3-minute case study: Intensive chart prep

By Erin Graham | March 17, 2017


Researchers have identified top performers on key financial and clinical metrics across the athenahealth network — and are uncovering the innovations that drive their success. Here's a snapshot of one tactic on the road to lower cost, higher value care.

Prepping patient charts early leads to improved quality metrics

The problem

With an expanding network of inpatient, ambulatory, emergency, and diagnostic services across Sussex County, Delaware, Beebe Medical Group has struggled with a lack of interoperability among the hospital systems in its state. While it is critical for the network's providers to have access to complete patient information, pulling the data together from many unconnected sources is slow and labor intensive.

The solution

A patient chart preparation strategy has allowed care teams to take visit planning — and the generation of clinical quality measures — to a new level. Many healthcare systems review patient charts the day before or the morning of a visit. But Beebe's electronic health record optimization team has instituted a policy of prepping all charts three full days before an office visit — for every patient, every time.

Nurses and medical assistants on each clinical team determine whether the patient's chart contains all of the appropriate documentation from within their own network of in-patient hospitals, ambulatory clinics, imaging centers, labs, and physical therapy facilities. Then they track down any relevant information from five other hospital systems by checking the Delaware Health Information Network. If notes or test results are still missing, staff call the patient to fill in gaps. And, if necessary, they reschedule the appointment until the chart is complete.

“Ultimately, we're here to support our providers," says Emily Oakes, RN, Beebe's EHR optimization and informatics specialist. “If we don't support them by having the information at their fingertips when they're facing the patient, then we didn't do our job."

The outcome

Beebe Medical Group is one of the top performers on the athenahealth network on key quality metrics — hypertension and HbA1c control, mammographies, and colorectal screenings — and intense chart preparation is one reason why. A system for data collection ensures that all preventive screening and other quality measures have been met. And when staff takes ample time for chart preparation, providers have a complete picture of a patient's health before each visit — and more time, within the visit, to focus on patient care.

Erin Graham is a writer based in Boston.

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