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Built on Iodine’s industry-leading CognitiveML engine, AwareUM emulates clinical thinking to improve productivity and meet medical necessity requirements
AUSTIN, Tex. – February 5, 2024 – Iodine Software, a leading healthcare enterprise AI software company, today announced the launch of AwareUM, its newest software solution that helps hospitals streamline their utilization management programs. This launch highlights Iodine's prowess in harnessing artificial intelligence to augment scarce clinical resources, streamlining workflows that were once considered resistant to automation due to the indispensable role of clinical, human judgment.
“The debut of AwareUM reaffirms Iodine’s position at the forefront of innovation, signaling the evolution of our business to empower the nation’s leading health systems in navigating the entire clinical revenue cycle,” said William Chan, co-founder and CEO, of Iodine. “Building on Iodine’s trailblazing role in the CDI domain, AwareUM will transform utilization management, propelling hospitals towards heightened productivity and efficiency. As a combined suite of solutions, AwareCDI and AwareUM will bridge the gap in communication between CDI and UM teams, empowering them to master the mid-revenue cycle by capturing accurate and thorough documentation, driving efficient workflows, and strengthening revenue integrity.”
AwareUM is powered by Iodine’s AI engine CognitiveML, with nearly 10 years’ experience driving accurate clinical predictions from a rich clinical dataset. By intelligently analyzing all clinical data and documentation in the medical record, AwareUM prioritizes cases for review at the right time and provides transparency and reasoning behind predictions, which enables the capture of correct patient status, streamlines the review process and puts key data at the reviewers’ fingertips. Additionally, AwareUM provides a dedicated hub for all UM work and helps teams communicate effectively with payers to establish medical necessity. AwareUM enables clinicians to work at the top of their license, automating important processes and improving overall efficiency.
AwareUM is already deployed in many top U.S. health systems with proven results: “AwareUM has transformed our approach to utilization reviews and allowed our nurses to focus more on understanding the patient’s needs by reducing the amount of time required for administrative tasks. With AwareUM, pertinent documentation and patient information is easily obtained, which has cut our review time by half. In addition, the case prioritization capabilities have helped us identify high-opportunity cases that need to be reviewed first, which has improved our observation rates significantly,” said Sarah Horner, Director of Case Management at Baptist Hospitals of Southeast Texas.
With significant expertise across the clinical revenue cycle, in addition to AwareUM, Iodine’s AwareCDI solution has helped more than 900 hospitals capture more than $1.5 billion in earned revenue through more efficient clinical documentation improvement (CDI). Together, AwareUM and AwareCDI streamline revenue cycle management operations, improving reimbursement and enabling providers to focus on the delivery of high quality, patient-centric care.
For more information, visit www.iodinesoftware.com/aware-um
About Iodine Software
Iodine is an enterprise AI company that builds transformative technologies to help healthcare organizations realize the full value of the care provided. Across the revenue cycle, Iodine’s solutions automate complex clinical tasks, create efficiencies and maximize revenue. The company’s powerful, predictive AI/ML engine emulates the judgment of clinicians by interpreting raw clinical data to generate real-time, highly focused, predictive insights. Clinicians and hospital administrators can leverage these insights 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.
Iodine Software Introduces AwareUM, a New Solution that Helps Hospitals Streamline Utilization Management and Strengthen Revenue Integrity
Iodine Software, a leading healthcare enterprise AI software company, today announced the launch of AwareUM, its newe...
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3 MIN READ
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 clinical dataset, 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.
Iodine Software to Harness the Power of Generative AI to Expand the Impact of Its Industry-Leading AI Solutions
Iodine Software will leverage generative AI to accelerate the impact of its solutions, which includes the 2023 Best i...
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3 MIN READ
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.
Impact Amplified: Exploring Success Stories from the Iodine Cohort
Every year Iodine Software conducts a client wide cohort study measuring various key metrics in the clinical document...
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3 MIN READ
Fixing a "broken" physician query process became a top priority for the clinical document improvement team at Western Maryland Health System
From the article in Healthcare Innovation:
Last year, WMHS tapped Artifact Health, a solutions company that develops physician query software via a mobile platform, to enable the organization's physicians to answer queries quickly and view supporting documentation right on their smartphones from wherever they chose. Click here to read full article.
