Title: An Integrative Literature Review On Accuracy In Anesthesia Information Management

Systems

In the evolving field of healthcare technology, Anesthesia Information Management Systems

(AIMS) stand out for their critical role in enhancing patient safety and operational efficiency in
surgical settings. However, the complexity of these systems, combined with the rapid advancement
in technology and the ever-changing healthcare regulations, presents a significant challenge for
researchers and practitioners alike when trying to evaluate their accuracy and effectiveness.

Writing a literature review on such a nuanced and technical topic requires not only a deep
understanding of the technology itself but also of the myriad ways in which it interacts with human
factors, medical protocols, and institutional policies. The task involves sifting through a vast amount
of scientific literature, including peer-reviewed journal articles, technical reports, and case studies, to
identify relevant research findings. Furthermore, synthesizing these findings into a coherent narrative
that accurately reflects the current state of knowledge in the field requires advanced analytical and
writing skills.

One of the primary difficulties in conducting an integrative literature review on the accuracy of
AIMS is the need to navigate through complex technical descriptions and to critically evaluate the
methodologies and conclusions of each study. Researchers must be adept at recognizing biases,
identifying gaps in the literature, and understanding the implications of various research findings for
practice. Additionally, given the interdisciplinary nature of the field, which intersects with
information technology, medicine, and healthcare policy, reviewers must be knowledgeable across
these domains to fully appreciate the nuances of the research.

Moreover, the rapid pace of technological innovation means that literature on the subject can quickly
become outdated, necessitating continuous monitoring of new research developments. This dynamic
landscape poses a challenge for reviewers aiming to provide a comprehensive and up-to-date
overview of the accuracy of AIMS.

Given the complexities and challenges involved in writing a literature review on such a specialized
topic, individuals and organizations may benefit from seeking professional assistance. Services like
⇒ StudyHub.vip ⇔ offer expert support in navigating the intricacies of academic research and
writing. Their team of professional writers and researchers possesses the necessary expertise to
produce high-quality, integrative literature reviews on a wide range of topics, including the accuracy
of Anesthesia Information Management Systems. By leveraging such services, individuals can
ensure that their review not only meets academic standards but also provides valuable insights into
the effectiveness and reliability of AIMS, contributing to the advancement of knowledge in the field
and the enhancement of patient care.

In conclusion, undertaking an integrative literature review on the accuracy of Anesthesia Information

