R1 RCM and Iodine Software’s comprehensive clinical documentation integrity solution connects managed services and intelligent technology R1 published the following on October 16, 2023 announcing R1 and Iodine Software as solutions partners. CDI can lead to improved patient outcomes as well as increased reimbursements for healthcare systems. But up until this point, CDI solutions have been siloed as separate approaches: Consulting and managed services are one approach; technology solutions are another. But what if these approaches joined their strengths together? How could that improve the completeness, accuracy, and specificity of the medical record and reduce documentation, coding, and billing errors? CDI Total Performance, powered by Iodine, does just this. A joint solution, CDI Total Performance combines the domain expertise and deep data insights of R1 RCM clinical documentation specialists with the Best in KLAS AwareCDI platform from Iodine Software. The need for a new CDI approach Efforts to codify clinical care are as old as documentation itself, with the first “modern” disease classification system developed in the early 18th century. With quantum leaps in specificity and complexity of medical coding in recent times, CDI becomes more important than ever as a driver of revenue performance. A strong CDI program is a critical imperative that comes with challenges Released earlier this year, the 2023 Revenue Intelligence Data and Insights Report unveils some of the RCM issues most profoundly impacting healthcare providers. Of the 13 revenue cycle stages covered, seven have clinical documentation integrity as a key enabler for process and outcome improvement. From determining appropriate patient status and capturing legitimate charges to recovering underpayments and reversing denials, CDI plays a foundational role in facilitating and improving mid-cycle and back-end revenue processes. There are several barriers that can hinder the effectiveness and sustainability of a CDI program. One is the industry perception of CDI programs as cost centers rather than revenue drivers. In fact, a national study of CDI leaders conducted last year by the Association of Clinical Documentation Integrity Specialists (ACDIS) for Iodine Software found 91% of CDI leaders track financial impact as a measure of success, while 68% track severity of illness (SOI)/risk of mortality (ROM) impact, and 53% make note of the observed-to-expected mortality rate. Even providers that do recognize CDI’s revenue opportunities can struggle to make headway because their programs lack transparency, accountability, or focused leadership, often due to strained resources. Additionally, many providers are reluctant to make changes to their CDI programs because they worry about the potential for disrupting regulatory compliance. Other factors preventing CDI excellence include: Constant regulatory and coding changes Difficulty measuring program effectiveness Technology limitations and integration Inefficient and low-quality physician queries Ideally, CDI programs should align with the Quadruple Aim – improving the experience of care, improving the health of populations, improving physician satisfaction, and reducing per capita costs of health care. A key role for CDI leadership, then, is to determine program priorities considering the aim, anticipate the potential barriers to achieving documentation excellence, set the table for appropriate expectations, and ensure that CDI program performance is assessed on a rational basis. Professional development drives CDI performance improvement The strength of any quality CDI program is a well-trained and educated team. Unfortunately, with ongoing staffing shortages, budget constraints, and cost-cutting priorities, hospitals often struggle to make the investment necessary to support their staff and, thus, see real improvement. Additionally, it can be difficult to quantify and therefore justify a return on investment from staff education and training. R1 CDI Total Performance engagements provide a caring, high-touch onboarding experience with new education and career development opportunities for the CDI team. These include monthly education sessions on clinical topics, quarterly coding clinics, regular quality audits of each CDI specialist and an annual review of Inpatient Prospective Payment System (IPPS) updates and rules. The model enables CDI teams to operate at top-of-license and just as important, reduces stressors that can lead to team and physician burnout. Introducing a new kind of CDI partnership R1 CDI Total Performance, powered by Iodine, brings to market a transformational solution built upon shared responsibility for collective CDI goals, deep clinical documentation expertise, and clinically intelligent technology. As an accountability partner, R1 invests in the success of their clients because their success depends on it. That begins with career growth for the team – R1 transforms CDI programs with best practices education gleaned from CDI engagements with leading hospitals and health systems that opens new professional opportunities for staff. Then R1 further empowers that team with Best in KLAS clinically intelligent technology to drive measurably better results and revenue. “We’ve been in this market a long time and know CDI is a big driver of success in our partnerships with leading hospitals and health systems,” said Kyle Hicok, Executive Vice President and Chief Commercial Officer at R1. “From our vantage point, we see an unsolved need for a more holistic approach to CDI and a real opportunity to innovate in this space. CDI Total Performance allows us to serve more hospitals and health systems wherever they are on the CDI journey and help them achieve documentation excellence that improves the quality of care and captures more earned revenue.” “CDI Total Performance is a unique comprehensive solution capable of delivering exceptional value to clients. Together, R1 and Iodine bring proven performance management prowess, documentation expertise, and impactful technology to deliver the financial, quality, and productivity gains demanded by health system executives at a speed that will set a new benchmark for industry expectations - right when health systems need it most,” said Troy Wasilefsky, Chief Revenue Officer for Iodine Software. Achieve CDI excellence with best practices and Best in KLAS software With 95 of the top 100 hospitals in the U.S. as customers, R1 is unique in its ability to develop, aggregate, and replicate CDI best practices at scale to improve clinical documentation performance. Iodine’s Best in KLAS AwareCDI technology provides new insights to CDI teams by strategically identifying and prioritizing cases for review and streamlining the query process to simplify and improve CDI, Coder collaboration, and physician response. As solution partners, R1 and Iodine deliver the only offering of its kind on the market, the closest thing there is to an easy button to fast-track CDI excellence. To learn more about R1 CDI solutions, visit www.r1rcm.com/cdi-solutions.

