Automation: A Necessity in Healthcare’s Digital Transformation
“Automation serves a key role in healthcare digital transformation by freeing resources for innovations that drive outcomes and health value,” Per Gartner.
Digital transformation and automation aren’t just buzz words anymore; they are the tickets to the future of HI and healthcare. HI professionals have always proven to adapt and evolve with the times, but now, with documentation and quality at the forefront of value-based care, we have the opportunity to leverage technology to redefine and solidify our roles in healthcare.
In the wake of the pandemic, an organization’s ability to quickly adapt to supply chain disruptions, market pressures, and rapidly changing customer expectations has become critical, according to the Enterprisers Project’s article, What is digital transformation?
The pandemic exposed weaknesses in the healthcare landscape (e.g., telehealth, cybersecurity, compliance, revenue cycle), giving executive leaders a new perspective on why digital transformation is essential to address these challenges going forward.
Automation has enabled many industries to revolutionize their operations. It has the same, or even more potential for the healthcare sector. Introduction of Business Process Automation can streamline the healthcare system for simplicity, increased service quality, and manage costs. Healthcare process automation consists of integrating applications, restructuring labor resources, and using software applications throughout the healthcare value chain. Source
Robotic Process Automation (RPA), Artificial Intelligence (AI) Machine Learning (ML) tools, Private/Public Cloud, Data Analytics, and Integration can help healthcare providers to implement and achieve greater operational efficiency. Here are a few ways automation can help the healthcare industry: –
Patient support through voice-bots
Maintain EHR systems
Patient admission and discharge
Insurance claim management
Inventory and supply chain management
The health information (HI) profession is responsible for a broad range of initiatives that require a lot of resources. When you really take the time to think about each HI process, how much are they costing your organization from operational, financial, and quality standpoints? Is there an opportunity to further streamline these processes?
This is our time to take a closer look at everything we do, determine what needs to change, establish our goals and priorities, and work toward a better future state/workflow by leveraging technology to automate HI processes.
Example of the Benefits of Automating Processes
One example relates to coding and clinical documentation improvement (CDI). Each team plays a critical role in value-based care by ensuring provider documentation accurately reflects the clinical status of a patient and the quality of services provided. Inaccurate or incomplete documentation means that the highest degree of coding specificity cannot be captured, leading to missed revenue opportunities and/or increased coding denials. It also means the true patient story is not accurately captured, leading to potential quality concerns.
Operational
Automating coding and CDI worklists eliminates the time spent determining which charts to review and when. Maximizing CDI case coverage by using AI to identify and automate targeted reviews ensures CDI teams are focusing on charts with the greatest potential CDI impact. Using AI-generated code suggestions to cut down manual code lookups and quickly add codes to be factored into working and final DRGs (diagnosis-related groups) improves productivity and leads to more charts accurately coded/reviewed per hour.
Utilizing one singular, collaborative workspace for all coding and CDI activities (coding, CDI reviews, query process, audit process, denials management, reporting, etc.) improves productivity and eliminates the time spent toggling between disparate systems or applications to complete work.
Financial
Improved clinical documentation and coding quality leads to appropriate reimbursement and fewer denials. Automating and streamlining each process leads to higher productivity and the ability to submit charts to billing quicker. These productivity gains will improve key performance metrics such as an organization’s DNFC (discharged, not final coded) and AR days (accounts receivable days).
Accurately capturing more codes with a higher degree of specificity will improve CMI (case mix index) to reflect a more complex patient population.
Utilizing one singular, collaborative workspace allows organizations to eliminate or consolidate disparate and/or legacy systems that are no longer needed. This frees up financial resources from the IT budget that can be reallocated toward other digital transformation initiatives.
Quality
Improving clinical documentation and coding quality ensures a patient’s severity of illness is consistent with what is documented, and the care provided.
Using AI to automatically identify patient charts with possible quality indicators such as patient safety indicators (PSIs) or hospital-acquired conditions (HACs) will allow quality teams to proactively intervene while the patient is still in-house, improving care outcomes. Source
Leveraging data to report on quality indicators and key performance metrics can be used to identify trends and vulnerabilities in current processes that are negatively impacting value-based care outcomes.
HI’s Potential
Digital transformation and automation aren’t just buzz words anymore; they are the tickets to the future of HI and healthcare. HI professionals have always proven to adapt and evolve with the times, but now, with documentation and quality at the forefront of value-based care, we have the opportunity to leverage technology to redefine and solidify our roles in healthcare.
Let’s take advantage of the benefits and possibilities technology can offer by bringing new levels of consistency, speed, and scalability to HI processes, directly impacting value-based care outcomes. It’s time to elevate our potential and never forget that health information is human information.