Advantages, Disadvantages, and Tips for Electronic Clinical Tracking

AUGUST 2013 Enews Articles


Advantages, Disadvantages, and Tips for Electronic Clinical Tracking
by Susi Delaney

In the spring of 2012, Birthwise Midwifery School made the decision to transition from a paper documentation system to an online clinical documentation system – TyphonGroup’s NPST. As the Clinical Director, I oversaw this transition and with the assistance of our clinical coordinator, Tiffany Carter Skillings, personalized the system for our needs, developed new documentation procedures, and developed training systems for students and preceptors. As demanding and time-consuming as this process was, the new system had the potential to greatly improve the clinical staff’s ability to track student progress throughout the program. Following are some of my learnings from this process:

Advantages of electronic clinical tracking with TyphonGroup NPST:

  • The system is moderately flexible, allowing program administrators to customize it to meet their specific needs.
  • It keeps students on track with documenting experiences – the program administrator can set a time limit (eg, 15 days) within which experiences must be entered.
  • Each experience is linked to a specific preceptor. Students document date of care, type of care, skills performed (either using a list of up to 50 required skills developed by the midwifery program, or by the use of ICD and CPT codes), and basic information about each experience (such as weeks’ gestation for prenatal visits and newborn weight for birth experiences).
  • It enables preceptors and program administrators to see experiences students have documented, as they document them. Program administrators can easily run reports to see experiences that have been approved by preceptors, as well as those that are pending or not approved.
  • It’s HIPAA compliant – Typhon discourages students from entering any identifiers, such as midwifery/medical record number or client initials. Each experience is assigned its own unique code by the system.
  • Continuity of care experiences can be linked together.
  • Preceptors can approve or not approve experiences. If a preceptor marks an experience as “not approved,” he/she can enter notes and an email is automatically sent to the student, notifying them that the experience was not approved. Students can edit the experience if needed and the preceptor can then mark the experience as approved, if appropriate.

Challenges of using the TyphonGroup NPST clinical tracking system:

  • Preceptors who are used to paper documentation may balk at electronic documentation. Birthwise helped preceptors with this process by holding group webinar trainings, as well as one-on-one phone or webinar trainings as needed to ensure that all preceptors understood how to use the system. Preceptor expectations are simple and training takes no more than 30 minutes.
  • The system for tracking continuity of care differs from that required by NARM. Birthwise worked with NARM to develop a separate form for students to complete (in addition to linking their continuity of care experiences in Typhon) and submit to the school to demonstrate their required continuity of care experiences.
  • Currently, preceptors are not notified automatically when students enter experiences. Students must work with preceptors to ensure that documented experiences are reviewed and approved. This is no different than when using a paper system.

Tips for transitioning from paper to electronic clinical documentation:

  • Take time to think about exactly what you need.
  • Try out any documentation system as much as possible before committing to purchasing it.
  • Allow time to personalize the documentation system for your program’s needs.
  • Develop a training manual specific to your program’s needs. Typhon offers clear, explicit training materials, but students do best with a guide that identifies exactly how the midwifery program expects them to document their experiences. Then hold an in-person or online training that teaches students how to document properly.

Susi Delaney, MA, CPM is the Administrative Director of AME, on faculty at Birthwise Midwifery School and the Midwives College of Utah, and enjoys precepting students at all stages of their training. She and her family live and homeschool on a blossoming homestead in southern Maine.

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