In today’s 21st century, technology has come to play a vital role in all facets of the health care industry. Over time, it has seeped into the field of anesthesia, and has come to influence anesthesia management and practice. The latest implementations of technological development in the practice are anesthesia information management systems (AIMS). AIMS serve as a form of electronic health record system (EHRS) that generates an automated, continuous electronic anesthesia database of patient information. These automated anesthesia records gather and store a collection of the patient’s physiological data during the intraoperative period. By collecting basic vital signs and other anesthesia-relevant data, AIMS allow anesthesia providers to access necessary patient information needed for future management, administration, quality assurance, and research purposes. The beauty of an anesthesia information management system is that it has a multi-system interface that combines patient data from pre and post-operative monitors, various hospital clinical data repositories or other EHRS. This provides for a more comprehensive and complete patient record. However, like with most technology in the health industry, the application of AIMS is complex and must be managed with care and consistency to improve patient care.
Anesthesia information management systems are claimed to show improvements in 7 key areas of anesthesia care: cost containment, operations management, reimbursement procedures, quality of care, safety, translational research, and documentation. For patients, AIMS provide more accurate and available recordings of responses to anesthesia that will lead to better health records of treatments. Physicians can also benefit by using the system to improve quality assurance with the help of more accurate and detailed patient reports. AIMS allow anesthesia providers to spend more time focusing on their patients and less time charting information. These systems additionally track provider’s individual performances over time through precise time keeping and measurements. This feature is advantageous for providers because it offers future legal protection in the form of accurate and unbiased recordings. AIMS also offer a tool to control resource management in operating rooms and administration of anesthesia supplies and medications. This tool will enable health care providers to enhance the efficiency of their payment billings and reduce administrative costs. If implemented, anesthesia information management systems can ultimately help decrease health care costs for patients and improve the quality of provider care.
However while the use of anesthesia information management systems boasts many potential advantages, there are still several limitations to be considered due to the complexity of integrating these systems into everyday practice. The problem with depending on information technology in health care is that all providers and users need to be on the same page in terms of procedures and use of the system. One major drawback of AIMS is that there is no standard implementation for providers, leading to major inconsistencies within the practice. If providers don’t know how to use the system, or how to regularly update the database, the resulting incomplete patient records could make it difficult for future anesthesia management and administration. This can prove problematic during vertical integration when providers are transferring patient information from one phase of care to the next. Additionally, some physicians are afraid that the constant training required to update the system will detract from their time spent focused on the patient and result in a loss of personal medical attention. By eliminating providers’ concentration on manually recording and checking of patient information, there creates a chance for missing data due to glitches in the system. Furthermore, if physician anesthesiologists do not receive proper training on how to use AIMS consistently, there opens up more possibilities of incorrect or incomplete information, miscommunication and poor documentation. The use of electronic health records is intended to relieve physician pressure during recordkeeping but, if not integrated properly, can lead to increased liability for physicians. The reality may be that although AIMS provides a solution to an inefficient paper-based system, inappropriate use of the systems can lead to new inefficiency when generating clinical information.
Despite these growing concerns that AIMS may still be underdeveloped for anesthesia practice, many anesthesiologists may soon find themselves pressured into making the switch to these electronic health record systems. The Centers for Medicare and Medicaid Services (CMS) have adopted the Health Information Technology for Economic and Clinical Health Act (HITECH) and will put it into effect in late 2015 to advance the mission of having a national electronic health record system. This means that physicians who provide services on Medicare programs must transition from paper charts to electronic health records or possibly face a 1% cut in reimbursement rates for not complying. Whether or not this mandate applies to them directly, the switch from paper charts to electronic records will become more prevalent for physician anesthesiologists. It is clear that they will soon have to consider the adoption of using systems such as AIMS in their practice to stay involved in patient decision-making processes within clinical care.
Anesthesiologist health care professionals and provider organizations should take cautionary steps to ensure that if they choose to integrate AIMS into their patient care, they select systems that are customized to best fit their practice patterns and therefore minimize user error. After making the switch, organizations should ensure that their staffs are continuously and properly trained on how to correctly apply the electronic system into their routine. If these security conditions are met, the risks associated with lost information from electronic record systems will not outweigh the risks associated with incomplete or inaccurate data in paper records. In the end, AIMS can prove incredibly valuable to patients and providers if the necessary phases are completed to implement them properly. Anesthesia practice could very well soon be saying goodbye to the ancient paper-based system, and welcoming a new era of information technology through anesthesia information management system.
