Frisby Joshua, Smith Vernon, Traub Stephen, Patel Vimla L
School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Phoenix, AZ, United States.
Department of Emergency Medicine, Mayo Clinic, Phoenix, AZ, United States.
J Biomed Inform. 2017 Jan;65:97-104. doi: 10.1016/j.jbi.2016.11.008. Epub 2016 Nov 29.
Hospital Emergency Departments (EDs) frequently experience crowding. One of the factors that contributes to this crowding is the "door to doctor time", which is the time from a patient's registration to when the patient is first seen by a physician. This is also one of the Meaningful Use (MU) performance measures that emergency departments report to the Center for Medicare and Medicaid Services (CMS). Current documentation methods for this measure are inaccurate due to the imprecision in manual data collection. We describe a method for automatically (in real time) and more accurately documenting the door to physician time. Using sensor-based technology, the distance between the physician and the computer is calculated by using the single board computers installed in patient rooms that log each time a Bluetooth signal is seen from a device that the physicians carry. This distance is compared automatically with the accepted room radius to determine if the physicians are present in the room at the time logged to provide greater precision. The logged times, accurate to the second, were compared with physicians' handwritten times, showing automatic recordings to be more precise. This real time automatic method will free the physician from extra cognitive load of manually recording data. This method for evaluation of performance is generic and can be used in any other setting outside the ED, and for purposes other than measuring physician time.
医院急诊科经常面临拥挤问题。导致这种拥挤的因素之一是“挂号到见医生时间”,即从患者挂号到首次被医生诊治的时间。这也是急诊科向医疗保险和医疗补助服务中心(CMS)报告的有意义使用(MU)绩效指标之一。由于手动数据收集的不精确性,目前该指标的记录方法并不准确。我们描述了一种自动(实时)且更准确记录挂号到医生时间的方法。利用基于传感器的技术,通过安装在病房的单板计算机计算医生与计算机之间的距离,该计算机每次检测到医生携带设备发出的蓝牙信号时都会进行记录。将此距离自动与公认的病房半径进行比较,以确定在记录时间时医生是否在病房内,从而提高精确性。精确到秒的记录时间与医生手写时间进行了比较,结果显示自动记录更为精确。这种实时自动方法将使医生从手动记录数据的额外认知负担中解脱出来。这种绩效评估方法具有通用性,可用于急诊科以外的任何其他场景,以及用于测量医生时间以外的其他目的。