Initial Evaluation of Scan-Form Preanesthetic Evaluation Decreasing Visits to an Outpatient Preanesthetic Evaluation Clinic
Gordon L. Gibby, Joe Layon, Judy Hoeft
University of Florida
In order to better serve ambulatory patients, our institution has supported the development of outlying surgical evaluation offices. Clinic managers questioned the need for all referred patients to travel to the hospital prior to the day of surgery for preanesthetic evaluation. In response, the authors developed a two-part paper preanesthetic form which can be transmitted by facsimile and scanned into an electronic medical record. We report on the initial experience using this medical informatics data capture system. Patients with the assistance of clerical personnel, completed a patient medical history scan form which was transmitted by facsimile to our preanesthetic evaluation clinic. This form includes 42 yes/no questions, as well as space for entry of up to four medications, two allergies and a phone number at which the patient could be contacted. Those who appeared to be ASA Physical Status I or II with no problems needing expedited review were not required to travel to the preanesthetic evaluation clinic. To those patients' forms were attached a blank scan form for the physician's evaluation and a survey form to gather information from the physicians; the packet was given to the physician scheduled to anesthetize the patient. The physician attempted to contact the patient by telephone the night before surgery. Prior to surgery, the physician completed the preanesthetic evaluation in the surgical holding area and obtained informed consent for the anesthetic. Forms were scanned into a dBase compatible database using Teleforms (Cardiff, Solano CA) software. In a 29-day period, 46 survey forms were returned by phsycians. In the same time period, 153 patients were allowed to bypass the usual visit to the preanesthetic evaluation clinic (many of whom will have surgery at a date later than the 29-day period). The phsyician's evaluations are shown in the following table.
Physician reporting on experience with 46 patients
24 (52%) Able to reach patient by phone night before surgery
16 (35%) Unable to reach patient
6 (13%) No response
35 (76%) Patient's history accurate
1 (2%) Patient's history had multiple false positive responses
10 (22%) No response
36 (78%) Patient was healthy and ready for surgery
1 (2%) Patient had an unexpected problem
9 (20%) No response
0 (0%) Patient needed more preoperative evalutation
0 (0%) Surgery delayed by an unexpected problem