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Insights Category: Building a resilient organization

Triumphing with Tech: Empowering Staff and Maximizing Results 

Key Takeaways:

  • Documentation integrity is the foundation of good quality rankings
  • OhioHealth was able to expand their scope and implement new workflows even at historically low staffing levels due to efficiencies introduced by Iodine’s Concurrent
  • Improving documentation accuracy and capturing all patient conditions led to improvements in SOI, ROM, and Vizient quality rankings, including OhioHealth jumping from 112th to 14th in the nation for Trauma Care

Iodine Intelligence tackles a new challenge in healthcare’s mid-revenue cycle every month, shedding light on problems and solutions and sharing valuable insights from industry experts. Listen to Episode 14 Triumphing with Tech: Empowering Staff and Maximizing Results to learn more.

In the world of healthcare, hospital quality rankings hold immense weight, guiding consumer decisions on where to receive care, impacting hospitals’ reputations, and influencing the language healthcare providers can include in contracts with payors. Ultimately, the foundation for achieving good quality rankings lies in capturing accurate and complete documentation. Documenting patient care and medical procedures accurately and comprehensively directly impacts the assignment of codes, which, in turn, affects risk adjustment and external metrics.

As CDI programs shift their focus to quality, they must also shift their processes and workflows. Whereas in the past CDI specialists might have focused exclusively on capturing CC’s and MCC’s, it is now increasingly important to capture all conditions and treatments, regardless of whether they qualify as a CC or MCC, because many of these conditions ultimately impact risk adjustment. “It becomes important to know not only did it happen, but when did it happen?” said Fran Jurcak, Iodine’s Chief Clinical Strategist “Was it something the patient brought in with them, either from a previous encounter or something that happened to them in the outside world of the hospital? Or is it something that actually happened during the inpatient encounter? Which is what we’re really trying to capture with some of these quality metrics.”

Tonya Motsinger is the System Director of Clinical Documentation Integrity at OhioHealth, and her program has instituted a variety of workflows with the intent of completely capturing all patient conditions and improving their quality. She echoed Fran’s sentiment, relating that her CDI department found instances where HACs and PSIs were being driven by documentation, not the care being give. “If we could change the words in the chart, there wasn’t really a PSI or a HAC that happened” said Tonya, “It was just that it was documented incorrectly.” In today’s world, it’s not enough for health systems to provide good care, they also need to document the care they’re giving accurately.

OhioHealth is a nationally recognized, non-for-profit health system based out of central Ohio, composed of 14 hospitals and over 200 outpatient and physician offices, and has been recognized as one of the top five large health systems in America by IBM Watson Health six times. The CDI program at OhioHealth has 54 full-time positions, including a director, two managers, an educator, and an informaticist, although currently the program has positions open and is down ten staff. They originally invested in Iodine out of a desire to increase the efficiency in their workflow; they had found that they were performing a lot of re-work and weren’t seeing a ton of benefit from that work. Continuing, and improving upon, the success that they had seen in the financial and quality spaces was also key – around three to four years ago OhioHealth’s CDI program had ramped up their focus on quality, including instituting some new processes and workflows, and wanted to sustain that progress. OhioHealth felt that Iodine’s product Concurrent, with it’s artificial intelligence and prioritization, could help them achieve their goals without comprising their already established success.

As a quality focused program, it’s very important that Tonya’s team is not only accurately capturing the patients’ severity of illness and risk of mortality, but also ensuring the chart is explicit on what occurred with a patient so coders can accurately capture all diagnoses and treatments. As part of this effort, OhioHealth has a number of workflows in place, including an extensive second review process for expirations, DRG mismatches, and low acuity which can help ensure complete capture of how sick a patient truly was. “I believe that these practice are really essential growth avenues to drive the success of any CDI program, and I think Iodine really helped us to expand on these” said Tonya.

 We’re about ten CDS down…but we’ve been able to, even at our very lowest staffing ever in the history of our department, take on more work and meet the organization’s board goals as a result of the help that Iodine’s provided for us through the prioritization.

