A randomized trial of automated electronic alerts demonstrating improved reimbursable anesthesia time documentation

Study Objective: To investigate whether alerting providers to errors results in improved documentation of reimbursable anesthesia care.Design: Prospective randomized controlled trial.Setting: Operating room (OR) of a university hospital.Interventions: Anesthesia cases were evaluated to determine whether they met the definition for appropriate anesthesia start time over 4 separate, 45-day calendar cycles: the pre-study period, study period, immediate post-study period, and 3-year follow-up period. During the study period, providers were randomly assigned to either a control or an alert group. Providers in the alert cohort received an automated alphanumeric page if the anesthesia start time occurred concurrently with the patient entering the OR, or more than 30 minutes before entering the OR.Measurements: Three years after the intervention period, overall compliance was analyzed to assess learned behavior.Main Results: Baseline compliance was 33% ± 5%. During the intervention period, providers in the alert group showed 87% ± 6% compliance compared with 41% ± 7% compliance in the control group (P < 0.001). Long-term follow-up after cessation of the alerts showed 85% ± 4% compliance.Conclusions: Automated electronic reminders for time-based billing charges are effective and result in improved ongoing reimbursement.