how to leverage cac technology to improve coding results · –cac helped to increase productivity...
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AHIMA 2016 Shandra M. Duncan, RHIT, CHTS-TS
How to Leverage CAC Technology to Improve Coding Results
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• Private, not-for-profit pediatric healthcare network • 16 Locations in Colorado • 100+ Years of Dedication to Children’s Health • 5k + Clinicians / 8k + Employees • Awards:
Children’s Hospital Colorado
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CHCO Statistics
Children's Hospital Colorado (CHCO) Licensed Bed Count (as of July 2015)
Anschutz Medical Campus 444
CHCO at Parker Adventist Hospital 5
CHCO at St. Joseph's Hospital 8
CHCO North Campus, Broomfield 6
CHCO South Campus, Highlands Ranch 16 TOTAL LICENSED BEDS: 479
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CHCO Statistics
• Outpatient Visits per year: – 2015: 620,993 – 2014: 589,094 – 2013: 524,191 – 2012: 462,424
• Inpatient Admissions:
– 2015: 17,593 – 2014: 18,528 – 2013: 17,159 – 2012: 14,259
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• CAC Implementation: –Preparing for ICD-10
–Things to consider: Productivity Adoption Efficiency Analytics
In the beginning …
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• In preparation for ICD-10, like many hospitals, CHOC implemented Computer Assisted Coding (CAC). –Optum Enterprise CAC – Implemented 04/2014 –Coders began practicing ICD-10 coding in the 2nd Qtr. of 2014.
News of the delay required us to push back to ICD-9. –ICD-10 coding practice resumed 2nd Qtr. of 2015. –Coders had 18 months to work in CAC prior to the 10/1/2015
ICD-10 Implementation. –Coders began building productivity momentum with the
assistance of CAC.
Planning for ICD-10
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• With expected productivity losses of up to a dismal 50%, Children’s Colorado was poised to ensure that productivity was not the primary focus as we adopted 70,000+ NEW codes.
• According to AHIMA, there was no instance of that level of reduction in productivity. – Article: Journal of AHIMA, Effects of ICD-10 on Coding Productivity, Melanie Endicott,
3/10/2016 • http://journal.ahima.org/2016/03/10/effects-of-icd-10-on-coding-productivity/
Planning for ICD-10
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• Productivity standards far exceeded with the implementation of Enterprise CAC
Coding Productivity Comparisons
Children's Hospital Colorado
Work Type I-9 W/O CAC I-9 W/CAC INCREASEIP 2 3.01 51%ED 8 15.21 90%UC 8 16 100%
AMB 6 8.68 45%OBS 6 6.94 15%OP 12 15.2 27%
Coding Productivity Per Hour
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Quarterly Productivity Snapshot | ICD-9 w/CAC
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Quarterly Productivity Snapshot | Post ICD-10
• Focus continues to be less on productivity – more on the quality of the coding; necessary during implementation of expansive code set
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• Overall average loss of productivity = 8% – Greatest challenges reside with Ambulatory & Inpatient due to PCS Code deficits and
learning curve.
Productivity
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• As early adopters, we faced a few challenges in the transition to computer-assisted coding technology: –Transitioning to a new encoder –Understanding proper system utilization –CRMs –Analytics
System Adoption
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• Coders introduced to a new encoder – Different, but assisted coders in learning new code set
• Understanding how to teach NLP engine was key – Ensuring coders understood the relationship between the highlighting and
modification functions and how they were ‘teaching’ NLP with every action taken
• Breaking old habits – Analytics helped us to understand the behaviors of the coders in the system – Visibility and acknowledgement of what was causing more challenges helped
to correct inefficiencies in workflows
The Transition
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• Executive Dashboard Expansive set of reports Ability to drill down for detailed information Productivity for all accounts worked Web-based launch to generate reports
Analytics
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CRMs
• Utilizing the CRM Ticket system was very important in the beginning to ensure optimal system performance and track/resolve issues in a timely manner.
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Analytics and Performance Monitoring Program
• Dedicated Analytics Specialist
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Looking back….
• The scorecard: – CAC helped to increase productivity prior to ICD-10, so the post
ICD-10 impact was minimal. – LOTS of practice time with the system and opportunity to work
through system adoption challenges long before– thanks to ICD-10 delays.
– Fostering efficient utilization of the tool has paid off largely and helped to develop greater NLP confidence.
– A powerful analytics tool helped to monitor coder progress, production and system trends.
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Questions
Shandra M. Duncan, RHIT, CHTS-TS [email protected] 720-777-6646 HIM Coding Manager
Melinda Patten, MHA, RHIA, CHPS, CDIP [email protected] 720-777-6657 Director, Health Information Management
Thank you
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