The following is a summary of ”New Coding Guidelines Reduce Emergency Department Note Bloat But More Work Is Needed,” published in the December 2023 issue of Emergency Medicine by Kyle Marshall et al.
The phrase “note bloat” comes from doctors’ notes getting longer and more repetitive. For a study, researchers sought to determine how new coding rules and best practices for recording affected the length of notes written by doctors in the emergency department (ED) and the time they spent writing them.
They looked at the length of all ED provider notes and the time doctors spent writing them between February 2018 and June 2023 in a big, multisite healthcare delivery company.
New coding rules from the American Medical Association and the Centers for Medicare & Medicaid Services meant we had to change the standard note form in January 2023. The main results were the length of the provider notes and the time spent writing them down.
The ED provider notes that made up their study group were 1,679,762. Six months after the intervention, the average number of notes went down by 872 words (95% CI: 867 to 877 words), but doctors spent the same amount of time writing them down. They cut the amount of ED provider notes by 872 words to follow new rules and standards.
The time doctors spent writing up notes stayed mostly the same, though. They give an early report of success in lowering the number of unnecessary notes in the ED to help guide future efforts to reduce the total amount of paperwork needed.
Source: sciencedirect.com/science/article/abs/pii/S0196064423005978
