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Accepted for/Published in: JMIR Cancer

Date Submitted: Jan 14, 2025
Date Accepted: Mar 12, 2026

The final, peer-reviewed published version of this preprint can be found here:

Digital and Paper-Based Hospital Workflows and 60-Day Mortality in Acute Leukemia: Retrospective Natural Experiment

Ramos Peñafiel CO, Cabrera García , Balderas Delgado C, Luna Tenle R, Milán Salvatierra A, Godínez Cubillo N, Acosta Altamirano G, Sánchez Conejo R, Gallardo Rodríguez AG

Digital and Paper-Based Hospital Workflows and 60-Day Mortality in Acute Leukemia: Retrospective Natural Experiment

JMIR Cancer 2026;12:e71306

DOI: 10.2196/71306

PMID: 41996689

Digital and Paper-Based Hospital Workflows and 60-Day Mortality in Acute Leukemia: A Natural Experiment From Mexico

  • Christian Omar Ramos Peñafiel; 
  • Álvaro Cabrera García; 
  • Carolina Balderas Delgado; 
  • Rocío Luna Tenle; 
  • Andrea Milán Salvatierra; 
  • Nora Godínez Cubillo; 
  • Gustavo Acosta Altamirano; 
  • Rosa Sánchez Conejo; 
  • Adán Germán Gallardo Rodríguez

ABSTRACT

Background:

Acute leukemias pose a significant challenge in Latin America, where social, biological, and infrastructural barriers lead to poorer outcomes compared to developed countries. These include a higher prevalence of unfavorable genetic alterations, limited access to specialized care, and variability in healthcare processes.

Objective:

To evaluate the impact of Electronic Medical Records (EMR) on early mortality among patients with acute leukemia

Methods:

A retrospective cohort study evaluated 274 patients with acute leukemia. Of these, 62% were treated in a traditional physical records (TFR) system and 38% in an EMR system. Data on treatment intensity, time to antibiotic administration, and mortality were analyzed using chi-square, Fisher’s exact tests, and Kaplan-Meier survival analysis.

Results:

Early mortality was significantly lower in the EMR group (5.8%) compared to the TFR group (35.9%, p = 0.000). EMR systems enabled faster responses to critical events like febrile neutropenia, with a median time to antibiotics of 54 minutes versus 272 minutes (p = 0.000). High-intensity regimens were more frequently administered in the EMR group, improving survival outcomes (Log-Rank= 0.000).

Conclusions:

EMR systems reduce mortality and optimize critical care processes. Their implementation in public hospitals is essential to improve outcomes in Latin America, ensuring timely and equitable care. Clinical Trial: Non-applicable


 Citation

Please cite as:

Ramos Peñafiel CO, Cabrera García , Balderas Delgado C, Luna Tenle R, Milán Salvatierra A, Godínez Cubillo N, Acosta Altamirano G, Sánchez Conejo R, Gallardo Rodríguez AG

Digital and Paper-Based Hospital Workflows and 60-Day Mortality in Acute Leukemia: Retrospective Natural Experiment

JMIR Cancer 2026;12:e71306

DOI: 10.2196/71306

PMID: 41996689

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