– Tonya Montsinger

While post implementation OhioHealth’s overall review rate has stayed the same, their query rate, especially among high priority cases, has increased. Despite spending time writing more queries, their workflow is so much more efficient they’ve been able to maintain their collaboration with coding, and took on even more work from a quality perspective, implementing additional workflows. This led to an improvement in their O:E ratio, their SOI and ROM, and their Vizient ranking. In 2019 OhioHealth was ranked 112th in the nation for trauma care, and they knew that wasn’t reflective of the care they were delivering. Today they are 14th in the nation, and number one in the state of Ohio.

Tonya noted that job satisfaction has improved as well. By enabling CDIS to review the right case at the right time and saving them from unnecessary review, OhioHealth has freed up staff for additional workflows like using the Vizient calculator, performing mortality reviews, and collaborating with coding and other departments. Describing the impact of the increased efficiency and effectiveness of their program due to having a prioritization tool, Tonya said, “I believe it creates a higher competence level in the CDS team, a little more of a strategic lens, because they can see the impact of their work beyond just case review, and they can sometimes even connect it with patient care.”

This expansion of skillset also gives CDI specialists opportunity for career advancement. As Fran noted, “We now have clinical ladders in the CDI space where five, seven years ago, there was no such thing.” In a world where hiring new staff can be challenging, retaining the staff you already have is key, and ensuring CDI specialists are satisfied and have room to grow within your organization can entice them to stay within your program.

Interested in Being on the Show?

Iodine Software’s mission has been to change healthcare by applying our deep experience in healthcare along with the latest technologies like machine learning to improve patient care. The Iodine Intelligence podcast is always looking for leaders in the healthcare technology space to further the conversation in how technology and clinicians can work together to empower intelligent care. if that sounds like you, we want to hear from you!

Opportunities and Obstacles: A CFO Conversation on Health System Financial Resiliency

Key Takeaways:

  • Health systems need to move beyond cost cutting strategies to weather the current financial climate, they need new strategies for generating revenue, including relying on automation to scale scarce clinical resources. BJC Healthcare focuses on people, process, and technology: where can they automate where previously they relied on people to do the work manually
  • Whereas previously labor was the primary driver of economic growth in healthcare, there is real opportunity for leveraging technology to capture additional opportunity. Mueller cautions healthcare orgs to ensure they have processes in place to support new technology implemented; and Damschroder pushes the importance of standardizing work and embedding new tools into the workflow.
  • The onslaught of AI powered technologies on the market makes evaluating and selecting a tool for investment confusing. Both HFH and BJC leverage Project Management Teams to ensure they get returns on their investments

Iodine Intelligence tackles a new challenge in healthcare’s mid-revenue cycle every month, shedding light on problems and solutions and sharing valuable insights from industry experts. Listen to Episode 13 Opportunities and Obstacles: a CFO Conversation on Health System Financial Resiliency to learn more.

Financial headwinds and staffing shortages from 2022 have prevailed, carrying over into 2023, forcing healthcare leaders to re-envision their workforce, redesign processes, and rethink strategies for achieving financial stability.

This month’s episode of Iodine Intelligence brings you a conversation we had in March, Iodine’s Chief Revenue Officer Troy Wasilefsky was joined by Henry Ford Health’s Executive VP and Chief Financial and Business Development Officer Robin Damschroder and BJC Healthcare’s VP of Revenue Management Harold Mueller to discuss the challenges healthcare systems are currently facing and strategies for building financial resiliency in the face of economic uncertainty.

Leveraging Technology to Capture Opportunity

The financial challenges facing healthcare providers today has led to an uptick in the use of consultants, particularly in the revenue cycle space, to try and stabilize health system economics. Overwhelmingly, the recommendation from these consultancies is cost reduction. CFOs are looking to slash budgets, with 75% stating they were planning on decreasing operating budgets as a cost savings measure.1

However, cutting costs doesn’t generate revenue. McKinsey has mapped out impacts to profit pools if no new sources of revenue are introduced. While passing on higher costs to payors and patients lessens the impact, profit pools are eroded in all three scenarios. Hospitals and health systems need a new source of revenue, or at the very least to be effectively capturing the revenue they’ve already earned.   

