Inaccurately recording the start of anesthesia care during a procedure is common and results in significant lost billing time for anesthesia practices and medical centers, suggests a study presented at the American Society of Anesthesiologists’ ADVANCE 2023.
The anesthesia start time (AST) must be documented from a computer logged into the electronic health record (EHR), and typically occurs once the patient is in the operating room (OR). However, the anesthesiologist meets with the patient prior to their arrival in the OR and begins tasks that are vital to the procedure – such as administering pre-medication and attaching monitors – and that time typically is not recorded. Depending on the patient and procedure, adding two to five minutes to the AST when logging it would account for the preparation and transit time, researchers say.
“These seemingly minor inaccuracies of recorded AST can cost medical centers and anesthesia practices hundreds of thousands of dollars in lost revenue,” said Nicholas Volpe Jr., M.D., MBA, lead author of the study and an anesthesiology resident physician at Northwestern University McGaw Medical Center, Chicago. “We suspect most anesthesiologists are unaware that they aren’t recording AST accurately. It’s not a result of negligence, but rather reflects that workflow hasn’t been optimized for accuracy.”
For the study, the researchers analyzed 40,312 procedures involving anesthesia – which occurred between November 1, 2021 and October 31, 2022 – at a single academic center. In 27,771 of the cases (68.74%), AST was recorded as starting once the patient was in the OR, without factoring in the preparation time. Using the national average charge for anesthesia time, the missing time translated to $638,671.57 in lost revenue for the year, the researchers determined.
