Effects of implementing an electronic system for the collection of patient reported symptoms on clinic note transcription length
17035 Background: Recent advances in information technology have made the goal of incorporating patient-reported symptoms possible. Initial studies have examined the validity of these systems but no systematic work has been done to examine the impact on overall practice efficiency. The PACE (Patient Assessment, Care, and Education) System captures patient-reported symptoms, quality of life, social and family history changes, and other clinical data at every office visit. The PACE System includes the Patient Care Monitor (PCM), a standardized, comprehensive assessment of a patient's condition that allows for a self-reported review of systems (ROS) via a wireless, touch screen computer tablet. The purpose of this study was to determine if implementation of the PCM had an impact on total transcription length. Methods: The study utilized a retrospective within subjects control design comparing transcription length by physicians practicing both with and without the PCM. The PACE System was implemented in October 2004 in a main outpatient oncology site in Billings, MT (PACE site). The analysis compared transcription length by physicians who practice in the Billings office where the PACE system was available, and also in four sites in Montana and Wyoming where the PACE system was not available during the same time period (January to October 2006). All available, consecutive physician notes were analyzed from eligible physicians during the analysis period. Results: Four physicians met inclusion criteria and 8,150 notes were analyzed. The average number of dictation words at PCM sites was 406.7 as compared to 485.5 at non- PCM sites (a 16% reduction). The average number of dictation lines at the PCM sites was 54.0 as compared to 58.5 at non-PCM sites (an 8% reduction). Conclusions: Increases in the use of information technology in outpatient oncology necessitate increased understanding of the validity and utility of these systems. This study of the PACE system suggests that there may be an efficiency benefit by implementing patient self-reporting systems. No significant financial relationships to disclose.