This report from McKinsey is pushing the idea that cost reduction alone cannot be the answer here. We need to find a way to also generate growth and new revenue, either new revenue, or at least be capturing revenue appropriately for the work that we’re already doing.”

–Troy Wasilefsky, Chief Revenue Officer at Iodine Software

When asked how he approaches balancing efforts to manage costs with growth strategies, Mueller responded, “I think from the standpoint of things that we can’t control. So, if you think about the last 24 months, the price of some of the travel nurses…you wouldn’t have believed them five years ago, if you were to look at the balance sheet. That being said, from a revenue cycle standpoint, we are focused on the people, process, and technology. So, how do we automate things that can be automated, that are manual?” Currently BJC has a number of projects in flight looking to automate tasks which are currently done manually, and hopefully, these projects will enable BJC to ultimately redeploy staff to other areas.

Damschroder echoed these thoughts on implementing automation; noting that as the cost to procure a patient has gone up and staffing shortages persist, opening the “digital front door” is more important than ever. “Patients want to be seen faster than we can often get them through our process,” says Damschroder, “So the health system that can get that gate open in a market faster, and turns the faucet on, I think, wins there.”

Prior to the COVID-19 pandemic, Henry Ford Health decreased their revenue cycle costs while improving their yield by tipping their revenue cycle on its side and inserting automation to cluster homogeneous work (ex. grouping denials by demographics, regardless of payor), enabling staff to complete work faster and more efficiently. Henry Ford Health implemented Iodine with the same idea: increasing the productivity of the staff they currently do have. Damschroder noted that they have a lot of openings in the revenue cycle, and they’re holding out on those openings in the hopes that Iodine’s product will enable them to cover their current workload without the need for additional hires. 

Healthcare Providers Need a New Driver of Economic Growth

These strategies of implementing automation to reduce workloads, improve processes and scale staffing aligns with McKinsey studies. Historically, labor has been a heavy driver of performance and growth in the healthcare industry, dramatically so when compared to other sectors of the US economy.

Research from the Bureau of Labor Statistics shows that 90% of the economic growth in the healthcare space comes from labor, with more than two-thirds of labor’s contribution coming from workforce expansion (4M net jobs were added) whereas other sectors’ growth was primarily driven by capital or innovation.2 However, McKinsey would argue that there is a $1T opportunity in healthcare stemming from accelerating and scaling innovation in four key areas: care delivery transformation, administrative simplification, clinical productivity, and technology enablement.3 

However, it’s not enough for healthcare providers to merely find and acquire the right technologies, they must also be mindful of how they’re implementing them. As Wasilefsky explained, “Innovation, technologies powered by AI and machine learning…they can bring a tremendous amount of opportunity to organizations, and yet, if you don’t use them, or build your processes around using them, and manage that change management, you’re not necessarily going to get all the results.”

Mueller was quick to point out that ensuring processes are in place to support the actual technology implementation is key. As an example, before 2019 the mid-revenue cycle at BJC was decentralized, many departments including CDI, HIM operations, and coding were not part of a shared service, and different hospitals deployed technology in different ways. BJC centralized services right after the start of the COVID-19 pandemic, and this enabled them to deploy Iodine, which BJC used as an opportunity to educate staff consistently, query physicians in a consistent manner, and gave them a tremendous lift in query volume. BJC facilities that deployed Iodine saw a 15%-20% lift in query rates, with physician response and agree rates staying the same. Although CDI specialists were reviewing the same volume of charts, Iodine’s prioritization ensured they reviewed the right charts at the right time, resulting in improved query volume.

