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Clinician and Health Care Leaders' Experiences with-and Perceptions of-COVID-19 Documentation Reduction Policies and Practices.
Moy, Amanda J; Schwartz, Jessica M; Withall, Jennifer; Lucas, Eugene; Cato, Kenrick D; Rosenbloom, S Trent; Johnson, Kevin; Murphy, Judy; Detmer, Don E; Rossetti, Sarah Collins.
  • Moy AJ; Department of Biomedical Informatics, Columbia University, New York, New York, United States.
  • Schwartz JM; Columbia University School of Nursing, New York, New York, United States.
  • Withall J; Columbia University School of Nursing, New York, New York, United States.
  • Lucas E; Department of Biomedical Informatics, Columbia University, New York, New York, United States.
  • Cato KD; NewYork-Presbyterian Hospital, New York, New York, United States.
  • Rosenbloom ST; Columbia University School of Nursing, New York, New York, United States.
  • Johnson K; NewYork-Presbyterian Hospital, New York, New York, United States.
  • Murphy J; Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, United States.
  • Detmer DE; Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States.
  • Rossetti SC; Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States.
Appl Clin Inform ; 12(5): 1061-1073, 2021 10.
Article in English | MEDLINE | ID: covidwho-1532199
ABSTRACT

BACKGROUND:

Substantial strategies to reduce clinical documentation were implemented by health care systems throughout the coronavirus disease-2019 (COVID-19) pandemic at national and local levels. This natural experiment provides an opportunity to study the impact of documentation reduction strategies on documentation burden among clinicians and other health professionals in the United States.

OBJECTIVES:

The aim of this study was to assess clinicians' and other health care leaders' experiences with and perceptions of COVID-19 documentation reduction strategies and identify which implemented strategies should be prioritized and remain permanent post-pandemic.

METHODS:

We conducted a national survey of clinicians and health care leaders to understand COVID-19 documentation reduction strategies implemented during the pandemic using snowball sampling through professional networks, listservs, and social media. We developed and validated a 19-item survey leveraging existing post-COVID-19 policy and practice recommendations proposed by Sinsky and Linzer. Participants rated reduction strategies for impact on documentation burden on a scale of 0 to 100. Free-text responses were thematically analyzed.

RESULTS:

Of the 351 surveys initiated, 193 (55%) were complete. Most participants were informaticians and/or clinicians and worked for a health system or in academia. A majority experienced telehealth expansion (81.9%) during the pandemic, which participants also rated as highly impactful (60.1-61.5) and preferred that it remain (90.5%). Implemented at lower proportions, documenting only pertinent positives to reduce note bloat (66.1 ± 28.3), changing compliance rules and performance metrics to eliminate those without evidence of net benefit (65.7 ± 26.3), and electronic health record (EHR) optimization sprints (64.3 ± 26.9) received the highest impact scores compared with other strategies presented; support for these strategies widely ranged (49.7-63.7%).

CONCLUSION:

The results of this survey suggest there are many perceived sources of and solutions for documentation burden. Within strategies, we found considerable support for telehealth, documenting pertinent positives, and changing compliance rules. We also found substantial variation in the experience of documentation burden among participants.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study / Qualitative research Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: Appl Clin Inform Year: 2021 Document Type: Article Affiliation country: S-0041-1739518

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study / Qualitative research Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: Appl Clin Inform Year: 2021 Document Type: Article Affiliation country: S-0041-1739518