Pediatric Otolaryngology

Utilizing a Hybrid Finance-Electronic Medical Record Dashboard to Monitor Pediatric Otolaryngology Surgical Outcomes During COVID-19

A hybrid finance/EMR dashboard utilizing surgical encounters driven by Current Procedural Terminology (CPT®) groupings was developed to enable real-time viewing of procedural trends in a multicenter academic health system without the need for manual chart reviews. The number of pediatric tonsillectomies, adenoidectomies, and pressure-equalization tube (PET) placements for the 12-month period in 2019 was compared with 2020 to assess COVID-19 impact. Thirty-day outcomes were assessed with chi-squared analysis.

The hybrid finance/EMR dashboard was developed based on defined procedure groupings for tonsillectomies, adenoidectomies, and PET placements. Patients under 18 years old who had procedures with any provider and any hospital within the health system were included. In 2019, 287 adenoidectomies, 1042 tonsillectomies, and 1231 PETs were performed vs a 2020 volume of 166, 625, and 697, respectively, a 40% volume decline. Post-tonsillectomy telephone callbacks (P = 0.035), hemorrhage (P = 0.021), and reoperations (P = 0.044) were higher in 2020 compared with 2019, and readmission/observation rates were lower after PET placement in 2020 compared with 2019 (P = 0.028). All other outcome measures were stable between years, and there were no mortalities.

In contrast to time-intensive chart review, the hybrid finance/EMR dashboard confers real-time analysis of surgical volumes and hospital outcomes. The dashboard quickly highlighted changes in complication rates during the COVID-19 pandemic for bread and butter pediatric Otolaryngology cases, allowing our teams to implement strategies and changes to combat these trends. This dashboard has shown utility for supporting rapidly adapting clinical practices and will be expanded to other procedure groupings and outcomes moving forward.

Pediatric Procedure Trends

2019 - 2020