In the News
Automating the Physician Query Process: One Organization’s Quick Turnaround
Fixing a "broken" physician query process became a top priority for the clinical document improvement team at Western...
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3 MIN READ
At a recent CDI conference, a presenter proudly announced, "Our hospital achieved a 100% physician query response rate in surgery."
The audience of seasoned CDI specialists seemed impressed but skeptical.
Hospital CDI programs rarely achieve high physician query response rates. Physicians find query workflow burdensome and time-consuming. A physician friend summed it up succinctly, "Queries are time away from making people better."
Back in the day, CDI specialists stuck paper queries in the paper chart for physicians to answer the next time they documented on the patient. These queries were not easily tracked, reported or discoverable. Today, some hospitals have replaced paper queries with email-type queries in the EMR, ironically with the same lack of tracking and reporting.
Yet, these email queries in the EMR have not eased the burden on providers. Response rates of 60% or lower are common, leaving significant opportunities for hospitals to achieve full reimbursement and accurate quality scores on the table.
Also, without the ability to easily track and report on provider query activity, hospital CDI programs still cannot effectively manage the process or motivate greater physician response rates. Some CDI specialists argue that paper queries were more successful.
To boost query response rates, CDI specialists and coders allocate significant bandwidth to manual follow-up efforts. A CDI Manager in the audience whispered to me, "Our response rate to queries in the in-basket is 40%, so we resort to verbal querying where we get a 70% response rate, but it's killing us."
The presenter echoed this statement when she detailed the keys to her 100% response rate in surgery. "We employ top-down leadership, physician advisor support and an electronic query process... with follow-up."
How much follow-up, I wondered? I asked her after the presentation, and she described the following CDI query follow-up activities:
* Searching patient charts to determine if physicians have responded to their queries
* Documenting query information and updating the status in multiple systems for tracking and reporting
* Emailing, calling and approaching physicians multiple times with query reminders
* Creating lists of physicians with unanswered queries for the physician advisor to chase-down
Attaining a 100% physician response rate to queries is a clear measure of success for any hospital CDI program. However, poor query workflows force a trade-off. CDI specialists appear to be devoting significant effort to query follow-up activities taking time away from reviewing additional charts and educating providers.
Blog
CDI’s uphill battle to boost query response rates
At a recent CDI conference, a presenter proudly announced, "Our hospital achieved a 100% physician query response rat...
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3 MIN READ
ChallengeAn over 60-hospital national health system had many motivations for seeking a new physician query solution.
To begin with, the health system's inefficient query workflows were having a direct and negative financial impact. For example:
Significant dollars were on hold because of unanswered queries, costing the health system hundreds of thousands of dollars in interest per month.
Clinical documentation improvement (CDI) and coding staff spent inordinate amounts of time following-up on unanswered queries, and the cost was reduced productivity and the loss in additional charts that could be reviewed, queried on and coded during that time.
Most critical, low query response rates at many hospitals negatively impacted accurate quality reporting and full reimbursement.
From a technical perspective, the health system operates different EHR systems across the enterprise. Each EHR system supported its own unique query process for providers, CDI and coding staff. Therefore, there was no easy way to view or measure query activity across the enterprise. Further, CDI and coding staff tracked queries in different software systems, creating silos of information and hindering collaboration between the two groups.
Despite COVID, query workflow improved. Physicians reported high satisfaction with the easier process. CDI staff, who had been transitioned to working from home because of the pandemic, achieved even greater physician engagement and higher productivity by using the Artifact platform.
Perhaps the greatest challenge was satisfying providers. Providers were extremely unhappy about query workflow. They felt queries were time-consuming and interfered with patient care. As a result, the health system's average query response rate was less than desirable with significant room for improvement.
Lastly, an unforeseen challenge emerged. In March of 2020, the COVID-19 pandemic hit causing unprecedented upheaval for hospitals across the globe.
