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A workflow task force affects emergency physician compliance for point-of-care ultrasound documentation and billing.
Lewiss, Resa E; Cook, Jessica; Sauler, Allison; Avitabile, Nicholas; Kaban, Nicole L; Rabrich, Jeffrey; Saul, Turandot; Siadecki, Sebastian D; Wiener, Dan.
Afiliação
  • Lewiss RE; Department of emergency medicine, Department of Radiology, University of Colorado Hospital, Aurora, CO, USA. resaelewiss@gmail.com.
  • Cook J; Department of emergency medicine, Yale-New Haven Hospital, New Haven, CT, USA.
  • Sauler A; Department of emergency medicine, Mount Sinai St. Luke's Mount Sinai West, New York, NY, USA.
  • Avitabile N; Department of emergency medicine, St. Barnabas Hospital, Bronx, NY, USA.
  • Kaban NL; Department of emergency medicine, Mount Sinai Beth Israel Hospital , New York, NY, USA.
  • Rabrich J; Department of emergency medicine, Mount Sinai St. Luke's Mount Sinai West, New York, NY, USA.
  • Saul T; Department of emergency medicine, Mount Sinai St. Luke's Mount Sinai West, New York, NY, USA.
  • Siadecki SD; Department of emergency medicine, Mount Sinai St. Luke's Mount Sinai West, New York, NY, USA.
  • Wiener D; Bronx-Lebanon Hospital Center, Bronx, NY, USA.
Crit Ultrasound J ; 8(1): 5, 2016 Dec.
Article em En | MEDLINE | ID: mdl-27207087
BACKGROUND: Emergency point-of-care ultrasound (POC u/s) is an example of a health information technology that improves patient care and time to correct diagnosis. POC u/s examinations should be documented, as they comprise an integral component of physician decision making. Incomplete documentation prevents coding, billing and physician group compensation for ultrasound-guided procedures and patient care. We aimed to assess the effect of directed education and personal feedback through a task force driven initiative to increase the number of POC u/s examinations documented and transferred to medical coders by emergency medicine physicians. METHODS: Three months before a chosen go-live date, departmental leadership, the ultrasound division, and residents formed a task force. Barriers to documentation were identified through brain storming and email solicitation. The total number and application-specific POC u/s examinations performed and transferred to the healthcare record and medical coders were compared for the pre- and post-task force intervention periods. Chi square analysis was used to determine the difference between the number of POC u/s examinations reported before and after the intervention. RESULTS: A total of 1652 POC u/s examinations were reported during the study period. Successful reporting to the patient care chart and medical coders increased from 41 % pre-task force intervention to 63 % post-intervention (p value 0.000). The number of scans performed during the 3-month periods (pre-intervetion, post-intervention 0-3 months, post-intervention 3-6 months) was similar (521, 594 and 537). When analyzed by specific application, the majority showed a statistically significant increase in the percentage of examinations reported, including those most critical for patient care decision making: (EFAST (41 vs. 64 %), vascular access (26 vs. 61 %), and cardiac (43 vs. 72 %); and those most commonly performed: biliary (44 vs. 61 %) and pelvic (60 vs. 66 %). Of the POC u/s studies coded and reported for reimbursement, 15.9 % were billed before intervention and 32 % were billed after intervention (p value: 0.000). CONCLUSIONS: The formation of a workflow solution task force positively affected emergency physician compliance with POC u/s documentation for coding and billing over a 6-month period. Further investigation should assess the long-term effect of the intervention and whether this translates into increased revenue to the department.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2016 Tipo de documento: Article