“You want to make sure that your technology supports your actual administrative processes, and the processes that you have in place… From an Iodine standpoint, when we had facilities that we had centralized (and we centralized them in waves) we saw a 15%-20% increase in query rates, with physician response rates staying the same and agree rates staying the same. And these folks were reviewing the same volume of charts, but they were actually in the in the right charts, “

-Harold Mueller, VP of Revenue at BJC Healthcare

Damschroder touched on change management; while some may interpret “standardization” to mean “you don’t trust me to do my work,” she was quick to push back that standardization is not about lack of trust, but rather about elevating staff to their top of license and focusing them on where they can make the biggest impact. 

Damschroder also talked about the importance of ensuring new tools are embedded in the workflow and that the new workflow has buy-in. Henry Ford’s Health trick is robust monitoring and transparency: ensuring everyone can see how everybody is performing. “When you can barely find the other workflow or the workaround somewhere else, it’s been fully adopted.” said Damschroder, “And when new people come into the organization, they don’t even recognize that there was an old workflow out there.”

Realizing the Promise of AI

While there may be a lot of promise surrounding AI powered technology, and the majority of healthcare executives recognize they need it if they hope to weather the current financial challenges, there remains some skepticism, largely stemming from lack of literacy surrounding artificial intelligence.

In fact, 60% of healthcare leaders report being confused by the range of automation and AI solutions.4 In the words of Wasilefsky, “AI is the new shiny bauble, and everybody uses that term, probably to an exhaustive level.” The confusion surrounding AI can make selecting an AI powered tool, and ensuring that investment will have a financial return, challenging. 

These feelings were reflected in the webinar attendees. In an Iodine survey of those attending the webinar, only 19% felt very confident in their ability to effectively evaluate and select the best AI tech needed to improve their financial performance, and only 28% of respondents felt they were getting quantifiable ROI from their current mid-revenue cycle solution. In fact, 80% of respondents felt they are missing out on earned revenue in the mid-rev cycle.

“This is something we hear in the market a lot. There’s an inherent skepticism of: have we seen the ROI prove out on some of these AI applications?” 

– Troy Wasilefsky, Chief Revenue Office at Iodine Software

The confusion surrounding AI is exacerbated by the glut of AI-powered solutions on the market. Between buzzword inflation, AI’s nebulous definition, and the vast range in AI technologies, their capabilities, and results, it can be difficult for healthcare leaders to truly wrap their arms around: what am I buying, what is it doing, and what outcomes can I truly expect? 

“As a representative of the vendor community I think a lot of this falls on us to not obfuscate the terminology of AI, and what AI is being utilized.” said Wasilefsky, “But instead, be far more transparent about what these technologies are, and how they work, and how they’re different from others, and also the impact piece.”

Mueller touched on the onslaught of AI-powered tech in the market, saying “Every vendor that we deal with that has a computer is “AI” now.” When it comes to evaluating AI powered solutions and measuring their impact, BJC has implemented Project Management teams, including some specifically in the revenue cycle space with revenue management experience, who evaluate business cases for new technology investments, and post implementation do a look-back to ensure they are seeing a return on their investment.

Damschroder echoed this, discussing HFH’s rigorous due diligence process regarding implementing new solutions. Regarding ensuring you see return on your investment, Damschroder emphasized the importance of ensuring adoption and that the new tool is embedded in the workflow. Whenever Henry Ford Health evaluates a new solution, they pay particular attention to: what is the lift to get this embedded in the workflow. For healthcare leaders out there who believe they’re not seeing the promised return on a technology investment, Damschroder’s advice was look at the workflow and ensure it’s embedded in the process, and then look at your adoption rates, because staff may not be using the tool or may only be using parts of it.

  1. Academy IQ, CFO Forum Debrief, December 2022
  2. The Productivity Imperative for Healthcare Delivering in the United States. McKinsey & Company. February, 2019.
  3. Claiming the $1 Trillion Prize in US Health Care. McKinsey & Company, September, 2013.
  4. The Academy Research and Analysis

Interested in Being on the Show?

Iodine Software’s mission has been to change healthcare by applying our deep experience in healthcare along with the latest technologies like machine learning to improve patient care. The Iodine Intelligence podcast is always looking for leaders in the healthcare technology space to further the conversation in how technology and clinicians can work together to empower intelligent care. if that sounds like you, we want to hear from you!

