Implementing standardized provider documentation in a tertiary epilepsy clinic
Document Type
Article
Abstract
© American Academy of Neurology. Objective To incorporate standardized documentation into an epilepsy clinic and to use these standardized data to compare patients' perception of epilepsy diagnosis to provider documentation.MethodsUsing quality improvement methodology, we implemented interventions to increase documentation of epilepsy diagnosis, seizure frequency, and type from 49.8% to 70% of adult nonemployee patients seen by 6 providers over 5 months of routine clinical care. The main intervention consisted of an interactive SmartPhrase that mirrored a documentation template developed by the Epilepsy Learning Healthcare System. We assessed the weekly proportion of complete SmartPhrases among eligible patient encounters with a statistical process control chart. We used a subset of patients with established epilepsy care linked to existing patient-reported survey data to examine the proportion of patient-to-provider agreement on epilepsy diagnosis (yes vs no/unsure). We also examined sociodemographic and clinical characteristics of patients who disagreed vs agreed with provider's documentation of epilepsy diagnosis.ResultsThe median SmartPhrase weekly completion rate was 78%. Established patients disagreed with providers with respect to epilepsy diagnosis in 18.5% of encounters ( = 0.13), indicating that they did not have or were unsure if they had epilepsy despite having a provider-documented epilepsy diagnosis. Patients who disagreed with providers were similar to those who agreed with respect to age, sex, ethnicity, marital status, seizure frequency, type, and other quality-of-life measures.ConclusionThis project supports the feasibility of implementing standardized documentation of data relevant to epilepsy care in a tertiary epilepsy clinic and highlights an opportunity for improvement in patient-provider communication.
Publication Date
7-14-2020
Publication Title
Neurology
ISSN
00283878
E-ISSN
1526632X
Volume
95
Issue
2
First Page
E213
Last Page
E223
PubMed ID
32546650
Digital Object Identifier (DOI)
10.1212/WNL.0000000000009778
Recommended Citation
Jones, Felipe J.S.; Smith, Jason R.; Ayub, Neishay; Herman, Susan T.; Buchhalter, Jeffrey R.; Fureman, Brandy E.; Cash, Sydney S.; Hoch, Daniel B.; and Moura, Lidia M.V.R., "Implementing standardized provider documentation in a tertiary epilepsy clinic" (2020). Neurology. 516.
https://scholar.barrowneuro.org/neurology/516