June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Impacts of Problem-Based Charting on Documentation Time at an Academic Outpatient Ophthalmology Center
Author Affiliations & Notes
  • Eliesa Ing
    Ophthalmology, OHSU, Portland, Oregon, United States
  • Jimmy N/A Chen
    Ophthalmology, OHSU, Portland, Oregon, United States
  • Thomas S Hwang
    Ophthalmology, OHSU, Portland, Oregon, United States
  • Christina J Flaxel
    Ophthalmology, OHSU, Portland, Oregon, United States
  • Michael F. Chiang
    Ophthalmology, OHSU, Portland, Oregon, United States
  • Michelle Hribar
    Ophthalmology, OHSU, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Eliesa Ing, None; Jimmy Chen, None; Thomas Hwang, None; Christina Flaxel, None; Michael Chiang, Noivartis (C); Michelle Hribar, None
  • Footnotes
    Support  P30EY10572 and R00LM12238 and unrestricted departmental funding from Research to Prevent Blindness (New York, NY)
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 1592. doi:
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      Eliesa Ing, Jimmy N/A Chen, Thomas S Hwang, Christina J Flaxel, Michael F. Chiang, Michelle Hribar; Impacts of Problem-Based Charting on Documentation Time at an Academic Outpatient Ophthalmology Center. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1592.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Problem-based charting (PBC) is a documentation method that integrates note writing and problem list management and has shown improved note quality and problem list utilization in inpatient settings. Ophthalmologists at OHSU who switched to PBC have anecdotally reported reduced time documenting. This study measures the effects of PBC on documentation time.

Methods : Documentation time was measured using EHR timestamp and audit log data extracted from OHSU’s datamart for providers who transitioned to PBC (2 retina and 1 glaucoma). All visits with complete timing data were included. Visits that occurred 4 months before and after transition to PBC were analyzed, along with a transition period when they first began using a PBC documentation template. Total documentation time before, during, and after visits were calculated for each provider and for technicians to account for varying numbers of patients per day. Appointment length, defined as time from patient checkin to checkout, was calculated.

Results : On average, the three providers spent 21.8 +/- 14.1 [MC1] minutes/patient documenting before, 23.4 +/- 16.6 minutes/patient while transitioning, and 20.2 +/- 16.2 minutes/patient after switching to PBC. Technicians spent a mean of 14.1 +/-17.8, 16.6 +/- 23.8, and 16.2 +/-20.4 minutes/patient before, during the transition, and after switching to PBC respectively.

Conclusions : Problem-based charting shows promise in increasing documentation efficiency for providers in outpatient ophthalmology, which could improve clinical efficiency and reduce provider burnout.

This is a 2020 ARVO Annual Meeting abstract.

 

Number of technicians, visits, and patients before, during the transition, and after switching to PBC, for each provider.

Number of technicians, visits, and patients before, during the transition, and after switching to PBC, for each provider.

 

Documentation time by before, during the transition, and after switching to PBC for providers and technicians.

Documentation time by before, during the transition, and after switching to PBC for providers and technicians.

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