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You can't just blame to tools for annoying hospital policy, but similarly to https://chrisgagne.com/1255/mary-poppendiecks-the-tyranny-of-the-plan/ https://chri

You can't just blame to tools for annoying hospital policy, but similarly to https://chrisgagne.com/1255/mary-poppendiecks-the-tyranny-of-the-plan/ https://chrisgagne.com/1255/mary-poppendiecks-the-tyranny-of... there's a nasty feedback loop that the provisioning of software for administration and tracking (vs direct use as tools) unlocks and enhance. The perceived ability to have more detailed documents means all the effort goes into the detail of the documents and, with finite effort (or at least finite amount the higher-ups are willing to spend on individual contributors to give them more time to do things), more effort is spent on record-keeping than on the actual job. Now that you have more record-keeping you can dig into "stats" and "trends" etc that may not have any statistical significance at the level you're inspecting them, but are suddenly much more visible, and pushes you towards tinkering with the process instead of the what of the work. And then that slows down the doing, which makes you more interested in tracking and improving the process, repeat repeat repeat.

nradov 3y ago
Hospital documentation (charting) policies are driven mainly by payer coverage rules and government care quality metrics. Administrator desire for stats and trends is much less of a factor. There is a huge amount of waste and inefficiency in most provider organizations so any attempts at process improvement should be encouraged. As the industry moves toward value-based care reimbursement models there will be more financial incentives to do so.
- majormajor 3y ago
  If not for computers and software would those coverage rules and metrics have evolved to the same level of detail? And then how do you keep insurance payers from considering things like "spent more than 5 minutes with a patient" that aren't "necessary" in the large majority of cases as "waste and inefficiency"?

nradov 3y ago

Hospital documentation (charting) policies are driven mainly by payer coverage rules and government care quality metrics. Administrator desire for stats and trends is much less of a factor. There is a huge amount of waste and inefficiency in most provider organizations so any attempts at process improvement should be encouraged. As the industry moves toward value-based care reimbursement models there will be more financial incentives to do so.

majormajor 3y ago
If not for computers and software would those coverage rules and metrics have evolved to the same level of detail? And then how do you keep insurance payers from considering things like "spent more than 5 minutes with a patient" that aren't "necessary" in the large majority of cases as "waste and inefficiency"?