{"id":4852,"date":"2017-03-13T13:39:00","date_gmt":"2017-03-13T17:39:00","guid":{"rendered":"https:\/\/systems4pt.com\/staging\/?p=4852"},"modified":"2017-03-27T09:44:18","modified_gmt":"2017-03-27T13:44:18","slug":"analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes","status":"publish","type":"post","link":"https:\/\/systems4pt.com\/staging\/analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes\/","title":{"rendered":"Analysis of 663,000 Patient Visits: Does Point-of-Care Documentation Result in Lower Patient Outcomes?"},"content":{"rendered":"

Analysis of 663,000 Patient Visits:\u00a0 Does Point-of-Care Documentation Result in Lower Patient Outcomes?<\/strong><\/span><\/h2>\n

We\u2019ve all heard both sides of this discussion:<\/span><\/h3>\n
    \n
  • Therapists need to document at point of care, during the patient encounter. Real-time documentation enables the therapist to stay on track through the day and leave work on time<\/span><\/li>\n<\/ul>\n

    Versus<\/strong><\/span><\/h3>\n
      \n
    • Spending time, \u201chands on the computer\u201d instead of \u201chands on the patient\u201d is wrong. We didn\u2019t go to PT school to be \u201ckeyboard jockeys.\u201d\u00a0 Treatment is the only thing that improves progression \u2013 as such, we need to maximize our treatment time with the patient \u2013 and document later<\/span><\/li>\n<\/ul>\n

      At times, opinions on the above can get heated.\u00a0 We often hear the rationale that \u201csupporting the proven science and evidence that surrounds physical therapy is our paramount, common goal.\u201d\u00a0 And that means maximizing patient outcomes \u2013 regardless of the impact on documentation time.<\/span><\/p>\n

      Embedded in the discussion that \u201cwe need to support the proven science and evidence\u201d lies the answer.<\/span><\/p>\n

      Putting emotion and opinion aside, it\u2019s very simple:\u00a0\u00a0Evidence can prove whether or not point-of-care documentation results in lower patient outcomes.<\/em><\/strong><\/span><\/p>\n

      To answer that question, Systems 4PT has completed a landmark research project, conducting an evidence-based analysis of 776 therapists over the span of 663,000 patient visits.\u00a0 All therapists involved were documenting on Systems 4PT EMR.\u00a0 The therapists involved followed their normal approach to treatment and documentation, as they did not know they were being measured.<\/span><\/p>\n

      During this research project, Systems 4PT analysts tracked a variety of data points for each therapist.\u00a0 For this discussion we will focus solely on our point-of-care documentation research, which identified:<\/span><\/p>\n

        \n
      • Whether each therapist documented daily notes, re-evals, and discharge notes at point of care, and<\/span><\/li>\n
      • If the therapist did document these notes at point of care, what percentage of documentation was completed during the patient\u2019s visit?<\/span><\/li>\n<\/ul>\n

        Likewise, Systems 4PT analysts tracked progression for each patient being treated.\u00a0 Our analysts identified, by patient:<\/span><\/p>\n

          \n
        • The percent of patient progression, based on improvements in functional outcome test scores<\/span><\/li>\n
        • The number visits required to yield that progression<\/span><\/li>\n<\/ul>\n

          This research project was a massive logistical and statistical undertaking.\u00a0 It yielded the evidence necessary to answer the question:\u00a0 Does point-of-care documentation result in lower patient outcomes?<\/em><\/span><\/p>\n

          DETAILED FINDINGS FOR POINT OF CARE (POC) Documentation:<\/strong><\/span><\/h2>\n

          \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0% Patient Progression\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 # of Visits Required\u00a0\u00a0\u00a0\u00a0 % of Therapists<\/u><\/span><\/p>\n

          100% of patients documented at POC: \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a049%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 14.8 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 25%<\/span><\/p>\n

          75 – 99.9% of patients documented at POC: \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 53%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 14.0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 15%<\/span><\/p>\n

          50 – 74.9% of patients documented at POC: \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 47%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 12.2\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 6%<\/span><\/p>\n

