Fig. 2. The architecture of the anesthesia information management system (AIMS) (operating room [OR] workstations, primary and secondary servers), and the Anesthesia Billing Alert System (ABAS) with its paging system notification loop. The clinicians listed in the electronic anesthesia record for which the error occurred are paged either during the case or after it ends to notify them of their documentation error(s). Common errors are listed in the figure. These include failure to document “key times,” such as the start of anesthesia care; inadvertent creation of “time sequence errors,” wherein events seem to occur out of order (  e.g. , induction of anesthesia precedes start of anesthesia care); and apparent “overlaps between cases,” in which the end of anesthesia care event for one case incorrectly occurs after the start of anesthesia care for a subsequent case. The ABAS also checks for “required attestations” regarding medical direction of the case, as well as specific medical procedures by the staff anesthesiologist.