Management Systems is a complex and demanding task that requires a high level of expertise and
dedication. Given the challenges involved, seeking professional writing assistance can be a prudent
strategy for ensuring the quality and relevance of the review, ultimately contributing to the
improvement of healthcare outcomes through better understanding and utilization of AIMS.
Unfortunately, access to this resource typically occurs only after installation. In the future, use of the
wireless barcode reader is a high priority. The network security issues were ultimately addressed, but
the presence of other required software applications was more difficult to resolve between the
institution and the vendor. Three end points were a priori selected for their higher clinical
importance; these were the airway devices, positive pressure and suction end points. Reduce drug
and material consumption by tracking product usage. Evaluation of a mandatory quality assurance
data capture in anesthesia: A secure electronic system to capture quality assurance information linked
to an automated anesthesia record. Once preoperative personnel verify the patient's answers,
software logic in the PreopPlanner uses the information to recommend institution-specific
preoperative testing and medical and anesthetic consultations. However, an accurate measure of
DOA would likely become an important tool in the administration of proper anesthetic care (Liu et
al., 2015). It would not only help ensure patients were properly anesthetized but would also help
guarantee that patients would recover quickly and safely from the effects of anesthetics once medical
procedures had concluded. The client PC workstation consists of a basic tower PC, touch-screen
liquid crystal display (LCD) monitor, keyboard, wireless Bluetooth barcode scanner, and a serial
interface connection to each device that is connected to the DocuSys PC. Big bang implies that all
AIMS workstations go live within several days or a week, which may be particularly important if
time for implementation and training is limited. Read more anesthesia information management
system that helps anesthesiologists focus on the patient 1 of 7 Download Now Download to read
offline Ad Recommended Focus On The Patient With Anesthesia Information Management System
McKesson A. The narcotic tracking challenge almost stopped the implementation. And, best of all, it
is completely free and easy to use. The response of anesthesia trainees to simulated critical incidents.
Unfortunately, this type of software provides distribution and maintenance challenges for an
institution’s information technology staff. Upon transfer of patients from the OR to the PACU, cases
are closed from within the postoperative module using the dedicated wireless PCs. Six weeks after
the initial request, the web survey site was closed. Monitoring alerts can be triggered when a selected
parameter exceeds limits, thus encouraging an appropriate action. Thus, while the potential
functionality of the DocuSys automatic allergy alerts was missing, clinicians still had documentation
of patient allergies from the OCW source. Community Health Network Decreases Lost Drug Charges
by 40% with Anesthesia M. An anesthesia information system for monitoring and record keeping
during surgical anesthesia. This simplistic system initiated the era of AIMS and the electronic
anesthesia record. However, the actual decision was driven by key organizational stakeholders who
sought specific benefits from such a system. Participants were all presented the same simulated
patient (described in online supplementary appendix 1). DataCaptor is the intermediate software
between the data device (monitor) and the DocuSafe software ( Figure 6 ). Data processing at the
anesthesia workstation: from data entry to data presentation. Complaints about workstation hardware
placement and the user interface are common, and the AIMS can become a lightning rod for
criticism by those who view it as an unnecessary burden and a source of medico-legal risk. 38 A new
PSR format and a revised process for reviewing and reconciling the data needed for anesthesia
billing may, at first, also increase administrative anxiety and workload. Each type of software
implementation leverages a unique information technology infrastructure. DocuSys, a proprietary
anesthesia information management system (AIMS), creates an electronic version of the anesthesia
record and provides additional information. However, procedures such as attestations of medical
direction apply to attending anesthesiologists but not to residents or CRNAs.
The implementation process of an anesthesia information management system (AIMS). AIMS with
integrated coding modules permit anesthesiologists to document ICD-9 and CPT codes in the OR in
collaboration with the surgeon. The Encyclopedia of Information Science and Technology, Sixth
Edition) continues the legacy set forth by the first five editions by providing comprehensive
coverage and up-to-date definitions of the most important issues, concepts, and trends pertaining to
technological advancements and information management within a variety of settings and industries.
Site visits to institutions where the vendor's product is already in use can provide additional insight if
the visitors have specific objectives regarding product assessment. Product Roll-Out Phase Three:
Live Implementation—March 26, 2009 The project went live several weeks after the mock
implementation under a set of conditions designed to facilitate its acceptance, optimize the system's
performance, and maximize patient safety. Because most of the instructions for the application’s
behavior are stored locally in files on the workstation, the files must be updated on all workstations
by the information technology staff. Therefore, at least 61 (44%) of all 140 US academic anesthesia
departments have committed to AIMS. This estimated adoption rate is conservative because the
numerator equals the affirmative responses, whereas the denominator equals the total population of
academic departments. Even if Internet access is blocked, utility software is required on AIMS
workstations for remote administrative access and protection against malware originating from
within the intranet. The IPM facilitates adherence to the implementation schedule and gives final
approval for the go-live event. Read more anesthesia information management system that helps
anesthesiologists focus on the patient 1 of 7 Download Now Download to read offline Ad
Recommended Focus On The Patient With Anesthesia Information Management System McKesson
