completed the questionnaire, and patient-reported responses showed high agreement with documentation (95.2% for general injuries and 91.7% for traffic injuries). An EMR-integrated mobile web-based patient self-report system was implemented in a real-world ED setting, and questionnaire completion was associated with greater documentation completeness, while patient-reported responses showed high agreement with documentation. These findings identify patient- and workflow-related considerations that may inform the future implementation and optimization of mobile self-report systems in the ED. Not applicable.