Geisinger, based in Danville, Pa., has achieved a 40% reduction in the average length of emergency department provider notes by using tools within its Epic EHR system.
This decrease in note length was prompted by the changes in billing and reimbursement guidelines introduced by CMS in 2023, Kyle Marshall, MD, an emergency medicine physician and associate chief medical informatics officer for operations at Geisinger, told Becker's.
To adapt to these changes, Geisinger decided to overhaul its ED note templates, which had been standardized across nine EDs over the past six years. The template was updated to replace lengthy historical sections with hyperlinks. These links open pop-up windows displaying past medical, surgical and social histories relevant to the current physician and patient encounter, thereby reducing note clutter while maintaining access to essential information, according to Dr. Marshall.
Previously, providers used smart links to automatically include all lab results and radiology reports in patient notes. Geisinger disabled these links for the ED, replacing them with hyperlinks that offer quick access to results without overwhelming the note.
In addition, Geisinger invested in provider education to ensure alignment with the new guidelines and to explain the rationale behind the changes to ED staff.
As a result of the note length reduction, efficiency in Geisinger's EDs has improved. Dr. Marshall noted that provider efficiency profile reports indicate less time spent on documentation and increased efficiency scores over time. Furthermore, the changes have reduced note length without impacting billing levels, ensuring compliance with the new guidelines.
Provider feedback to the changes has been largely positive, said Dr. Marshall, with many appreciating the simplified documentation process and the ease of using the updated Epic tools. The standardization has also enhanced the readability of notes for outpatient providers and patients, improving the overall experience.