          25 – 49.9% of patients documented at POC: \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 47%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 15.4\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 6%<\/span><\/p>\n

          1 –\u00a0 24.9% of patients documented at POC: \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a046%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 12.2\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 6%<\/span><\/p>\n

          0% of patients documented at POC: \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 53% \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 15.0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a042%<\/span><\/p>\n

           <\/p>\n

          Interpretation<\/strong><\/span><\/h2>\n

          It bears noting that all of the 663,000 visits analyzed were documented on Systems 4PT EMR.\u00a0 The evidence-based conclusions that follow may or may not hold true with other EMR software.\u00a0 In particular slower, checklist-type approaches to EMR would likely yield different results.<\/span><\/p>\n

          \u201cHopscotching\u201d around the data:<\/span><\/p>\n

          It\u2019s a black or white issue: Therapists tend to either document at point of care or wait to document later<\/strong><\/span><\/p>\n

            \n
          • The largest category of therapists (42%) did not document at point of care<\/span><\/li>\n
          • 25% of therapists documented 100% (everything)\u00a0during the visit<\/span><\/li>\n
          • 15% documented 75-99.9% at point of care<\/span><\/li>\n<\/ul>\n

            Therapists tend not to \u201cdabble\u201d with point-of-care documentation<\/strong><\/span><\/p>\n

              \n
            • Only 6% of therapists documented 1-24.9% at point of care<\/span><\/li>\n
            • Only 6% of therapists documented 25-49.9% at point of care<\/span><\/li>\n
            • Only 6% of therapists documented 50-74.9% at point of care<\/span><\/li>\n<\/ul>\n

              Note that the lowest functional progression was delivered by therapists who documented a small portion (1-25%) of their notes at point of care (they dabbled)<\/strong><\/span><\/p>\n

                \n
              • Patient progression was 13.2% lower than best practices, albeit in 18.8% fewer visits<\/span><\/li>\n<\/ul>\n

                100% point-of-care documentation yielded 7.5% lower patient progression than 0% point-of-care documentation.<\/strong><\/span><\/p>\n

                  \n
                • With 1.3% fewer visits required<\/span><\/li>\n<\/ul>\n

                  Results for therapists who documented 75-99.9% of their notes at point of care, bear a second look<\/strong><\/span><\/p>\n

                    \n
                  • These therapists\u2019 patients enjoyed equally high functional progression as the patients of therapists who documented nothing at point of care<\/span><\/li>\n
                  • And therapists who documented 75-99.9% at point of care achieved these top-ranked outcomes in 6.7% fewer visits vs. therapists who waited until after the patient visit to document<\/span><\/li>\n<\/ul>\n

                    CONCLUSION AND RECOMMENDATIONS<\/strong><\/span><\/p>\n

                      \n
                    • We live in a world of science and evidence.\u00a0\u00a0 It is appropriate that therapists are fair to themselves and apply this same evidence-based thinking to how they document (and how late they work)<\/span><\/li>\n<\/ul>\n

                      Stay Flexible<\/em><\/strong><\/span><\/h3>\n
                        \n
                      • If conditions don\u2019t warrant point-of-care documentation, focus on the patient and document later<\/span><\/li>\n
                      • Therapists who documented every character during the patient encounter yielded 7.5% lower patient progression vs. those who documented nothing during the patient visit<\/span><\/li>\n
                      • The evidence suggests that religiously documenting 100% of the<\/span><\/li>\n<\/ul>\n