Iodine Software will leverage generative AI to accelerate the impact of its solutions, which includes the 2023 Best in KLAS for Clinical Documentation integrity solution, AwareCDI Iodine Software, a pioneer in healthcare AI technology, today announced an expanded relationship with OpenAI, an AI research and development company. As part of this collaboration, Iodine will gain access to OpenAI’s cutting edge artificial intelligence technologies, including its powerful language model GPT-4. Iodine Software has a deep-rooted history in clinical AI technology, having developed sophisticated, industry leading solutions that enhance financial performance in the mid-revenue cycle.  This collaboration with Open AI allows it to further infuse generative AI and large language models across the breadth of its AwareCDI product suite to improve prediction accuracy, streamline query processes, and develop clinical automation tools that will further stem revenue cycle leakage by ensuring documentation accuracy.  “We are thrilled to collaborate with a fellow pioneer in the field of artificial intelligence,” said William Chan, Iodine CEO and co-founder, “Strategic, fast paced yet cautious innovation has always been our guiding principle. The evolution towards generative AI is a natural next step for us. We are optimistic about its potential impact, yet cautious due to the significant impact on patient care, physician trust and patient reimbursements. Aware of its limitations, such as data hallucinations, we are committed to a responsible approach, ensuring we balance progress with prudence.”  The efficacy of Artificial Intelligence is dependent on data on which the language models are trained. Iodine Software is an industry leader with an unmatched dataset that contains more than 27 percent of all U.S. inpatient data, giving the company an unprecedented opportunity to transform how it supports hospitals across a variety of functions. A recent market analysis of the volatility of CMI validated that Iodine Software’s data cohort is representative of the overall market, which makes it one of  the best and powerful assets for training machine-learning and large language models. By incorporating the latest innovations in large language models, Iodine Software can ensure more specific patient documentation and coding efficiency, increase prediction accuracy, and improve its predictive analytics. These advancements will contribute to streamlining the physician documentation experience, allowing physicians to focus more on patient care, and helping hospitals and health systems to capture more earned revenue from the care they provide. About Iodine SoftwareIodine is an enterprise AI company that is championing a radical rethink of how to create value for healthcare professionals, leaders, and their organizations: automating complex clinical tasks, generating insights and empowering intelligent care. Iodine's powerful predictive engine complements the skills and judgment of healthcare professionals by interpreting raw clinical data to generate real-time, highly focused, predictive insights that clinicians and hospital administrators can leverage to dramatically augment the management of care delivery - facilitating critical decisions, scaling clinical workforces through automation, and improving the financial position of health systems. For more information, please visit iodinesoftware.com. PR Contact: press@iodinesoftware.com.

