Disappearing Help Text: Implementing a Note-Based Tool for In-Line Clinical Decision Support and Note Bloat...

Area of Science:

• Medical Informatics
• Clinical Documentation Improvement

Background:

• Lengthy clinical notes and poor readability pose challenges in healthcare.
• Efficient documentation is crucial for patient care, billing, and provider workflow.

Purpose of the Study:

• To introduce and evaluate a novel clinical decision support tool called "disappearing help text."
• To assess the impact of disappearing help text on note length, readability, and documentation practices within Pediatric Hospital Medicine.

Main Methods:

• Developed an unobtrusive, in-line disappearing help text tool integrated into note templates.
• Implemented the tool in Pediatric Hospital Medicine (PHM) note templates to guide documentation best practices.

Main Results:

• Significantly reduced the use of laboratory SmartLinks across note types (e.g., admission, progress, discharge).
• Achieved a notable reduction in median note length, indicating "note bloat" reduction (e.g., 18.7% in progress notes).
• Observed a decrease in monthly coding queries without adverse effects on billing compliance audits.

Conclusions:

• Disappearing help text effectively improves clinical note readability and reduces documentation length.
• This tool serves as a valuable clinical decision support mechanism for enhancing documentation quality and provider efficiency.
• Implementation led to decreased automatic insertion of laboratories and overall character count reduction in notes.