Flourishing in the Current Financial Climate

The past few years have seen the further growth of longstanding macroeconomic challenges to which no hospital system is immune. From inflation, both generally and in wage growth, to labor shortages, particularly in nursing, to the continued impacts of the global pandemic, providers everywhere are familiar with the headwinds facing the industry. In a September 2022 report, McKinsey & Company referred to the circumstances healthcare systems face as a “gathering storm,” and no wonder: McKinsey suggests that inflation alone could add an additional $370 billion in healthcare spending above the expected baseline by 2027, with endemic COVID-19 adding another $222 billion to that increase.1  On top of these major forces growing costs, accelerated salary growth, turnover, and shortages in labor make the environment even more difficult.

Passing on costs and hiring are unlikely to fix the problem

With headwinds like these facing the industry, to whom can the burden of increased healthcare costs be passed? Employers, facing their own financial pressures, are unlikely to foot the bill, with 95% of employers stating they “would pass along any cost increase greater than 4 percent per annum to employees.”2 Patients themselves face challenges, with “more than 20 percent of consumers report[ing] having more than $1,000 in medical debt…will have difficulty absorbing these higher costs for much longer.”3 According to a WebMD survey, almost 7 in 10 Americans have deferred care due to a lack of affordability.”4 

The government doesn’t look to be in the best shape to step in, either. As McKinsey points out, “a range of factors indicate that it may be difficult for the government to absorb the additional medical-cost burden.”5 The United States is experiencing inflation rates that haven’t been seen since the 1970s, healthcare spending represents a record 20% of GDP6, and federal responses to the COVID pandemic drove the largest federal budget deficits ever in 2020 and 2021. Add on top of this a narrowly split Congress, and substantive progress on tackling increased healthcare expenditures is an uphill battle. 

Providers across the industry “cited revenue cycle management as a top priority for the next year, pointing to a broad set of specific priorities, including revenue integrity, charge capture, and complex claims, and underscoring a robust set of RCM needs across the provider ecosystem.”7

For systems who have managed to maintain strong enough finances to hire heavily, critical staff just aren’t there for the taking. An analysis on labor market data revealed a potential shortage of 3.2 million healthcare workers by 2026. This healthcare labor crisis cuts across a number of job categories, but is especially serious in nursing, with the United States facing a potential shortage of 200,000 to 450,000 registered nurses by 2025. By this time, the shortage of physicians could reach 50,000 to 80,000 physicians. This has major implications not only for care, but for areas directly impacting revenues, like clinical documentation integrity (CDI) and utilization management (UM).

In short, generating additional revenue by increasing costs and counting on someone else to pick up the tab is far from a secure bet, and hiring to solve the problem will remain an immense challenge. How, then, can healthcare leaders respond?

Systems can use technology to capture more revenue for the work they’re already doing

Clinician shortages and economic pressure are driving demand for solutions that enable existing teams to be more productive, efficient, and drive ROI. In an October 2022 report jointly developed by Bain & Company and KLAS Research, the authors found that over the past year, 45% of providers accelerated software investment, with only 10% slowing down and “forward-thinking providers doubling down on technology roadmaps.” Providers across the industry “cited revenue cycle management as a top priority for the next year, pointing to a broad set of specific priorities, including revenue integrity, charge capture, and complex claims, and underscoring a robust set of RCM needs across the provider ecosystem.”7

Not all solutions, however, are equal to the task at hand, and among the challenges providers face in responding to financial headwinds are vendor proliferation and an increase in tech stack complexity. Numerous solutions claim to solve for the pains ailing hospital systems, but in the current climate, an acute focus on ROI and long-term financial peace of mind is key. Systems can’t invest indiscriminately in technology for technology’s sake. Rather, a challenging financial landscape makes judicious, careful decisions on technology all the more important. Deciding on a nascent solution without proven ROI or a second-tier solution to save a few dollars up front can have real consequences.