SolutionWith various challenges and motivations, the large national health system had to find a solution that would fit their complicated environment and achieve the following goals:
An effective solution would need to sit across all EHRs, have a shared interface for CDI and HIM staff to collaborate on queries and be accessible to all providers across the health system.
Providers needed to find the technology easy and convenient so they would adopt it and become engaged in the query process.
Query volume, response rate and response time measures needed to be tracked accurately across the enterprise and show significant improvement to justify a financial return on improving the process.
The health system selected Artifact Health's HIPAA-compliant, cloud-based, mobile query platform because the technology checked all the boxes to be effective in their complex environment. Also, with many different EHR systems, the implementation and deployment approach would be critical to success. So, the health system valued Artifact's focus and strong commitment to customer support.
ResultsThe implementation kicked-off in early February of 2020 and the project team brought 20% of the health system's over 60 hospitals live on the Artifact platform right before COVID hit in mid-March. At that point, the project was paused for three months due to the pandemic.
Because of positive results from the initial group of hospitals, the health system made a decision to restart the implementation process in June, and by September all 60+ hospitals were live on Artifact.
The initial group of hospitals live on the Artifact platform before the pandemic hit demonstrated the following results:
Average monthly query volume climbed 36% by September due to efficiencies gained and the reduction in CDI time spent following up on unanswered queries.
Average physician response time was cut in half, down to less than a day. The vast majority of physician responses were coming in within the first hour from the time the query was sent.
Accounts on hold for these hospitals decreased by 69%.
Despite COVID, query workflow improved. Physicians reported high satisfaction with the easier process. CDI staff, who had been transitioned to working from home because of the pandemic, achieved even greater physician engagement and higher productivity by using the Artifact platform.
SummaryWithout knowing it, the large national health system had proactively positioned themselves for the "new normal" setup by the pandemic:
They relieved providers of a time-consuming administrative task when providers need more time to care for patients.
They increased the productivity of hundreds of CDI and coding staff working remotely by giving them a tool that engages providers.
They put an effective query process in place to help financially recover from the disruption caused by the pandemic capturing proper and full reimbursement for services and reducing accounts on hold.
Finally, at a time when hospitals have a paramount public health responsibility to document and report patient data accurately and comprehensively, they collaborated with experts at AHIMA to provide a standardize compliant query template library to ensure high-quality, comprehensive clinical documentation.
Case Study
How a large national health system deployed mobile technology to simplify query workflow for physicians
An over 60-hospital national health system had many motivations for seeking a new physician query solution. The healt...
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3 MIN READ
From the article in Healthcare IT Today:
Most physicians would tell you that they already spend too much time on documentation and coding. Adding insult to injury, after the coding job is done we often have to explain their decisions to medical coders, a process which can take as long as 20 minutes, according to vendor Artifact Health. Click here to read full article.
In the News
Mobile App Streamlines Physician Query Process
From the article in Healthcare IT Today:
Most physicians would tell you that they already spend too much time on d...
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3 MIN READ
Health systems are using mHealth tools and platforms to improve the often-cumbersome physician query process, resulting in more accurate medical records and billing processes and less-stressed physicians.
From the article in mHealth Intelligence:
Documentation queries are the perfect application for mHealth, Brotman says. They're not so time-sensitive that they justify an interruption of the clinical workflow - yet it is best to answer them before a case can be coded and billed and while a patient is fresh in the doctor's mind. Click here to read full article.
In the News
mHealth Tools Help Hospitals Improve the Physician Query Process
Health systems are using mHealth tools and platforms to improve the often-cumbersome physician query process, resulti...
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3 MIN READ
WMHS ensures medical records are accurate and the health system receives proper reimbursement using a mobile physician query platform.
From the article in RevCycle Intelligence:
Decreasing duplicative efforts and automating the physician query process increased the response rate from 65 to 100 percent. The streamlined process also resulted in the average time to answer a clinical documentation and coding question dropping from about four days to just four hours. Click here to read full article.
In the News
Automated Physician Queries Improve Clinical Documentation at WMHS
WMHS ensures medical records are accurate and the health system receives proper reimbursement using a mobile physicia...
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