[Implementation of a patient data management system. Effects on intensive care documentation]

Area of Science:

• Critical Care Medicine
• Health Informatics
• Health Services Research

Context:

• Intensive Care Units (ICUs) increasingly adopt digital solutions for patient data management.
• A commercial Patient Data Management System (PDMS) was implemented in a 25-bed surgical ICU to replace paper-based charting.
• The PDMS aimed to improve documentation, streamline data compilation from medical devices, and facilitate administrative tasks, potentially impacting hospital reimbursement.

Purpose:

• To evaluate the impact of PDMS implementation on documentation quality and reimbursement-relevant parameters in a German surgical ICU.
• To assess changes in cost and reimbursement data, including case mix, length of stay, coded diagnoses and procedures, and mortality rates.
• To determine if the benefits of PDMS implementation justified the investment.

Summary:

• A retrospective analysis of 8 years of data (3 years pre-PDMS, 5 years post-PDMS) revealed minimal changes in key documentation parameters.
• While the number of coded diagnoses increased post-PDMS, the proportion of DRG-relevant diagnoses decreased. Procedure coding and ventilator-associated DRG cases showed no significant increase.
• Costs and revenues saw slight increases, but profitability varied. PDMS implementation had no significant impact on ICU mortality rates.

Impact:

• The study found that the effects of PDMS on documentation of reimbursement-relevant parameters were too small to offset the total investment costs.
• The long-term follow-up methodology proved successful and adaptable for other healthcare organizations.
• No significant influence of the PDMS on patient mortality was observed.