A clinical documentation improvement program at Phoenix Children’s Hospital has increased clinician productivity and the quality of documentation while eliminating transcription services in ambulatory clinics, saving $1 million annually.
Physicians are using the Quippe clinical documentation software of Medicomp Systems, says Vinay Vaidya, MD, vice president and chief medical information officer at the hospital. Medicomp got the contract because of its expertise in documentation and the ease of building pediatric templates that included disease-specific templates.
“We’ve been able to customize documentation templates based on not only the unique needs of each specialty but also the most common specific diseases within each pediatric specialty,” Vaidya adds. “This helps us to track quality measures and monitor patient outcomes, which is a key requirement for successful chronic disease management.”
A series of templates, supported with data from the Allscripts electronic health record and a data warehouse built on Microsoft technology that pulls data from 50 different information systems, can capture disease-specific information on patients, which are fed to dashboards created at the hospital that physicians can access during pre-visit planning sessions as much as 14 days before a patient’s appointment. The dashboards include decision support that offers tools and reminders within the Quippe software as the physician documents care.
And the degree of necessary documentation can sometimes be overwhelming, says Michael Shishov, MD, a pediatric rheumatologist. “Juvenile idiopathic arthritis is a complicated disease to document because we must capture details on 71 individual joints as well as a number of other measures.”
Documenting family history used to be difficult, with coded and structured data that physicians would have to dictate multiple times. Working with the IT department and vendor, physicians created disease-specific templates, and now there is no need for repetitive entry of the same data, Vaidya says.
The speed of building the templates went faster than expected because the hospital’s database contains 360,000 medical and symptom disease terms “and the templates almost build themselves,” he adds.
For tech-savvy clinicians, the analytics database is pretty much self-service, and the doctors do their own analyses, Vaidya notes. In reality, however, the IT department does most of the analyses that non-techies want, such as a physician asking for a report on patients who miss the most visits.
What physicians really like, Shishov says, is that the documentation is of high quality and they don’t regularly have to spend hours at home finishing documentation after they leave the office. “Thanks to our IT specialists, clinical inactive disease, a complicated quality metric comprised of six different domains, is now successfully recorded by providers in 99 percent of our notes, and we’re still able to complete almost all of our documentation during regular office hours.”