Bar-code medication administration system for anesthetics: effects on documentation and billing.
OBJECTIVE
The effects of using a new bar-code medication administration (BCMA) system for anesthetics to automate documentation of drug administration by anesthesiologists were studied.


METHODS
From October 1, 2004, to September 15, 2005, all medications administered to patients undergoing cardiac surgery were documented with a BCMA system at a large acute care facility. Drug claims data for 12 targeted anesthetics in diagnosis-related groups (DRGs) 104-111 were analyzed to determine the quantity of drugs charged and the revenue generated. Those data were compared with claims data for a historical case-control group (October 1, 2003, to September 15, 2004, for the same DRGs) for which medication use was documented manually. From October 1, 2005, to October 1, 2006, anesthesiologists for cardiac surgeries either voluntarily used the automated system or completed anesthesia records manually.


RESULTS
A total of 870 cardiac surgery cases for which the BCMA system was used were evaluated. There were 961 cardiac surgery cases in the historical control group. The BCMA system increased the quantity of drugs documented per case by 21.7% and drug revenue captured per case by 18.8%. The time needed by operating-room pharmacy staff to process an anesthesia record for billing decreased by eight minutes per case. After two years, anesthesiologists voluntarily used the new technology on 100% of cardiac surgery patients.


CONCLUSIONS
Implementation of a BCMA system for anesthetic use in cardiac surgery increased the quantity of drugs charged by 21.7% per case and drug revenue per case by 18.8%. Anesthesiologists continued to use the automated system on a voluntary basis after conclusion of the initial study.
Nolen
Agatha L
AL
Hospital Corporation of America, Corporate Offices, Nashville, TN 37203, USA. agatha.nolen@hcahealthcare.com
Rodes
W Dyer
WD
D000066:Accounting; D000777:Anesthetics / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures; D004282:Documentation / Q000379:methods*; D004348:Drug Labeling / Q000379:methods; D001330:Electronic Data Processing / Q000379:methods*; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D007344:Insurance Claim Reporting; D016347:Medical Records Systems, Computerized / Q000191:economics*; D008508:Medication Errors / Q000517:prevention & control; D008510:Medication Systems, Hospital; D010607:Pharmacy Service, Hospital / Q000191:economics; D019095:Point-of-Care Systems; D012051:Reimbursement Mechanisms; D017751:Safety Management / Q000379:methods; D013714:Tennessee; D014584:User-Computer Interface
D000777:Anesthetics