Key Takeaways: Each year Iodine conducts multiple cohort studies, focused on productivity improvements and overall impacts to performance experienced by clients throughout their journey with Iodine In 2022, 94% of facilities experienced a lift in productivity with Iodine, with the average facility seeing a 136% lift in normalized query volume With Iodine, physician response rates either stay steady, or significantly improve in cases where Interact has also been deployed, even in the face of increased queries Iodine also measures the impact queries have, including CC and MCC capture volumes, CMI, and GMLOS. The vast majority of facilities experienced an improvement in MCC capture with Iodine, with a median of a 27% increase in the number of cases that have an MCC The increase in MCC capture resulted in significant financial impact: an additional $3.5 million in annual reimbursement 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 15 Impact Amplified: Exploring Success Stores from the Iodine Cohort to learn more. Methodology Iodine's Cohort Studies started as an internal initiative in 2017 in an effort to understand the impact clients saw with AwareCDI and how certain key metrics were trending. Each year Iodine conducts multiple cohort studies, some focus on productivity improvements, others report on overall impacts to performance clients experience throughout their journey with Iodine. Cohort studies are completed by comparing pre-Iodine data as a baseline against the most recent CMS fiscal year's data with Iodine. Every facility for which there is at least two months of baseline data and two months of measurement data is included in the study. Only like months are compared to account for seasonal variety (i.e. January-March of 2021 is compared to January-March of 2022) and for DRG based cohort studies, only that year's CMS DRG tables are used. The intent is to examine: if a CDI team performed at the same level as they did pre-Iodine, what would that performance have been, and what is the difference between that modeled performance and what was actually observed with Iodine. Productivity Iodine examines productivity through two main means, unique case query rate and normalized query volume. Iodine measures both query rate and query volume to provide as complete a picture of CDI performance as possible. Since unique case query rate is an indicator of whether CDI specialists are looking at the right cases, it is possible to have a high query rate by only reviewing those cases that you feel confident you will query, but as a result your query volume will drop. Conversely, you can drive up your query volume by increasing staffing, but that's not very efficient. Examining both query rate and query volume ensures that Iodine has positive impacts on both and is driving as much value for clients as possible. Many health systems use query rate as a measure of success of their CDI program, although methods of calculating this metric can vary between organizations. Iodine examines query rate as a measure of the percent of cases that have been reviewed and resulted in a query - from an efficiency perspective it measures if CDI specialists are looking at the right records. In 2022, the average Iodine client more than doubled their query volume, as compared to their performance immediately preceding the adoption of AwareCDI. Iodine measures normalized query volume as a measure of the overall output from a CDI program, as more queries lead to more accurate documentation which has a variety of downstream affects including accurate reimbursements, quality reporting, and more. Iodine adjusts for changes in CDI staffing over time, and compares the incremental queries sent in the fiscal year 2022 against the baseline period, the year immediately prior to a facility adopting AwareCDI. With Iodine, 80% of facilities saw an improvement to their unique case query rate, with the median hospital experiencing a 42% lift in query rate. So, if prior to Iodine a CDI program was querying 32% of the cases they reviewed, and they experienced the median impact with Iodine, they're now querying 45% of review cases. Higher productivity and more efficient and effective processes enables clients to expand the scope of their programs and accomplish more with their existing staff. One client had a team of 17 CDIS and after implementing Iodine they increased their query rate from 21% to 35% using only half of their staff, enabling the remaining staff to be redeployed to performing retrospective reviews. Other orgs have leveraged the freed up man-hours to increase collaboration with other departments like coding, implement second-level reviews on mortality or PSI cases, and improve job satisfaction as CDI specialists work at top of license. Physician Response Administrative burden is already at an all time high for many physicians, which means the prospect of a CDI department suddenly sending twice as many queries, if not more, can be a daunting one for providers. However, Iodine's cohort studies show that with Iodine physician response rates either stay steady, or significantly improve in cases where Interact has also been deployed. When reviewing and responding to a query is no longer a burden for physicians, response rates and times can improve, even in the face of additional queries. On average, there is an almost 17 hour savings in response time, with CDI specialists waiting 31 hours or less for a physician to answer a query, meaning CDI specialists don't have to spend as much time and energy chasing down responses. The average physician spends 60 seconds or less reviewing and responding to a query, and the median physician response rate for an Iodine client with Interact is 94%. Impact of a Query In addition to lifts in productivity, Iodine also measures the impact those additional queries have, including CC and MCC capture volumes, CMI, and GMLOS, with the theory that as documentation gets addressed, it more accurately reflects the true acuity of the patient population, and as a result these measures naturally go up. The more the productivity of CDI teams improves, the more one can expect MCC capture to increase, as well as CMI and GMLOS to a certain extent. In line with our productivity metrics, the vast majority of facilities, 90%, experienced an improvement in MCC capture with Iodine. On average, their MCC capture volume improved by almost seven percentage points, which ultimately resulted in a 27% increase in the number of cases that have an MCC - more than one out of every four cases. While CMI is a common metric across the industry, especially for CFOs, it's influenced by a wide variety of factors, many of which are outside CDI's control. This includes things like changing patient populations, shifts in med/surg volumes, changes to service line volumes and more. Almost as many facilities experienced a lift in GMLOS as MCC capture (84%). GMLOS is a good indication as to whether or not a hospital is getting credited for how much effort it takes to care for a patient. If a patient is under documented, it will appear that they should have a short hospital stay, and then there can be a gap between expected LOS and actual LOS. Financial Impact Iodine utilizes two different methods for calculating financial impact, a "bottoms up" approach based on the value of a query, and a "top down" approach based on increase in MCC volumes. The bottom's up approach is calculated by examining: what are the number of queries issues by a hospital, how many of those queries are likely to have a financial impact, what was that impact measured in CMI MS-DRG relative weight points. Using this approach, a fictional hospital with 10,000 discharges, a 30/70 med/surg split and a $6,000 base rate would see an additional $2.4 million in appropriate reimburse. Using the top down approach, looking across our entire cohort (which includes everything from hospitals that have been with Iodine for just the minimum two months to hospitals who have been an Iodine client for seven years) the average is $3.5 million in annual additional reimbursements based on improved MCC volumes.