Why Record Templates Matter in Anesthesia  (Plus 3 Free Forms You Can Use Right New With EMR Software)

Anesthesia EMR software is a proven investment in efficiency and effortlessly meeting healthcare standards.

But to bring your EMR software to optimal performance with your day-to-day, using anesthesia record templates is like adding gas to the fire.

Easily customizable and readily available without a second thought, anesthesia record templates quietly optimize an already efficient workflow. 

They’ll become your favorite tool you’ll not realize you’re using.

4 Benefits of Anesthesia Record Templates

Working in tandem with your existing digital patient EMR forms, anesthesia record templates allow for:

  1. Efficient data capture
  2. Improved patient outcomes
  3. Data standardization and consistency
  4. Enhanced charge capture

1. Efficient Data Capture

Anesthesia record templates allow for quick data entry during patient interactions and charting, letting anesthesiologists focus on their primary duty: delivering the best care possible.

Built into a form, templates are pre-populated with information specific to a treatment that’s needed to complete each digital document. With a single click, large sets of data are added to a patient care form, such as:

  • Medications
  • Surgical timeline
  • Surgical procedure
  • CPT code (surgical and anesthesia)
  • Monitoring equipment used
  • ASA status
  • Emergency status
  • Patient status (inpatient vs. outpatient)
  • Post-op disposition (PACU recovery, Phase 1, Phase 2, or ICU)
  • Normal preoperative measures

Rather than spending valuable time filling out individual form fields, an anesthesiologist can employ a pre-built template and save themselves from logging data that’s standard to a procedure. During any stage of patient care, the only thing you’ll need to complete on a template-based form is documenting information that can only be captured as treatment is administered.

Common templates include:

  • Anesthesia care plan template
  • Anesthesia informed consent template
  • Anesthesia handoff template
  • Anesthesia chart template
  • Anesthesia case log template
  • Anesthesia pre-op template
  • Anesthesia contract template

Customized Templates for Boosted Efficiency

Templates are not meant to be one-size-fits-all digital solutions. Your templates can be made to truly be yours. 

Customizable for certain medical procedures, stages of patient care, or even to a specific doctor, templates add an element of automation to a normal workflow.

You’ll spend less time transitioning from assisting in an emergency appendectomy to conducting a pre-hospital evaluation. Templates can also be customized to meet documentation requirements by the facility you’re working in or those set by healthcare regulators. You’ll seldom need to worry about being out of compliance.

2. Improved Patient Outcomes

By eliminating time spent on the “paperwork” side of medical care, anesthesia providers are able to better serve those they’re caring for.

Instead of navigating clunky software interfaces or confusing forms, anesthesia providers can devote more time to delivering treatment or making a true connection with the patient. By devoting more time to the patient, an anesthesia provider gets a better understanding of their pain level or any concerns they have about treatment.

Those few extra minutes afforded for a human connection with a care provider can make a world of difference in a patient’s treatment, recuperation, and overall surgical experience. 

From a practical standpoint, templates make sure relevant information about a patient and their treatment is captured and logged. From one care provider to the next, there are no gaps in a patient’s documented treatment history.

In essence, templates act as another safeguard against anything being overlooked or forgotten in patient treatment.

3. Data Standardization for Compliance and Consistency

With countless medical codes that change almost daily and new reporting metrics, keeping up with patient recordkeeping regulations is challenging.

As templates pre-populate a form with information, those automatic entries can be updated to reflect new reporting standards, such as those for MACRA, in real time.

This is especially important for anesthesia practices with multiple providers where it would be nearly impossible to provide everyone with updated reporting information at the drop of a hat.

On the same token, anesthesia record templates ensure your entire staff is meeting internal standards. With templates tailored to a practice’s specific needs, there’s no chance for a staff member collecting the wrong or unnecessary information or providing data that’s out of step with your standard operating procedures.

For bigger medical facilities with several sites, a set of accessible templates ensures that all medical care providers are operating out of the same playbook regardless of where they are. You’ll never worry about any differences in anesthesia record sheets or patient charts.

This standardization means an auditor will have a much easier time reviewing your records because they’ll be uniform and in compliance. You’ll also have a much easier time compiling large sets of patient data for evaluation.

4. Enhanced Charge Capture

While delivering patient care, the last thought on any anesthesia provider’s mind should be how they’ll create an invoice for compensation.

Anesthesia record templates eliminate this concern. 

When integrated with billing software, templates automatically add billable patient treatments to an active invoice. That information is also in-sync with the latest medical billing codes. Your invoices are always:

  • Accurate
  • In compliance
  • Generated in a timely manner

In addition, anesthesia record templates act as another set of eyes on the information you’re using to generate invoices. By pre-populating forms with information, there’s less of a chance for blank form fields that result in a rejected claim. Disputes with insurers become a rarity while your revenue cycle becomes predictable and reliable.

The Value of Anesthesia Record Templates With Forms

As a patient care tool that’s always working in tandem with you, anesthesia record templates save precious time.

With templates customized to your specific needs for patient interactions, your EMR software becomes seemingly invisible in your workflow.

Need sample anesthesia forms?

Why not try a few out? Download these free forms and start using them today!