As of 2012, a new metric for ED throughput is physician contact time – with the caveat that assigning a physician name on a tracking system, or the time of the first orders, is not adequate to measure this. Surprised? Some docs put their name on the patient as soon as the patient arrives in their pod; after all, they will be seeing the patient. 
Others only put their name on the patient’s tracking board entry after they’ve physically seen the patient. If and when they remember, that is. Some figure that the time from “arrival in room” to “seen by physician” time is most important – and indeed, that may be what they’re being graded on. Others figure that the time from “seen by physician” to “admitted” or “discharged” may be most important – and indeed, that may be what they’re being graded on.
But now that CMS has said
“Our ED physicians “Assign” themselves to patients using the tracking board function of EHR. Does documentation of the date/time “assigned” qualify as Provider Contact Date/Time? Otherwise, the earliest documentation of contact with the patient would typically be the first order or the first LIP progress note. Are those acceptable forms of documentation for these data elements?”
“No, this would not be sufficient documentation of provider contact. You would need to use documentation that supports the time of the first direct, personal exchange between an ambulatory patient and a physician or institutionally credentialed provider to initiate the medical screening examination.”
–Quality Insights of Pennsylvania
I predict three things:
(1) ED directors will try to persuade docs to only put their name on the patient at the instant they actually see the patient,
(2) this will be a miserable failure that fails to generate accurate data and causes much friction, and that
(3) passive tracking (using RFID smart badges that track when you enter a room) will suddenly be of great interest to many EDs. May be a good time to invest in these products.
Tags: Emergency Department, Computers, Information Technology, Healthcare, Healthcare IT, Usability, User Interaction Design, Tracking System, passive tracking, RFID