Iodine is focused on driving real ROI to help systems find long-term financial resiliency

Throughout our history, Iodine has developed solutions with real-world, high-level value in mind. Our tools help systems go beyond merely weathering McKinsey’s “gathering storm” to something better: future readiness. We don’t merely contribute to financial stability, but serve as a full partner in revenue enhancement to help you capture the revenue you’ve already earned and achieve lasting, big-picture financial peace of mind. We do this by using our clinical machine learning AI suite of solutions to help staff spend their time on the work that most benefits from their skill and attention. 

This isn’t just a long-term play, either: Iodine solutions deliver value at speed. For example, a five-hospital system in the mid-Atlantic with 94k+ admissions saw a first-month financial impact of $2.2 million, with $27.1 million in annualized impact. This big-picture value is made possible by improvements to key metrics in the functions we support. Programs powered by Iodine solutions drive increased output per FTE, with higher query volume. Iodine-supported CDI programs saw a median productivity lift of 134% in our 2021 Productivity Cohort Analysis, with improvement seen in 92% of facilities. One four-hospital system in the Southeast saw major improvements to their CMI, with 9.8% growth in surgery and 14.6% overall within the first six months after implementation. In short, we have a proven track record of delivering in concrete ways on the promise of our solutions: driving real, financially meaningful ROI.

While the challenges that face healthcare systems aren’t going away, neither are we. We’re excited to build on the work we’ve done with our current clients to help as many providers as we can flourish, no matter the financial climate.

1 “The gathering storm in US healthcare: How leaders can respond and thrive,” McKinsey & Company, September 2022.
2 “Employers look to expand health benefits while managing medical costs.” McKinsey executive survey from July 2022
3 McKinsey Consumer Healthcare Insights, February 2022
4 “Cost of Medical Care Leads to Delays for Many Americans: Survey”, WebMD, May 2022
5 “The gathering storm in US healthcare: How leaders can respond and thrive,” McKinsey & Company, September 2022
6 National Health Expenditure Data: Projected, Centers for Medicare & Medicaid Services, April 27, 2022
7 “2022 Healthcare Provider IT Report: Post-Pandemic Investment Priorities,” Bain & Company, Inc. and KLAS Research, October 2022

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Moving Beyond the Standard Markers for Success

Join Fran Jurcak, Iodine’s Chief Clinical Strategist, and Nita Bruce, Senior Product Support Specialist, in partnership with ACDIS as they discuss how CDI teams can better measure productivity and program success beyond historically utilized CDI metrics.

Creating a High-Performing CDI Program

In partnership with Iodine Software, the Association of Clinical Documentation Integrity Specialist (ACDIS) CDI Leadership Council asked several of its members to evaluate the results of a nationwide survey detailing the metrics CDI leaders use to prove program effectiveness, prioritize their responsibilities, and reach peak performance. The Council members were then asked to discuss their organizational approach to metrics and proving impact.

Click here for the full industry report, and to get an inside look at how CDI leaders are approaching CDI programmatic concerns!

Achieving ROI at Speed

Key Takeaways:

  • The CDI profession has evolved and is no longer about capturing a single CC or MCC, but rather the true clinical picture of the patient
  • West Tennessee Healthcare saw an increase in query volume after implementing Iodine accompanied by a financial return 3x more than expected
  • Leveraging Interact allowed West Tennessee to improve physician response times and rates even while simultaneously increasing query volume

Iodine Intelligence tackles a new challenge in healthcare’s mid-revenue cycle every month, shedding light on problems and solutions and sharing valuable insights from industry experts. Listen to Episode 6: Achieving ROI at Speed to learn more.

The Clinical Documentation Integrity (CDI) profession has evolved along with documentation requirements, and it’s no longer about capturing a single CC or MCC, but rather an accurate and complete record of everything that happened during an inpatient encounter. Technology provides a unique opportunity to enhance the CDI workflow. Rather than CDI specialists aiming to review all cases (and wasting an inordinate amount of time reviewing cases with no opportunity) the technology reviews 100% of cases, and prioritizes those with the greatest likelihood of opportunity for specialists to review to validate the clinical information and confirm the query opportunity.

