Documenting resident activity in continuity clinic using a hospital or clinic health information management system

Continuity clinic directors, residency program directors, all faculty teaching in primary care pediatrics, and pediatric residents themselves all need information about resident activity in Continuity Clinic. Programs have found it time-consuming and costly to track activity by entering data from every patient encounter in continuity clinic. With the Health Information Management System (HIMS) of both our continuity clinic sites, we have developed methods for tracking resident activity using HIMS data (i.e. clinic billing data), thus eliminating the need for our own data entry. We have successfully implemented these methods at both a university health science center hospital-based clinic and a county health district community health center practice. From the HIMS, we can now produce activity reports which include number of patients seen by each resident, types and percentages of clinical activities, types and percentages of diagnoses, and patient demographics (e.g. age, gender, ethnicity, financial class). By importing this data into a data base (ACCESS), we are able to compare performance across residents, across three years of residency, and between our two continuity clinic sites. The data can be used by faculty to evaluate clinic/practice productivity and income potential (an ever increasing demand) and to monitor the scope and size of resident panels and individual residents' practice patterns. In this presentation, we will show sample activity reports and discuss the necessary steps for working with a hospital or clinic HIMS. Our motto is "why do data entry, if the billing department is already doing it?" We will discuss strategies for getting HIMS to modify their software or process to meet your training needs, identify the necessary data fields in the computer system, and discuss how to use the data for individual and program evaluation.