title: Acute pain management efficiency improves with point-of-care handheld electronic billing system.
abstract: BACKGROUND
  Technology advances continue to impact patient care and physician workflow. To enable more efficient performance of billing activities, a point-of-care (POC) handheld computer technology replaced a paper-based system on an acute pain management service.
  
  
  METHODS
  Using a handheld personal digital assistant (PDA) and software from MDeverywhere (MDe, MDeverywhere, Long Island, NY), we performed a 1-yr prospective observational study of an anesthesiology acute pain management service billings and collections. Seventeen anesthesiologists providing billable acute pain services were trained and entered their charges on a PDA. Twelve months of data, just before electronic implementation (pre-elec), were compared to a 12-m period after implementation (post-elec).
  
  
  RESULTS
  The total charges were 4883 for 890 patients pre-elec and 5368 for 1128 patients post-elec. With adoption of handheld billing, the charge lag days decreased from 29.3 to 7.0 (P < 0.001). The days in accounts receivable trended downward from 59.9 to 51.1 (P = 0.031). The average number of charge lag days decreased significantly with month (P = 0.0002). The net collection rate increased from 37.4% pre-elec to 40.3% post-elec (P < 0.001). The return on investment was 1.18 fold (118%).
  
  
  CONCLUSIONS
  Implementation of POC electronic billing using PDAs to replace a paper-based billing system improved the collection rate and decreased the number of charge lag days with a positive return on investment. The handheld PDA billing system provided POC support for physicians during their daily clinical (e.g., patient locations, rounding lists) and billing activities, improving workflow.
authors.affiliation: Department of Anesthesiology, University of Kentucky, Lexington, Kentucky, USA. bgfahy2@email.uky.edu
authors.forename: Brenda G
authors.initials: BG
authors.lastname: Fahy
mesh_terms: D000067:Accounts Payable and Receivable; D000208:Acute Disease; D000761:Anesthesia Department, Hospital / Q000191:economics / Q000458:organization & administration; D034201:Computers, Handheld; D003365:Costs and Cost Analysis; D003625:Data Collection; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000191:economics*; D019095:Point-of-Care Systems / Q000191:economics*; D011446:Prospective Studies; D012984:Software