If you have been a nurse for long, you know that hospitals have to answer to the government in some shape and form. Or I suppose they could try to not adhere to the government’s requests, but then, said hospital would lose reimbursement which amounts to lots of money. So, we all know where that hospital would then end up…out of business. It is a sad day when the primary nurse realizes that a hospital is a business; a very caring and empathetic one, right?
Well, one way a hospital meets the demands of CMS is by submitting data…lots of data! This actually costs the hospital lots of money. A small arm of this data submitting process is the actual data abstraction from the patient’s charts. Many hospitals hire nurses to review these charts, collect the necessary data andthen enter that data in to a web based system.
Back in the paper charting days, this was really the only way to get this done. Now, we have EHRs (electronic health records) where the data those nurses are abstracting is in a computer. If all of the data is now in a computer, shouldn’t we be able to get that data out of the computers into that web based data entry system? Surely, the companies who built the EHRs for hospitals were told the necessary parts of a chart. And surely, if the government is tying the hospital’s reimbursement to their data submission, the hospital would demand the computerized charts to always include those necessary parts. This has the opportunity to be a real money saver for hospitals. They will not need near as many data abstractors. Hospitals can now use these nurses to help educate and explain to the front line clinicians why these best practice guidelines are in place and make sure there is quality care when doing these guidelines, not just doing it because the government says we have to. After all, isn’t this why the guidelines were put in place in the first place!!