And, a retrospective, observational study is the perfect vehicle for an agenda. You pick the criteria you want to measure, the most favorable time period, and voilà! These authors picked a six month pre-intervention period and a six-month post-intervention period. Triage categories were similar for that six month period. And then...they present data on a three-month subset. Indeed, all their descriptive statistics are of only a three-month subset excepting ambulance offload waiting time – for which they have full six month data. Why choose a study period fraught with missing data?
Then, yes, by every measure they are less efficient at seeing patients with the Cerner product. The FirstNet system had been in place for six months by the time they report data – but, it's still not unreasonable to suggest they're somewhat suffering the growing pains of inexperience. Then, they also understaff the ED by 3.2 resident shifts and 3.5 attending shifts per week. An under-staffed ED for a relatively new implementation of a product with low physician acceptance?
As little love I have for Cerner FirstNet, I'm not sure this study gives it a fair shot.
"Effect of an electronic medical record information system on emergency department performance"