Anesthesia Information Management System Implementation: A Practical Guide

Abstract

Anesthesia Information Management Systems (AIMS) display and archive perioperative physiological data and patient information. Although currently in limited use, the potential benefits of an AIMS with regard to enhancement of patient safety, clinical effectiveness and quality improvement, charge capture and professional fee billing, regulatory compliance, and anesthesia outcomes research are great. The processes and precautions appropriate for AIMS selection, installation, and implementation are complex, however, and have been learned at each site by trial and error. This collaborative effort summarizes essential considerations for successful AIMS implementation, including product evaluation, assessment of information technology needs, resource availability, leadership roles, and training.

Anesthesia Information Management Systems: Past, Present, and Future of Anesthesia Records

“…Finally, the contemporaneous and objective physiologic data captured by an automated anesthesia record may provide a more credible medicolegal defense than a handwritten record generated by the anesthesia provider after the fact when an adverse outcome has occurred. Improved cost containment 16,48,49 Decrease drug cost/utilization More accurate accounting of anesthesia supplies and medications Tool for controlling resource management in the operating room Improved operations management 10,50 Decrease workload on billing personnel when reviewing anesthesia records Improve anesthesia department's administrative role in the perioperative setting Improve staff scheduling Generate a real-time surgical whiteboard to improve situational awareness Facilitate reductions in staffing costs OR modeling for administrative decision support Improved reimbursement 10,50,51,52,67 Enhance anesthesia billing and charge capture Increase hospital reimbursement Merge financial systems with clinical documentation to gain efficiencies Improved quality of care 12,52 -61 Automatic risk calculation and anesthetic management recommendations Artificial intelligence to prevent adverse intraoperative events Facilitate implementation and adherence to departmental protocols Implement evidence based medicine (e.g. adherence to clinical guidelines for antibiotic prophylaxis, administration of beta blockade, venous thromboembolism prophylaxis) Tool to provide point-of-care clinical decision support Can provide timely clinical feedback to impact clinical behavior Improved safety 6,62 -66 Automatic notification of or location errors Development of drug diversion surveillance Help avoid blood transfusion reactions Enhance situational awareness Improved translational research 44 -46,53,68 Helps develop evidence-based medicine guidelines from data sets of empiric clinical practice Link intraoperative data to outcomes data (e.g.…”

The Anesthetic Record: How Content and Design Influence Function In Anesthetic Practice and Beyond

“…The electronic anesthetic record, in its current manifestation, is just one part of a more complex "anesthesia information management system" (AIMS) where the anesthetic record component interfaces with numerous other hospital data bases, such as medical records, preoperative assessments, laboratory results and surgical scheduling. The AIMS can also be expanded to create research, quality assurance and professional services (billing) databases [5].…”

“…For example, AIMS can allow point-of-care access to other medical and laboratory information. Some systems have been designed to provide alerts for allergies [5] or to improve timely surgical antibiotic re-dosing by offering the clinician reminder prompts [28]. Other potential applications in which the anesthesia information system plays an active role in improving patient care are likely limited only by one's imagination.…”

“…The AIMS has sophisticated managerial functions which allow it to be used for such diverse purposes as recording professional services (billing) and tracking supply utilization (medication and disposables). Those readers seeking an in-depth discussion of the AIMS are referred to several excellent previouslypublished articles [5,[38][39][40].…”

“…The electronic anesthetic record, in its current manifestation, is just one part of a more complex "anesthesia information management system" (AIMS) where the anesthetic record component interfaces with numerous other hospital data bases, such as medical records, preoperative assessments, laboratory results and surgical scheduling. The AIMS can also be expanded to create research, quality assurance and professional services (billing) databases [5].Evidence suggests that the AIMS' greatest strength (powerful capabilities) is also its main drawback (complexity) which has hindered its widespread adoption [6] despite vigorous endorsement by the Anesthesia Patient Safety Foundation [7]. Nonetheless, evidence also suggests that implementation of AIMS is on the cusp of an upward surge [6] and it may be that the handwritten anesthetic record, having served our specialty for over 100 years, is soon to be of historical interest only.…”