                        Don\u2019t Dabble<\/em><\/strong><\/span><\/h3>\n
                          \n
                        • The evidence suggests that therapists who \u201cinvest in point-of-care documentation training\u201d and who \u201cdedicate to documenting at point of care\u201d are more successful than therapists \u201cwho document a little\u201d at point of care.<\/span><\/li>\n
                        • 18% of therapists documented 1-74.9% of their notes at point of care. This group of therapists delivered the lowest progression of patient function \u2013 12% lower than best practices.<\/span>\n
                            \n
                          • To a trained, point-of-care expert, these findings make sense:<\/span>\n
                              \n
                            • Point-of-care documentation doesn\u2019t \u201cjust happen\u201d as an option or as a spur of the moment choice.<\/span><\/li>\n
                            • Successful point-of-care documentation requires discipline: Hardware accessibility, documentation style, and time management techniques are each unique and very intentional vs. a random, dabbling approach.<\/em><\/strong><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                              The Perfect Balance<\/em><\/strong><\/span><\/h3>\n
                                \n
                              • Therapists who documented most of their notes (75-99.9%) with the patient at point of care:<\/span><\/li>\n
                              • Delivered the highest progression of functional deficits<\/span>\n
                                  \n
                                • Tied for first place with therapists who documented nothing at point of care.<\/span><\/li>\n<\/ul>\n<\/li>\n
                                • In 6.7% fewer visits vs. therapists who documented 0% at point of care<\/span><\/li>\n
                                • And no doubt, therapists who documented 75-99.9% at point of care:<\/span>\n
                                    \n
                                  • Went home earlier than those who documented everything later.<\/span><\/li>\n
                                  • Spent less time catching up on notes at home versus therapists who documented 0% at point of care<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                    This statistical analysis proves that, there is no problem, there is no shame, and there is no downside to dedicating to point-of-care documentation<\/u>.\u00a0\u00a0 As stated, this requires \u201cthe right EMR\u201d as well as \u201cthe right hardware and techniques.\u201d\u00a0 But, there is an obvious and significant upside:\u00a0 Therapists who document at the point of care are able to leave work on time, or earlier than therapists who wait to document after the patient visit.<\/span><\/p>\n

                                    Be fair to yourself.\u00a0 Set the goal to master point-of-care documentation.\u00a0 You will both maximize patient outcomes and take your life back!<\/span><\/p>\n

                                     <\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":4858,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[56],"tags":[],"class_list":["post-4852","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"\nAnalysis of 663,000 Patient Visits: Does Point-of-Care Documentation Result in Lower Patient Outcomes? - Systems4PT<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Analysis of 663,000 Patient Visits: Does Point-of-Care Documentation Result in Lower Patient Outcomes?\" \/>\n<meta property=\"og:url\" content=\"https:\/\/systems4pt.com\/staging\/analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes\/\" \/>\n<meta property=\"og:site_name\" content=\"Systems4PT\" \/>\n<meta property=\"article:published_time\" content=\"2017-03-13T17:39:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2017-03-27T13:44:18+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/systems4pt.com\/staging\/wp-content\/uploads\/2017\/03\/AdobeStock_128899049.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1707\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Systems4PT\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Systems4PT\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/systems4pt.com\/staging\/analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/systems4pt.com\/staging\/analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes\/\"},\"author\":{\"name\":\"Systems4PT\",\"@id\":\"https:\/\/systems4pt.com\/staging\/#\/schema\/person\/cbd6a79a0c6efcdf4bf949f37beca785\"},\"headline\":\"Analysis of 663,000 Patient Visits: Does Point-of-Care Documentation Result in Lower Patient Outcomes?\",\"datePublished\":\"2017-03-13T17:39:00+00:00\",\"dateModified\":\"2017-03-27T13:44:18+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/systems4pt.com\/staging\/analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes\/\"},\"wordCount\":1171,\"publisher\":{\"@id\":\"https:\/\/systems4pt.com\/staging\/#organization\"},\"image\":{\"@id\":\"https:\/\/systems4pt.com\/staging\/analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/systems4pt.com\/staging\/wp-content\/uploads\/2017\/03\/AdobeStock_128899049.jpeg\",\"articleSection\":[\"General\"],\"inLanguage\":\"en\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/systems4pt.com\/staging\/analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes\/\",\"url\":\"https:\/\/systems4pt.com\/staging\/analysis-663000-patient-visits-point-care-documentation-result-lower-patient-outcomes\/\",\"name\":\"Analysis of 663,000 Patient Visits: Does Point-of-Care Documentation Result in Lower Patient Outcomes? 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