A. Practitioners are aware of patient allergy data but do not benefit from additional software
oversight. Demographic data (gender and resident year) were recorded as well. Winner of the
Standing Ovation Award for “Best PowerPoint Templates” from Presentations Magazine. Point-of-
Care Hardware Most potential customers recognize the importance of choosing the right software
model and vendor, and they recognize the difficulty of this task. Furthermore, AI can help mitigate
the risks associated with adverse intraoperative events by interpreting AIMS-collected patient data
and performing real-time analysis. Although it increases anesthesia provider “buy-in” by sharing
control of the user interface, customization requires substantial commitments of time and effort. The
team must also specify how each interface is to be configured to receive only those elements relevant
to anesthetic management. Provenance and peer review Not commissioned; externally peer
reviewed. Therefore, during go-live and for the first few weeks thereafter, it may be prudent to
review all AIMS documents before they are placed in the patient's EMR. Although duplicate record-
keeping is tedious and time-consuming, it may also be advisable to generate paper and electronic
anesthesia records concurrently for each case for several days after go-live. PACU PCs, which are
not used for real-time data acquisition, are wireless laptops. Its presence does not seem to have
caused any significant problems. One important application, OCW, could not be installed without
conflict. Furthermore, since most AIMS implementations also install other applications upon the
point of care workstation (enterprise electronic mail, web browser, medical reference), a keyboard
and mouse is necessary for these cross-industry applications that do not assume a touchscreen. As an
alternative to direct manual entry of drugs, drug selections can be scanned into the system from a
barcode list at the anesthesia workstation ( Figure 13 ). To maintain certification, these professionals
must report measures of clinical practice quality. Health IT Summit New York 2014 - Case Study
“Investment in a Health IT Infras. The keyboard and LCD display are mounted on the right side of
the anesthesia machines, above the tower PC. It provided a method to record patient indicators,
based on the preoperative assessment, to track medical devices (monitors, ventilators, etc), and to
document the administration of fluids and medications. (Chase et al., 1983) Unlike the earlier Case
Western prototype, it did not have the capability of recording real-time vital signs, i.e. data from
patient monitors. The product as purchased contained the following primary modules: PreSurgical
Care Management System (PCM) consists of HealthQuestionnaire and PreopPlanner. Benefits of an
AIMS include improved legibility of the anesthesia record and greater efficiency in documentation
efforts. By describing basic concepts and practical approaches for AIMS implementation, this article
may facilitate more widespread use of this valuable evolving technology by anesthesiologists in both
academic and community practice.
These specifications resulted in the need for 2 to 3 serial ports on our client PCs. Finally, regardless
of which hardware is chosen, it must be mounted or secured in an economical and effective manner.
In addition, the AIMS were rated highly as to user acceptance, reliability, improvement of billing
processes, and reporting purposes. Scanned data are quickly available and readable by clinicians but
cannot be searched for individual data elements. While accommodations were made, Ochsner
required that software for system maintenance remain on the PCs. Table 3: Major Motivating Factors
for Installing an Anesthesia Information Management Systems (AIMS) Before Implementation
Table 4: Please Rate Each of the Following Items for the time After Anesthesia Information
Management Systems (AIMS) Implementation (Early Adopters) Barriers to Implement AIMS.
Narrative DocuNotes were created to meet desired documentation requirements, and selected ones
can be made mandatory. This note is not a hard stop because this event does not occur in all cases.
For more information, please refer to our Privacy Policy. The study was performed using the CAE
Human Patient Simulator (CAE, Quebec, Canada). Immediate patient care must take priority over
charting. Successful AIMS implementation requires many decisions regarding hardware and system
configuration and the training and support of personnel. Exposure of the equipment to this level of
maneuvering should be considered when evaluating the necessary durability. For clinicians, the
AIMS must also generate an electronic signature suitable for billing and compliance documentation.
Upon case completion, the AIMS data are immediately available to other information systems, such
as bi. The modern AIMS is, however, more than an electronic recording of relevant case
measurements and narrative commentary. Winner of the Standing Ovation Award for “Best
PowerPoint Templates” from Presentations Magazine. Effect of using a safety checklist on patient
complications after surgery: a systematic review and meta-analysis. Given those considerations,
pastel colors had to be eliminated. Open Access Book (Free Access) - Encyclopedia of Information
Science and Technology, Sixth Edition (ISBN: 9781668473665). In general, hospitals benefit from
AIMS even without the assistance of AI. It translates the monitor data stream into data that DocuSys
can interpret. PACU, postanesthesia care unit; OR, operating room. The RFP response usually
includes a list of active AIMS installations at similar institution and names of previous customers
who can provide referrals. The scenario timer began at the entrance of the participant into the room
and ended once the simulator was given an anaesthetic agent. In complex cases or with unstable
patients requiring multiple clinical interventions, the number of parameters to be documented may
increase significantly and there may be a considerable time lag between observation and charting.
Throughout each of these settings, the charting of patient care takes place in a different design
environment, but data flow from each one to the next so that, together, the data become the legal
record of the anesthetic encounter. Alternatively, this advanced functionality may include more
comprehensive uses of the intraoperative data such as a quality improvement reporting module or
richer user interface such as minor procedure documentation templates. In those circumstances, the
