WIP 74 - Outpatient EMR Workflow Optimization for Adolescent Reproductive Health Visits

Publication Number: WIP 74.7646

Ana Patricia Torga, Childrens National Hospital, Washington, DC, United States; Sharyn Malcolm, Children's National Health System, Laurel, MD, United States; Angela Hasler, Children’s National, Washington, DC, United States

Background: The adoption of electronic medical records (EMRs) in the United States has brought numerous advantages to medical practices but has also increased the documentation and clerical workload for physicians, contributing to high rates of provider burnout (Budd, 2023). Pediatricians, for instance, spend approximately three hours daily on EMR use (Tai-Seale et al., 2017), with an average of 16 minutes per patient encounter—31% of which is dedicated to documentation and 13% to order placement (Overhage & Johnson, 2020). Additionally, inaccuracies in International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) coding may adversely affect relative value unit (RVU) calculations and overall revenue generation (King et al., 2001).

Objective: This quality improvement project (QIP) seeks to implement Quick Visits, an integrated care workflow within the Cerner EMR. The goal is to reduce documentation burden and optimize revenue streams for adolescent reproductive health visits within an adolescent medicine subspecialty clinic. The initiative aims to enhance time to chart closure, improve documentation and ICD coding accuracy, and ensure billing accuracy.

Design/Methods: A retrospective chart review of adolescent reproductive health visits will identify gaps in standardization and establish baseline performance metrics for adolescent medicine providers at our urban tertiary academic institution. Based on the findings, Quick Visit templates will be developed to target identified areas for improvement. The new templates, coupled with provider education, will be disseminated across the outpatient department to support standardized and efficient documentation practices and revenue cycle optimization.

The QIP was submitted to our institution's Institutional Review Board (IRB) and was deemed IRB-exempt. We are currently in the stage of analyzing baseline metrics to inform the development of the Quick Visit templates.