• Measure the financial impact of CDI reviews • Prioritise cases for review based on focus DRGs, length of stay, specialty, and more • Generate custom reports to drive organisation objectives with actionable insight • Identify potential quality flags to improve documentation and care planning in real time
Hospitals are recognising the importance of accurate and complete documentation not just for capturing complexity and optimising reimbursement, but also for ensuring quality care and patient safety by communicating information to all members of the clinical team along the care continuum. With Clinical Documentation Integrity (CDI) initiatives gaining momentum across Australia and New Zealand hospitals, how do CDI teams capture and measure the work that they do? How do they collaborate and communicate with coding and quality teams? What tools do they use to support a concurrent workflow to enable real time interaction with clinicians? 3M 360 Encompass System provides a CDI workflow that is separate from the coding workflow enabling transparency of work between the two teams to facilitate collaboration. 3M 360 Encompass supports real time data flow to support concurrent review of documentation as it occurs, identifying opportunities for improvement in real time. By leveraging game-changing technology, 3M 360 Encompass System’s powerful computer-assisted CDI helps CDI teams delve more deeply into records and pinpoint the clinical documentation that matters most. This drives process improvement in an outcomes-based health care environment.
Clinical documentation drives much of the data that health care organisations use for analysis and funding. The ability to assess and share this data in real-time is increasingly important as the health care industry transitions to outcomes-based payments. CDI teams play a critical role because they can identify relevant data, improve it and share it with other clinical and administrative teams to improve outcomes that directly affect reimbursement. As organisations realise the value and expand the scope of their CDI programs, many find they simply aren’t staffed to meet increased patient volume. These resourcing issues then increases the burden on clinical coding teams who need to fill the gap through retrospective queries. How can CDI teams work smarter, not harder in ensuring that they are reviewing the cases where the biggest impacts can be made?
Computer-assisted CDI features within the 3M 360 Encompass System provide CDI teams with health information technology systems and an enhanced workflow that provide users with electronic query capability, prioritised worklists, access to CDI reference materials, auto-suggested queries, and CDI edits. These tools not only increase clinician response rates, but they also boost CDI specialist productivity and reduce the volume of retrospective queries required by the coder. In addition, 3M 360 Encompass System’s top-rated computer-assisted coding tools reveal hidden diagnoses and procedures buried deep within the documentation to help establish patient complexity more accurately.
3M’s prioritisation algorithm analyses unstructured data using natural language processing to identify the following types of high-priority reviews:
• Organisation-specific focus DRGs
• Cases for which there are multiple principal diagnoses or those without a complication or comorbidity
• Cases for which the length of stay doesn’t correlate with the DRG complexity level
• Discharges for which there is a pending query
• Cases that include an automated query to the clinician (CAPD)
• Documentation that includes clinical indicators of a condition without a corresponding diagnosis
• Cases where there may be a HAC indicator that may need a documentation review.
3M 360 Encompass System not only prioritises cases, but it also provides insight into why each case is a priority opportunity. Users can customise and define the types of cases for review as well as assign custom hierarchies of worklists (e.g., based on system, facility, team, or user). 3M 360 Encompass System also uses machine learning to continually update and improve CDI priorities based on new documentation. Customisable self-service reports allow CDI teams to continually monitor and improve outcomes, impact of the program, and accuracy of the algorithm and priority cases.
3M 360 Encompass System can assist in identifying Hospital Acquired Complications (HACs) concurrently and provides a dynamic dashboard to assist in early review by quality teams. Quality and CDI teams can act immediately to correct documentation or enhance care planning in real time.
For hospitals to meet the rising demands of competition, compliance, communication and patient outcomes, they must have an efficient and accurate revenue cycle management system.
But what does that really look like?
It looks like coding and clinical documentation working from the same content, reducing duplication. It looks like facility and professional services coders using one application, putting an end to disjointed workflows and communication breakdowns. It’s timely, complete query responses from clinicians and full confidence that HACs are captured. It’s big-picture insights so hospitals can stay ahead of market changes.
It looks like your teams, workflows and applications are focused on improving patient care and how to properly document medical records. The 3M 360 Encompass System platform can make this possible.
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