original entry time stamp should remain and the note include reference to the time when the event
actually occurred. However, new management and automation tools allow upgrades to be sent to the
client workstations through the network and enable careful version checking for the files shared
across vendors.
Its presence does not seem to have caused any significant problems. One important application,
OCW, could not be installed without conflict. Database users can run ad hoc queries, with the
assistance of our in-house IS staff if needed. Though the highly competitive computer hardware
industry offers many pricing options, the initial capital costs must be balanced with the long-term
operating maintenance expenses associated with each hardware option. Future versions of the
software will allow anesthesia practices to configure their own additional protocols, triggered by
specific patient and clinical data. While facilitation of professional billing was desired, direct
electronic submission was not a criterion for AIMS selection. First, the electronic record is not
environmentally friendly. The incremental approach mitigates much of the risk of the big bang but
requires processing and archiving both paper-based and electronic anesthesia records and PSRs
during the transition. User Interface (UI): A representation of data which conveys information
between a computer and its user. The decision to implement a given type of point-of-care software
must incorporate cost and functionality criteria. In those circumstances, the original entry time stamp
should remain and the note include reference to the time when the event actually occurred.
Participants were debriefed to discuss their performance on the scenario (see online supplementary
appendix 1 for a detailed description of the scenario). Therefore, the complexity of AIMS
workstation installation and configuration increases significantly for these off-site anesthetizing
locations. The printed report, accessed from the administrative tab ( Figure 11C ), is many pages
longer than its former paper chart counterpart. The time and cost associated with drug reconciliation
were not primarily the result of any issue with DocuSys, but rather the result of a major change in
our workflow. We also acknowledge that the scenario presented was artificial in that the resident
performed independently without attending physician's support and that multiple sabotages were
present in the set-up, which would be very unlikely in actual practice. Laryngoscope blades are in the
cart but have not been checked. Technical Infrastructure for Automated Physiological Device
Interfaces To enable the remote viewing of waveforms, many physiological monitoring
implementations from the leading vendors have included a “monitoring network,” which carries
vital-sign information to central viewing stations. Effect of an interactive visual reminder in an
anesthesia information management system on timeliness of prophylactic antibiotic administration.
The sophistication of this process is not in how the data are collected as images but rather in how the
images are indexed and retrieved to re-create the paper chart in electronic fashion. In spring 2010,
Merge Healthcare purchased DocuSys. Most of the conflicts dealt with network security and
required software applications for all institutional PCs. The availability of thousands of data elements
associated with each case allows for extensive data analysis and reporting on individual cases and
groups. Some vendors offer unique functionality that requires vendor-specific hardware. Institutions
should benefit financially from improved coding accuracy and also from Diagnosis Related Groups
designations that reflect an anesthesiologist's typically comprehensive assessment of comorbid
medical conditions. 29 CMS has also proposed increased reimbursement for CPT codes associated
with any of 14 defined comorbidities (e.g., congestive heart failure, malnutrition) that make surgical
patient management more difficult. After case closure, DocuSys sends its data to the same
reconciliation database. Effect of concurrent computerized documentation of comorbid conditions
on the risk of mortality index. Our interface IS support group worked closely with the AIMS vendor
to customize the data integration. Product Roll-Out Phase One: Training After the preliminary
configurations of the system were completed and interface requirements were met, introduction to
our department began. Each PC has the workstation DocuSafe software installed, as well as Capsule
Technologies' (Paris, France) DataCaptor. Interface issues, however, will probably never entirely
disappear.
Man-made versus computer-generated anesthesia records. Anesthesia information management
systems: a survey of current implementation policies and practices. A user-friendly touch-sensitive
interface enabling an easy event tracking flow. Although the expectation at the mock implementation
was that all systems would be operational, the reality fell short in several areas: Narcotic tracking and
wastage User log on Image quality of the printed electronic record Accuracy of the surgery
scheduling interface Difficulties with wireless units because of conflicts over dynamic versus static
internet protocol (IP) addresses Incomplete allergy data from the pharmacy database. In the months
since implementation, the intraoperative use of the AIMS has expanded rapidly to include most
cases where the equipment is relatively fixed (main ORs, obstetrical ORs, and outpatient surgery
ORs). Consequently, very short cases and emergency cases were frequently done as paper records.
Pharmacy's support of the DocuSys project hinged on the requirement that controlled substance
reconciliation be an integral part of case closure (a hard stop) and that the Department of
Anesthesiology assume the primary role for auditing all cases. Effects of computer-based clinical
decision support systems on clinician performance and patient outcome. Cambridge Consultants
Innovation Day 2012: Innovating for consumers in emergi. An anesthesia information system for
monitoring and record keeping during surgical anesthesia. The values for 2008 and 2009 are
estimated based on the assumption that departments that are in the process of implementing their
system will do so during 2008, and that departments that have purchased their AIMS but had not yet
begun installation will do so during 2009. By spring 2011, we expect to have the next major version
