By Dr. Douglas Keene, Chief Medical Officer, Recordation
Twitter:Â @douglaskeenetwt
Twitter:Â @RecordationInc
Less than a decade ago, 90 percent of all physicians were still recording patient information by hand and using color-coded filing systems to store patient data. Fast forward to today, however, and this number has flipped, with about nine in ten doctors expected to rely on EMRs by the end of 2017. However, while hospitals have undergone rapid changes when it comes to adopting EMRs, anesthesiology departments have, in large part, remained years behind this trend, achieving only about half the adoption rate of other hospital departments. For ambulatory surgery centers and other rural clinics, adoption of Anesthesia Information Management Systems (AIMS) has lagged even farther behind, as many smaller practices cite high fees, lengthy implementation processes and cumbersome, overly complex systems as prohibitive for implementation and use of an AIMS.
As a board-certified anesthesiologist, pain management and clinical informatics specialist, I’ve come to see the benefit that AIMS can have for smaller facilities and ambulatory surgery centers. As healthcare continues to decentralize, it becomes more and more important for these facilities to implement an AIMS solution to stay competitive in this increasingly crowded marketplace, and to streamline the sharing of information between primary care provider, hospital, and surgery center. AIMS can provide a more comprehensive electronic medical record of all the things that anesthesiologists have previously documented on paper during the anesthetic care of a patient, from pre-testing, into the OR, and then out through the recovery room. The result is improved legibility, more accurate data capture, improved chart completion, real-time decision support, and higher quality care.
While there are many benefits to EMRs, moving from a paper system to an anesthesia information management system is a big step, and one that can be daunting for many providers considering making the move. However, with EMRs in use across many departments, modern AIMS solutions are designed to mimic the same workflow and processes physicians are accustomed to using across patient care, making this transition as smooth as possible, while maintaining – and even improving — the bottom line: patient safety, satisfaction and organizational excellence.
A Better Anesthesia Information Management System
Despite the increase in EMRs in the hospital and clinical setting, anesthesiologists have struggled to adopt new data focused technologies in the operating room. As any good physician would wonder, anesthesiologists are asking: How can we be sure that an anesthesia information management system won’t require screen time that will take our attention away from the patient or cause disruptions in workflow?
Paying attention and watching the patient is a key part of anesthesia delivery, and AIMS should, in fact, empower anesthesiologists to be more diligent during patient care. In fact, early adopters of AIMS have found that anesthesiologists can actually spend less time documenting and writing and more time monitoring the patient. In addition, AIMS solutions improve the legibility of information that has traditionally been handwritten and AIMS capture more information than that recorded with a paper system. During a surgery, these systems can automatically pull in vital signs, including pulse oximetry, the end-tidal CO2, the inspired and expired volatile agents concentrations, etc., meaning that instead of observing these measurements and manually recording this data by hand, this information is automatically captured and displayed more meaningfully, freeing providers up to spend more time in direct patient care.
Intuitive user experience and interface, and the ability to easily customize the software to the unique workflow and needs of a specific physician or facility are essential elements for practices considering AIMS adoption. Many of today’s solutions are designed to mimic traditional interfaces and workflows that anesthesiologists are already familiar with and we’ve found that there is often little to no learning curve for physicians getting up and running with such systems. In fact, many early adopters of AIMS have found that they felt comfortable after using the system during two or three surgical procedures, and after six or seven cases, it was second nature, and workflows started to improve.
Conclusion: Planning for the Future
One of the key advantages to AIMS systems are their ability to help practices prepare for the future. Doctors have always been required to abide by certain reporting standards to ensure that protocols and guidelines are followed, and AIMS can help physicians to more easily track and document these requirements. This will only become more important as compliance reporting evolves and the industry shifts further toward a value-based model.
By pulling tracking operating room metrics such as anesthesia induction and emergence times, coupled with demographics and automated high resolution physiologic data capture, practices using AIMS are able establish benchmarks of safety and efficiency, and find ways of their improvement. Not only can this data be used to improve patient care, but also to increase the department of anesthesia’s and facility’s likelihood of survival in a competitive healthcare system that is based on data analysis. The patient, anesthesia care team and facility all benefit in this scenario.