As athletic trainers flirt with idea of 3rd party reimbursement we need to have a better handle on the foundational skills to be able to properly submit services rendered to insurance.... The dreaded documentation.
I am not sure athletic trainers understand the responsibility of robust documentation if an AT wants to qualify for the most reimbursement.
With documentation, some work-life balance implications need to be considered.
From the Journal of Healthcare Management, in a survey on electronic health record (EHR) every participating clinician reported EHR-related distress affecting professional activities.
The five main themes and problem areas that emerged from physician interviews were:
1. System blocks to clinicians providing patient care
2. Poor local implementation, design, and functionality of the EHR
3. Billing priorities at odds with ideal workflow and best practice care
4. Lack of efficiency
5. Poor teamwork function
Participants said they were distressed by a variety of EHR-related causes such as documentation being prioritized over patient care, time for patient care activities reduced due to documentation requirements, unexpected changes in the EHR, query alerts regarding documentation, and multiple clicks or entries to complete a simple task.
Many distressing events centered on EHR design and implementation: lost notes, log-in issues, numerous alerts and pop-ups, hard stops that impede workflow, PDF scans filing, slow data entry, inaccurate data (e.g., “way too much noise in the note”), and unrealistic documentation expectations (e.g., queries, clarifications, and coding expectations). Other events were related to personal overload (e.g., excessive time on the computer and the feeling of not being able to keep up).
Participants conveyed a range of negative emotional responses to their distressing experiences, including demoralization, underappreciation, and a sense of failure. One participant described their inability to simultaneously document in the EHR and deliver quality care.
Participants mentioned anger with the EHR inhibiting the ability to finish work (“it breaks you”). For some, self-doubt and anxiety were secondary to an inability to keep up with the workload. The high volume contributed to a “mental load of unfinished notes” that participants connected to negative effects on patient care and work-life balance.
There were also the patient safety dangers of what the clinicians called a “bloated chart” populated by lengthy, templated, or copy-and-pasted notes full of unnecessary information, creating instances of missed important information. Participants reported that professionalism could also be undermined by billing requirements.
Skeff, Kelley M. MD, PhD; Brown-Johnson, Cati G. PhD; Asch, Steven M. MD; Zionts, Dani L.; Winget, Marcy PhD; Kerem, Yaniv MD. Professional Behavior and Value Erosion: A Qualitative Study of Physicians and the Electronic Health Record. Journal of Healthcare Management. 2022:67(5), 339-352. DOI: 10.1097/JHM-D-21-00070
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