(8.0) installed, and with it, to address several ongoing deficiencies, including the mechanism for
amending a closed electronic record with an appropriate audit trail. Even when the AIMS functions
well, new users inevitably produce EMRs with errors, omissions, and inconsistencies. Our interface
IS support group worked closely with the AIMS vendor to customize the data integration. However,
if the AIMS fails during go-live, this approach risks becoming a big bust, and it may be difficult to
reschedule training and support for a second attempt. The vendor provides numerous management
reports as well as quality measures and can create special reports, such as those related to
performance and quality of care metrics. Within groups, resident year did not have a significant
effect on performance, implying that the errors made in the scenario they encountered were systems-
based and not individual-based or a result of inexperience. The sophistication of this process is not in
how the data are collected as images but rather in how the images are indexed and retrieved to re-
create the paper chart in electronic fashion. However, adequate support can minimize implementation
difficulties, and leadership, planning, and patience largely mitigate these obstacles. Monitoring alerts
can be triggered when a selected parameter exceeds limits, thus encouraging an appropriate action.
Another approach to real-time data exchange is software system integration that allows sharing of
data fields between different applications. The other potential limitations of this study include the
fact that participants were limited to 38 residents from a single academic institution, all encountering
relatively few cases and in a simulated environment. The DocuSys software and database reside on a
secure server networked to multiple DocuSys client PCs ( Figure 5 ). During the early
implementation process, neither patient allergy nor medication data sources were electronically
available. Report Back from San Antonio Breast Cancer Symposium (SABCS) 2023: Spotlight. Web
software is especially advantageous when the workstations that access the system are extremely large
in number or in unpredictable locations. Training of IT staff for network, server, and workstation
support is a vendor responsibility and training the SA and other administrators to manage the PD
and generate customized reports should also be included in the AIMS contract. Participants were
scored by two independent, blinded, anaesthesiologist raters. Results Of the 49 anaesthesiology
residents offered enrolment in the study, 38 were recruited (78%); 8 (21%) were CA-1 residents, 17
(45%) were CA-2 residents and 13 (34%) were CA-3 residents ( table 1 ). Another limitation is that
we used a single checklist with a single means of implementation.
Initially, this was perceived to be accomplished purely by recording and evaluating the patient’s
physiological trend. When fully implemented, scanning will offer a more efficient way to enter drugs
into the AIMS prior to administration to the patient. Usage has improved, though, with dedicated in-
house IS support and vendor revisions to the database structure. Eleven departments had already
implemented an AIMS, 16 were currently implementing such a system, and six were in the process
of selecting an AIMS. No respondents were piloting an AIMS. Alternatively, log-on credentials can
be managed by an institutional active user directory or other security privilege database. PACU,
postanesthesia care unit; OR, operating room. Ochsner's basic record had remained relatively
unchanged for decades. The electronic record that would be sent to Hospital Medical Records had to
be in black and white, so symbols rather than colors were used to indicate graphed parameters.
Practice Quality Measures A single clinical encounter between a provider and a patient, viewed
alone, can represent quality of care and efficient practice; however, performance manifested over
hundreds of cases is more representative and revealing. Although it increases anesthesia provider
“buy-in” by sharing control of the user interface, customization requires substantial commitments of
time and effort. Finally, regardless of which hardware is chosen, it must be mounted or secured in an
economical and effective manner. At the end of a case, the traditional handwritten paper record is in
multiple, similar-looking pages. These rates are considerably higher than previous estimates of AIMS
adoption. When the vendor installs the hardware, the vendor's expert surveys workstation location to
identify all monitoring and anesthesia equipment, data port configurations and availability, and
proximity of electrical and network connectivity. We collaborated extensively with Medical Records
to select the required reports and define their final format. Among adopters, the top ranked
anticipated benefits from installing an AIMS included improved clinical documentation, improved
data collection for clinical research, enhancement of quality improvement programs, and compliance
with requirements of regulatory authorities. Installation of the DocuSafe software uncovered some
unexpected conflicts with institutional network management and software policies. The vendor
resolved the issue with the DocuSys backup limitations. Database reports can audit the use of this
note to ensure that it is used appropriately. Future versions of the software will allow anesthesia
practices to configure their own additional protocols, triggered by specific patient and clinical data.
Sharing data with the emergency department, blood bank, or computerized physician order entry
system can facilitate patient care through timely sharing of vital signs, allergies, medications, and
difficult airway status. These are most effective if each trainee works at an individual workstation
running a training version of the AIMS application. Closed Loop Medication Management - A
preferred way to go go forward for Prov. Community Health Network Decreases Lost Drug Charges
by 40% with Anesthesia M. Each entry into the electronic record is marked by the time when it was
entered. Federal agencies are increasingly seeking such documentation and basing payment partly on
participation in these activities. Sources and magnitude of job stress among physicians. Case auditing
is necessary for departmental QA 30 and for institutional compliance reports. Although the result was
significant, the increase in time was relatively small (approximately 2?min). However, some
institutions prefer to have their own IT personnel validate and install all server and workstations
software.