Procedure Logs and credentialing for Pain Fellows

[Stimulate]

I recently got some advice that I should keep a detailed procedure log during fellowship because hospitals will want to know our "numbers" to credential us.

Has anybody found a good system for procedure logs? I don't use a PDA but if there is a good (especially free!!) program for this (with respect to interventional pain procedures) I would certainly consider making a purchase.

Also for anyone who has gone through this credentialing process, what type of information can facilities ask for in these HIPAA days (patient name, date or birth, medical record number, date of procedure, etc.)? Just trying to get an idea of how detailed a log I need to keep.

Thanks in advance for your assistance.

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[PainDr]

I recently got some advice that I should keep a detailed procedure log during fellowship because hospitals will want to know our "numbers" to credential us.

Has anybody found a good system for procedure logs? I don't use a PDA but if there is a good (especially free!!) program for this (with respect to interventional pain procedures) I would certainly consider making a purchase.

Also for anyone who has gone through this credentialing process, what type of information can facilities ask for in these HIPAA days (patient name, date or birth, medical record number, date of procedure, etc.)? Just trying to get an idea of how detailed a log I need to keep.

Thanks in advance for your assistance.

I'm surprised your program doesn't have a system in place. My fellowship provided us with a program for logging procedures and clinic pts (apparently, records of both types of encounters are required by ACGME...or so we were told). We could only access the system from certain computers so it was kind of a pain in the neck. We were required to list one identifier (either the name or hospital ID number) date of encounter, type of encounter and name of attending. When it came time for hospital credentialing, yes, they wanted my logs. Also, they wanted everything...procedures, inpts, clinic pts...everything.

 

[drusso]

Set up an Excel spreadsheet with both individual data and summary cumulative procedure tallies. That works nicely.

 

[axm397]

I'm not a fellow (yet) but we keep an excel spreadsheet with date, patient ID, location procedure performed, attending, procedure performed, and complications/observations. We keep track of our EMG/NCS, periph injections, spine injections, and botox injections. Each subcategory of procedures get subtotals. We record whether we observed or actually performed and keep track of both numbers.

 

[Mister Mxyzptlk]

Anyone can dummy up a spreadsheet. Keep copies of all your op reports for good measure.

 

[Louisville04]

When it came time for hospital credentialing, yes, they wanted my logs. Also, they wanted everything...procedures, inpts, clinic pts...everything.

Do ASC's also have a strict credentialing process?

 

[jsaul]

for the most part- most ASC's will be begging you to do cases there. Most will not ask for such things.

 

[PainDr]

for the most part- most ASC's will be begging you to do cases there. Most will not ask for such things.

No...they won't, but they'll usually require you to have hospital privileges somewhere and the hospitals will require proper documentation.

 

[jsaul]

No...they won't, but they'll usually require you to have hospital privileges somewhere and the hospitals will require proper documentation.

ASC's are created to make money for their owners. I have had ASC's as far as 30 miles from me come literally begging me to do cases there. this goes on in many places around the country, not just in my geographic location.

Of course they will require some sort of validation but it is not so rigorous in the credentialing aspect where they ask for logs,etc. the various hospitals i go to did not even ask for that



as far as asc's requiring hospital privaledges, none of the asc's I work in or have been asked to work in required that

 

[Disciple]

No...they won't, but they'll usually require you to have hospital privileges.

The ASC I work at does not.

 

[jsaul]

*

 

[Ligament]

I'm revising my procedure logs right now. What is the official ACGME definition of a "New" vs. "Return" patient in regards to the ACGME pain procedure log? I see two possible definitions:

1. Consult and treat. Patient new to clinic and new procedure.
2. New procedure. ie. patient may or may not be established in clinic and may have had prior procedures (lets say SI injections) in the clinic but this is the first epidural injection...

?

 

[Ligament]

Ok, I called the Executive Director and Associate Executive Director of the Anesthesiology staff at the ACGME. They do NOT know the official definitions of new vs. return visit in regards to logging procedures! They have both been very helpful however.

So who knows if anyone has ever filled these things out correctly.

They are forwarding my questions to some sort of Anesthesia chairman for ACGME to get the correct definitions.

Ugh.

I'm revising my procedure logs right now. What is the official ACGME definition of a "New" vs. "Return" patient in regards to the ACGME pain procedure log? I see two possible definitions:

1. Consult and treat. Patient new to clinic and new procedure.
2. New procedure. ie. patient may or may not be established in clinic and may have had prior procedures (lets say SI injections) in the clinic but this is the first epidural injection...

?

 

[C Fiber]

It's too hard to keep clinic patient logs but you still have to estimate and put the numbers onto your ACGME log (your program should have this - if they don't, they run the risk of loosing their accredidation, so get the secretaries to make a form, NOW).

I kept a copy of all my implant, vertebroplasty, IDET, pumps, etc dictations. I blacked out the names and DOB, but not the date. Hopefully that is HIPPA compliant enough. For all others, I put the patient stickies and stick them onto a $0.99 notebook that fits in my coat pocket. I then scribble the procedure next to the patient stickies. Again, blacked out the patient names and DOB. I carried my little notebook in my pocket at all times throughout the year. Every month we had to turn in our log to the department, this allowed me to whip out my numbers very quick.......Do not ask me about New/Return patients......I never understood that so I am sure the the log is not very accurate as far as New/old pts.

AND YES!!! All hospitals, all ASCs that I applied to wanted to see a log book. Some actually asked for verification letters from my program director about my number of implants.