Using Electronic Health Record Activity to Represent Interdisciplinary Care Teams and Examining their Contribution to Hospital Length of Stay.

ABSTRACT

Modeling variance in patient outcomes using medical claims and other forms of aggregated administrative data may ignore significant contributions associated with providers who are not recorded in billing transactions. We examined the association between interdisciplinary provider factors and length of stay (LOS) for 1,099 lumbar spine surgery patients. Interdisciplinary provider "dose" (number of providers/case), "workload" (care of other patients), and "activity" factors were defined and generated. Hierarchical Regression models were used to test the impact of these provider factors controlling for the effect of socio-demographic and clinical factors. Interdisciplinary provider factors explained 12% of additional variance in LOS. EHR-based interdisciplinary care team representations hold promise in contributing to our understanding of health care delivery and quality. Keywords interdisciplinary care, nursing documentation, workload, length of stay, electronic health records (EHR).