Meaningless Use: Assessing Compliance With a Clinically Meaningless Emergency Department Documentation Requirement.

Area of Science:

• Health Informatics
• Emergency Medicine
• Public Health Policy

Background:

• New York State mandates Emergency Department (ED) providers document patient employment status and commute mode in the electronic health record (EHR).
• This initiative may divert providers from critical diagnostic and treatment duties, potentially leading to data inaccuracies.
• The clinical relevance of employment data in the ED setting is questionable, as the focus is on emergent condition management.

Purpose of the Study:

• To assess Emergency Department provider adherence to documenting patient employment status in the EHR.
• To compare provider-entered employment data with registration-collected data, considered the gold standard.
• To identify reasons for non-adherence or inaccurate data entry by ED providers.

Main Methods:

• A convenience sample of 100 patients admitted from the ED was retrospectively analyzed.
• Provider-entered employment status was compared against registration-entered employment status for concordance.
• The impact of ED busyness on data accuracy was assessed, and providers were interviewed regarding their documentation practices.

Main Results:

• For 92% of patients, providers recorded employment status as 'N/A'.
• For the remaining 8% recorded as 'retired', provider entry matched registration entry in 87.5% of cases.
• No statistically significant correlation was found between ED busyness and the accuracy of employment data entry.

Conclusions:

• ED providers frequently document employment status as 'N/A' due to perceived lack of clinical relevance.
• Mandatory documentation of non-clinical data fields can lead to provider distraction and potentially inaccurate EHR information.
• Data derived from such clinically irrelevant fields should be interpreted with caution due to potential inaccuracies.