1. TARGET CONDITION IMPLEMENTATION PLAN FOLLOW UP The methods of entry and the corresponding time saved are tabulated as follows: (The Wilcoxon Rank Sum Test was used and a p-value of less than 0.05 was considered statistically significant) On the basis of a 5-day-work week and a total of 48 working weeks a year, and that the average number of entry items on a working day is 10 in the treatment room, 6.533 [(1.9+7.9)*10*5*48] working hours can be saved when using codes for entry; whereas using keyword for entry, a total of 12.067 [(6.9+11.2)*10*5*48] working hours, i.e. 1.5 working days, can be conserved in a year. The results showed that the implementation of our project successfully make the diagnosis and code entry a more user-friendly and time-saving process. ActionResponsibleDeadline Identification of most efficient keywordsA Lee31 st Oct 2011 Identification of codesT Chan31 st Oct 2011 List of most frequently performed proceduresA Lee30 th Nov 2011 BACKGROUND/ CURRENT CONDITION In the Hong Kong Eye Hospital, a variety of minor procedures are carried out in the Treatment Room every day. Each specific condition or procedure is assigned a diagnosis code or procedure code under the Clinical Management System (CMS). Entry of such codes into the CMS via a computer terminal is a multi-step process. A significant amount of time can be consumed in code entry, and this holds particularly true when a large number of procedures are carried out on every day. In our project, we aim to review the current code entry method and the primary measure is the time for code entry. PROBLEM ANALYSIS The whole code entry process is divided into the following steps: Steps 1 and 4 are automated processes by computer programmes. Unless there is an overhaul of the current computing system, these steps are unlikely to be altered. Step 2 and 3 are user-dependent processes. Entry of diagnosis and procedure can be achieved by direct entry of exact wordings, which is the method usually adopted. With such method, the mean duration for diagnosis entry has been estimated to be 17.3s and that for procedure entry 22.9s. The total time depends on the number of cases per day. This is unpredictable and currently there is no cap on the number of procedures. Title: Making Entry of Diagnosis/Procedure a More User-Friendly Process Leader: Dr. Allie Lee, Dr. Tommy Chan Facilitator : Dr. Andy Cheng Sponsor : Dr. Stanley Chi, Dr. Ben Lam Start Date: 30 th September, 2011 End Date: 1 st December, 2011 Last Updated: 1 st February, 2012 ID: We aim to streamline Step 2 and 3 the above-explained process. A list of most commonly performed procedures and their diagnoses will be composed (see Fig 1). The most efficient keywords for each search will be identified, i.e. least number of alphabet entry with most relevant result shown. The code for each diagnosis/ procedure will also be displayed. This information will be displayed in the form of a table near the computer terminal for reference during entry. Fig 1. Table of keywords Methods\Time SavedDiagnosisP-valueProcedureP-value Key words6.9s0.00411.2s0.0007 Codes1.9s0.3027.9s0.001 1. Scanning of patient gum label (6s) 2. Entry of diagnosis code by keyword search or direct code entry (17.3s) 3. Entry of procedure code by keyword search or direct code entry (22.5s) 4. Saving of entry and start over with next patient (1s) Value- added items Non- value- added items

2. ProcedureKeywordsCodeDiagnosisKeywordsCode Procedure chair I & C of eyelid Inc cur08.09ChalazionChal373.2 Excise minor lesion lid NEC Eyel min exc 08.22Disorder of eyelid NOS Eyel dis374.9 Punctal occlusion Pu oc09.91Dry eye syndrome Dry eye375.15 B-scanUltrasound study of the eye Ul ey95.13Vitreous haemorrha ge Vit hae379.23 Mature cataract Mat cat366.17 ScleritisScleri379.00 Slit lampCornea foreign body removal Co fb re98.21Cornea foreign body Co fo bo930.0 Corneal scrape for smear Cor scr11.21Corneal ulcer Cor ulc370.00 Electrolysi s of eyelid Electrol08.99Trichiasis w/o entropion Trichi374.05 The Table