The painful truth

Abstract

The EMR has introduced a significant documentation burden to the busy TSs. This documentation burden is critical for defining hospital charges and WRVUs, and it differs from that of OSs and NSs. Workflow changes, such as the introduction of scribes, may lessen the documentation burden and improve hospital charges and WRVUs of the TSs.

Acute Care Surgeons Spend More Time than General Surgeons on the Electronic Health Record (EHR)

“…Daily EHR documentation plays a critical role in the trauma service for patient care, communication, and hospital and physician compensation, even as time required for documentation becomes increasingly unsustainable. 15 The EGS service schedule may more closely resemble that of a general surgeon, but unpredictable surges in volume and acuity may decrease available EHR time per patient. Conversely, the critical care aspect of ACS requires increased time on the EHR per patient, as the complexity of this population necessitate frequent and thorough documentation and chart review.…”

Consultative vs Dedicated Inpatient Service for GI Training and Patient Care

“…Although this study focused primarily on internal medicine residents, its findings are likely generalizable to GI fellows (2). Another study examining documentation demands on trauma surgery providers (another procedure-oriented profession) found that 55% of their documentation was related to nonprocedural, financial-related issues (1,760 hours over the course of a year) (3). Ideally, GI fellows would spend less time on nonpatient facing administrative issues and more time learning, performing endoscopy, and engaging educational activities (4).…”

Surviving in the Electronic Era: My Top EMR Hacks

“…Scribes for example "pay for themselves" by improving the documentation quality and quantity for trauma and orthopaedic surgeons. 10 The presence of a scribe allows for the physician to focus on the patient and the problem rather than worrying about the ICD-10 code, orders, and the after-visit summary. By hiring a scribe without using a service and training them for pediatric orthopaedic specific documentation not only improves the quality of the notes but also allows for control of the term of employment, thus limiting turn-offer and simultaneously improving overall productivity.…”