How Capturing True Clinical Intent Improves Patient Care March 1, 2016

Transcription

1 How Capturing True Clinical Intent Improves Patient Care March 1, 2016 John W. Showalter MD, MSIS Chief Health Information Officer University of Mississippi Medical Center

2 Conflict of Interest John W. Showalter, MD MSIS Has no real or apparent conflicts of interest to report.

3 Learning Objectives Describe the process of interfacing standard code set with clinical terminology to select the correct clinical term for each patient complaint Understand the importance of capturing the clinician s true clinical intent for the patient narrative and communicating that across the entire care workflow Differentiate between the capture of simple clinical terms with the use of terminology that is highly granular Evaluate the importance of ensuring the accurate persistence of the clinical information Recognize how the highly specific capture of clinical information will provide more accurate coding and reporting

4 An Introduction of How Benefits Were Realized for the Value of Health IT Satisfaction: Improved communication with patients and between providers by increasing the detail on the patient s problem list Treatment/Clinical: Improved patient risk adjustment and thus risk adjusted mortality Savings: Increased revenue by increasing Case Mix Index (CMI)

5 Congestive Heart Failure

6 Systolic Congestive Heart Failure

7 Chronic Systolic Heart Failure

8 Cardiology Outpatient Codes

9 Cardiology Outpatient Codes

10 Average CC/MCC Count per Encounter 2015

11 Cardiology CMI

12 Femur Fracture

13 Femur Fracture Detailed

14 Orthopedics Unspecified Inpatient Codes 2015

15 Orthopedics Unspecified Inpatient Codes 2015

16 Orthopedics Adult CMI Year Over Year

17 Altered Mental Status

18 Altered Mental Status: Coma

19 Altered Mental Status: Coma - Detail

20 Altered Mental Status: Delirium

21 Neurosurgery Outpatient Codes

22 Neurosurgery Outpatient Codes

23 Neurosurgical Denials Due to Needing More Information

24 Overall Unspecified Code Use

25 Overall Unspecified Code Use

26 Overall CMI: Year Over Year

27 Overall CMI: Year Over Year

28 Stabilizing Transition to New Interns >$2,000,000 in Revenue Overall CMI: Year Over Year

29 Specificity Does Affect Care Clinical decision making Research Transitions of care Revenue Cycle Patient Engagement

30 Specificity Impacts Engagement As a parent You re rushing your fouryear-old to the emergency room while they re having a serious asthma attack As a child You re caring for your elderly parent with Alzheimer s and faced with making decisions about their care and treatment

31 A Parent Cares 1 in 11 children have asthma 1 in 5 children with asthma went to an ED last year ICD-10 gets rid of two problematic descriptors No intrinsic vs. extrinsic it s just asthma No chronic obstructive asthma vs. bronchitis vs. COPD ICD-10 now includes descriptions Mild, moderate, and severe Intermittent or persistent Changes from cause to behavior

32 A Child Cares By 2050, we expect a three-fold increase in the number of Alzheimer s patients ICD-9 had only one code for Alzheimer s ICD-10 introduces concepts about the onset, whether there is delirium or dementia, and whether there is behavioral disturbance This allows us to better understand how treatments are going for these populations

33 A Summary of How Benefits Were Realized for the Value of Health IT Satisfaction: Increased physician satisfaction with the use of the calculator Treatment/Clinical: Improved risk adjusted mortality for Orthopedics and more efficient clinical decision making Patient Engagement: Increased clarity for care givers Savings: Increased revenue by more that $2,000,000 while reducing denials

34 Questions