 

 

Historically, one of the biggest challenges within CDI is knowing when to review a cases. “So, I looked at it [a case] today, but how soon will something change? Whether it be additional clinical information for a condition I looked at today, or a whole new condition that develops during the patient encounter. The only way, historically, that CDI had an opportunity to identify that, was to review every case every day, which is impossible” Fran Jurcak explained, “At Iodine, we allow ourselves, through technology, to identify when something has changed of significant value that then requires a re-review.”

 

“So for us, the new metric is not how many reviews do you actually get to, it’s how many of the priority reviews are you getting to, because with technology you’re getting at 100% reviews of all cases, so it’s really about which are the cases that CDI needed to look at, and then comparing that from the pre-Iodine performance to post-Iodine performance.“
– Fran Jurcak, Chief Clinical Strategist

West Tennessee Healthcare has six facilities in the West Tennessee area, the largest being Jackson-Madison County General with 740 beds. Their CDI team encompasses 11 CDI reviewers (some of whom are general, some of whom are specialized), a CDI manager and educator, and CDI director.

Several years ago their program shifted to focus on quality and improving their CMS star rating which led to West Tennessee implementing a variety of products in Iodine’s AwareCDI suite: Forecast which automatically predicts final DRG and GMLOS, Concurrent which prioritizes cases in CDI specialist’s workflow for review, Interact (formerly Artifact) which is a physician engagement tool that eases the query response process, and Retrospect which prioritizes post-discharge, post-code, pre-bill review. In the words of Denise Humphreys, their Director of CDI, “I think this product, in total, has helped us evolve as just a day to day CDI program to something that really specializes in: can we help our facility, our whole system, in attaining the goals that we have.”

Industry recommendation for a seasoned CDI team is a query rate of 20%-25% if you’re reviewing all charts; after implementation Denise’s team reviewed only prioritized cases and their query rate went up to 35%-38%. This resulted in increases in their case mix index, CC and MCC capture rates, and a financial return on investment that was 3x more than expected, allowing West Tennessee to pay off the full cost of Iodine within 3 months.

 

“We have a query escalation policy here where if the query is not answered after 14 days, it goes on a suspension list…The number one offender that was on the suspension list every week was one of the first to use Interact…the first to answer a query, and he did within 40 seconds of us sending it. And he’s not been anywhere near the suspension list for the query process since.”
– Denise Humphreys, Director of CDI West Tennessee Healthcare

While increased query volume could be cause for concern in some physician circles where administrative burden is already high, Denise stated that the largest impact she saw to her program after implementation was physician satisfaction. Pre-Iodine, they regularly had physicians on suspension lists for taking more than 14 days to respond to queries. After implementing Interact, their biggest offender responded to a query within 40 seconds of receiving it – and he hasn’t been on the suspension list since.

Interact creates a quick and easy workflow that is intuitive, doesn’t interrupt physicians during their standard patient process and allows them to communicate in a fashion that works best for them – within the EMR or via a mobile app. Discussing the advantages of Interact, Denise stated, “One of the main things we’re looking for, and we have experienced already, is an excess of additional time during our day. We’re not chasing queries like we were before.” The additional time during the day enables Denise’s team to expand their scope, and focus on impacting their O:E ratio, improving their star rating, physician engagement and education, increasing SOI and ROM and more.

West Tennessee is going live with Iodine’s Retrospect this July. Retrospect – a post-charge, post-code, pre-bill tool that helps CDI and coders identify discrepancies between the clinical evidence documented and the final code and capture additional leakage – will help West Tennessee monitor their backend and make sure their coding and documenting correctly. Having Iodine products end-to-end will help West Tennessee ensure documentation accuracy across all medical records.

Interested in Being on the Show?

Iodine Software’s mission has been to change healthcare by applying our deep experience in healthcare along with the latest technologies like machine learning to improve patient care. The Iodine Intelligence podcast is always looking for leaders in the healthcare technology space to further the conversation in how technology and clinicians can work together to empower intelligent care. if that sounds like you, we want to hear from you!

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