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Published on: August 8, 2019
Effects of Computer-Based Documentation Procedures on Health Care Workload Assessment and Resource Allocation: An
Kathleen F Sarmiento1, Eilis A Boudreau1, Connor J Smith1
1is the National VHA TeleSleep Lead and is a Research Fellow, both at the San Francisco VA Healthcare System in California. is a Neurologist, and is a Research Investigator, both at VA Portland Healthcare system in Oregon. is an Informatics Research Associate, Eilis Boudreau is an Associate Professor of Neurology, and Robert Folmer is an Associate Professor of Otolaryngology, all at Oregon Health & Science University in Portland. is the Lead Clinical Analyst, Systems Design and Standardization in the Managerial Cost Accounting Office, VHA Office of Finance. Kathleen Sarmiento is an Associate Professor of Medicine, and Bhavika Kaul is a Critical Care Medicine Fellow, both at the University of California, San Francisco.
Background:
Computer-based documentation (CBD) is used commonly throughout the world to track patient care and clinical workloads. However, if capture of clinical services within the electronic health record (EHR) is not implemented properly, patient care services and workload credit will be inaccurate, which impacts business decisions related to demand for care and resources allocated to meet the demand. Understaffing of medical personnel can contribute to delays in treatment, missed treatments, and workforce turnover.
Objective:
To illustrate the impact of CBD procedures on health care workload assessment and resource allocation, this article uses data from the US Department of Veterans Affairs Corporate Data Warehouse to provide examples from the Veterans Health Administration (VHA) sleep medicine programs.
Discussion:
Inaccurate CBD led to underreporting of sleep medicine services provided at VHA facilities nationwide and contributed to insufficient allocation of resources and personnel. Recent modifications in CBD protocols (Stop Codes) improved the accuracy of data capture and reporting while providing VHA sleep programs with data they can use to advocate for workforce expansion to meet patient care needs.
Conclusions:
Inaccurate CBD of clinical workloads can result in inadequate allocation of health care personnel and resources to meet the needs of patients. Untreated sleep disorders are associated with increased risk of depression, anxiety, impaired neurocognitive functions, cardiovascular disease, motor vehicle accidents, and premature death. Educating health care providers and administrators on the importance of accurate designation of clinical services within the EHR is necessary to facilitate improvements in health care availability and delivery.
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Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.