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Comparing Costs of Data Entry: Manual Charts vs Computerized Registry

Comparing Costs of Data Entry: Manual Charts vs Computerized Registry. Allan Lieberthal MD, Marlene Lugg Dr.P.H, Stephen Tannenbaum MD Kaiser-Permanente, Southern California. Problem Addressed.

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Comparing Costs of Data Entry: Manual Charts vs Computerized Registry

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  1. Comparing Costs of Data Entry: Manual Charts vs Computerized Registry Allan Lieberthal MD, Marlene Lugg Dr.P.H, Stephen Tannenbaum MD Kaiser-Permanente, Southern California

  2. Problem Addressed • Clinicians are concerned that data entry into a registry will increase office work and costs compared with current manual procedures

  3. Study Plan • Compare nurse’s time entering immunization data and preparing patient and school immunization records using manual and electronic methods

  4. Methods • 10 LVN’s and NA’s • All active KITS users • Most with prior experience with manual logs • 9 case scenarios typical of daily immunization practice

  5. Methods • Nurses performed same procedure using KITS followed by manual system • Enter data into KITS or manual log plus AAP immunization record • Enter data into or print California Immunization Record • Prepare or print school report when needed • Observed and timed by investigator or nursing supervisor • Statistics • 3 way ANOVA, 2 way blocked design

  6. KITSKaiser-Permanente Immunization Tracking System • Operational since 1994 • Mainframe-Character based • 910,000 patients - 0-18 Y/O • > 20 million immunizations • Approx. 5000 users • MD’s, NP’s, RN’s, LVN’s, NA’s etc.

  7. KITS Menu

  8. Manufacturer/Lot Defaults

  9. Add Innoculation

  10. VIS

  11. California Immunization Record

  12. Age Scenario Patient ImmGiv KITS/Log Chart CIR SchoolForm AM Setup X 1 2 mo Routine shots Current 4 X X X 2 4 mo Routine shots Current 4 X X X 3 12mo Routine shots Current 5 X X X 4 5 yr Routine shots Current 3 X X X X 5 3 yr Up to date, school New 0 KITS X X 6 13 yr UTD, lost CIR, school Current 0 X X 7 8 yr Behind, new school New 3 X X X X 8 12 yr Routine shots Current 2 X X X Scenarios

  13. Registry Manual Difference P-Value Setup 2:51 3:25 0:33 0.02 Scenario 1 0:47 2:44 1:57 <.001 Scenario 2 0:49 1:50 1:01 <.001 Scenario 3 1:09 2:17 1:08 <.001 Scenario 4 0:43 1:47 1:04 <.001 Scenario 5 2:42 2:51 0:08 0.47 Scenario 6 0:37 2:28 1:51 <.001 Scenario 7 3:09 3:07 -0:02 0.62 Scenario 8 0:28 0:44 0:16 0.02 Results

  14. Conclusions • Use of a registry takes less office time than use of a manual system • Greatest time savings occurs when immunization and/or school records require completion • If each scenario is done twice a day, average time saved per day would be approximately 16 minutes

  15. Joan Franco RN Martin Lee PhD KITS Administrative Team Jacqueline Arana, MA Gloria Arguello, LVN Doreen Ayala, LVN Elena Doronio, LVN Susana D’Souza, MA Celia Gonzalez, LVN Herena Hartenstein, LVN Marcella Jackson, LVN Roy Judiong, LVN Frances Martinez, LVN Acknowledgements

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