Prior to the implementation of Picis, a cumbersome and repetitive process of manual documentation was in place. The anesthesiologists would write the same information, such as name, case and diagnosis, redundantly on the anesthesia record, preoperative notes and billing sheet, specifically burdensome when there are multiple short cases. Deciphering handwriting was often frustrating for physicians, especially regarding airway issues, where on the paper space is limited and clinicians would cram information into one small corner.
On large cases, up to 45 minutes were spent working through procedures with the patient. Without an automated system, anesthesiologists would have to manually reconstruct documentation for that entire time period. In addition, with the paper record, waiting for record retrieval could take anywhere from minutes to hours and required physicians to dig through the paperwork to find information.
From a billing perspective, anesthesiologists had to enter a dozen or more data elements on a paper billing sheet to be mailed to the billing company with a copy of the face sheet. The paper process was serving as a barrier to optimal patient care and cost efficiency in the interoperative process.
In November 2008, CWH selected Picis Anesthesia Manager as the automated anesthesia information-management system (AIMS) that would produce a more complete, accurate and legible anesthesia record and ultimately help increase perioperative efficiencies. Used for online care documentation in CWH’s 12 operating rooms as well as other locations across the facility, Picis Anesthesia Manager ensures a consistent flow and availability of patient information throughout the patient-care chain.
Realizing that physician participation and buy-in is essential for the success of any AIMS implementation, CWH leveraged Physician Adoption Services from Picis, where an experienced anesthesiologist from Picis provided onsite consulting, training and support for the clinical staff. CWH also initiated an evening computer lab to help ease the transition to the AIMS by providing an environment for physicians to become familiar with the system without the pressure of caring for patients at the same time. When the go-live date came, all of the physicians were comfortable with the system.
With the physicians on board, the Picis solution was poised to drive results. Automatically documenting critical patient data gave anesthesiologists more time for patient care, and Picis Anesthesia Manager reduced retrieval time by up to 10 minutes per case. The system provides immediate access to the record across the continuum of care, facilitating the sharing of anesthesia information throughout the hospital. For example, the diabetes care team can access the anesthesia record for diabetic patients to study outcomes management.
Furthermore, Picis Anesthesia Manager has dramatically improved its professional fee billing by creating a complete billing report that requires little data entry, since most information is automatically downloaded from the AIMS. Manual data entry is decreased, data accuracy is improved and the time and effort required to issue a bill is reduced.
As an added benefit, Picis Anesthesia Manager helps practitioners comply with the Physicians Quality Reporting Initiative (PQRI), Center for Medicare and Medicaid Services (CMS) and Surgical Care Improvement Project (SCIP) regulations through consistent documentation practices. CWH views the Picis system’s flexibility as a way to keep up with changing healthcare regulations and requirements.
The Picis Anesthesia Manager enables Central Washington Hospital to better meet its mission of “responding to community needs by providing quality healthcare through caring, competence and accountability.”
About the Author
Dr. John Thomas is an anesthesiologist at Central Washington Hospital, Wenatchee, Wash. For more on OptumInsight, click here.