Clinical Informatics in ASCs Are you ready? BY DAREN SMITH

Clinical informatics pro- motes the “understand- ing, integration and appli- cation of information technology in healthcare

settings,” according to the Healthcare Information and Management Sys- tems Society. Stated in simpler terms, it is the application of data, including analytics, and technology to deliver health care services. Informatics has been used in health care for decades, with significant growth taking place over the past several years. For many years, surgery centers did not need to concern themselves with falling behind hospitals and other pro- viders in the use of clinical informat- ics since profitable, compliant opera- tions could be sustained using paper records and basic computer systems and software. Those days, however, are quickly coming to an end. It will not be long until clinical

informatics are an essential, required component of operating a successful, compliant surgery center. In fact, that day may already be upon us.

The Promise of Clinical Informatics Clinical informatics can have many uses in ASCs that go beyond meet- ing requirements like the reporting of quality data G-codes to Medicare and collection of data on other quality measures as part of Medicare’s ASC Quality Reporting Program (such as “ASC-9: Endoscopy/Poly Surveil- lance: Appropriate Follow-Up Inter- val for Normal Colonoscopy in Aver- age Risk Patients” and “ASC-10: Endoscopy/Poly Surveillance: Colo- noscopy Interval for Patients with a History of Adenomatous Polyps”). The data entered into computer sys-

tems can also help surgery centers make evidence-based decisions. Three of the most significant ways that the use of informatics can bene- fit an ASC are enhancing the quality of care, facilitating accountability and containing costs.

Enhancing quality of care: It is one thing to believe your ASC provides great care and quite another to know it. Without data on quality, claims of pro- viding exceptional care are based on observations and “gut feelings.” When it comes to finding true “best prac- tices,” however, observations and gut feelings can only go so far. For example, perhaps your ASC is interested in reducing your patients’ rate of postoperative nausea and vom- iting (PONV). If you are not collect- ing data on PONV, how do you know where to begin in this effort and what to target for change? If you make changes, how will you know if those changes have the desired effect? If you are using clinical informatics,

the answers to these questions become much easier. By comparing the PONV


rates between physicians who perform the same case, you may find that one physician’s patients experience the low- est nausea and vomiting levels. Now you can work to assess what this physi- cian does differently from other physi- cians to bring about the desired result. With that information, your ASC can come up with a new standard of care, supported by data, and then pres- ent it to the other physicians in your ASC. The proof of a better practice that can reduce PONV will be in black and white. Facilitating accountability: To

run an optimal schedule, ASCs need to know when to discharge patients. Discharging too soon can create safety risks, while keeping patients in the facility longer than is necessary will tie up a bed and staff time. By deter- mining a benchmark for phase two recovery times by procedure, you can limit the number of times these scenar- ios occur in your ASC. Once you have a benchmark, you can use informatics to monitor for devi- ations and hold team members account-

The advice and opinions expressed in this article are those of the author’s and do not represent official Ambulatory Surgery Center Association policy or opinion.

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