Documentation of Clinical Activities Using a Web-Based Application within an Eight Hospital Integrated Health Care System: A Six-Year Experience

Abstract

Purpose

To assess the first 6 years of documented clinical interventions and activities by a health care system pharmacy department after implementation of a Web-based documentation tool.

Methods

Saint Barnabas Health Care System (SBHCS) implemented the Quantifi Web-based documentation tool in October of 2002. Nine global intervention categories were developed, and the activities of SBHCS's pharmacists were tracked from January 2003 to December 2008. The following data were monitored: total number of interventions per category, number of interventions per category stratified by year, total cost savings, cost savings by global category, top 5 activities documented each year, top 5 cost-saving interventions documented each year, and top 5 intervened medications each year.

Results

A total of 760,555 clinical activities were documented during the study period, with the greatest number of interventions being from the order clarification category (30%) from 2003 through 2005 and the laboratory analysis category (25% to 30%) from 2006 to 2008. The total number of documented activities trended upward each year, as a whole and in nearly every individual category. The total documented direct cost savings during the study period was $6,169,593, with the therapeutic interventions category ($1,993,490) being the most influential. The total cost savings generally trended upward over the 6-year period.

Conclusions

Implementation of the Web-based documentation tool had a positive impact on pharmacists' documentation rates. The tool is a practical and convenient method for documenting clinical activities and interventions in real-time, with corresponding cost-savings information, for a pharmacy department within an integrated health care system.