Iodine Intelligence - Empowering Intelligent Care

Artificial intelligence (AI) and Natural Language Processing (NLP) are taking over the health industry and renovating healthcare technology. It has for some time now being a Lodestar into improving and delivering quality healthcare. A ton of information is being collected but isn’t being utilized simply because the existing technology doesn’t know what to do with the data. A recent report from RBC Capital Markets states 30% of the world's data is generated in the healthcare industry, and it is expected to surpass 36% in the next three years. Handling this sort of information is a challenge as most healthcare AI technology relies on simple technologies like rules and checklists.

On this episode, Lauren Hickey, the content strategist at Iodine, chats with Diana O’Connor, the clinical product consultant manager at Iodine, and Justin Geradot, the client service operations manager at Iodine, about their new flagship technology, CONCURRENT. Hickey, Diana, and Justin chat about...

1. What can prevent CDIs from fully adopting concurrent.

2. How auto-assignment works

3. Barriers and quiet periods.

"CONCURRENT is our flagship software that utilizes artificial intelligence and machine learning to prioritize patients concurrently while in-house. It uses, at a high level, different amount of misalignment of information between clinical evidence that support a certain condition and the actual expectation documentation of those conditions and uses the difference to prioritize," said Justin.

"CDI is complex. There is a lot of different workflow strategies that people use. CONCURRENT is more than just a technical implementation, we are taking account of different philosophies and workflows," said Diana.

Lauren then asked Justin about auto-assignment and quiet periods, and he went on to say:

"Auto assignment is a way concurrent distributes cases to CDS’s for review. It is one of the oldest features for CONCURRENT specifically to address the problem that scope changes as a result of CONCURRENT. Before CONCURRENT, CDIs way to locate cases was through location or service line. When prioritization is added, balancing for caseloads gets more difficult. Auto assignment instead of using service line to distribute cases uses priority status, assigning cases with more priority first then working their way down.”

“Quiet period is how much period a case must incubate before its considered for auto-assignment. This is a change for a lot of CDI departments. A lot of CDI teams want to see cases every two days at a minimum. With prioritization, we set a 24hr quiet period to get the necessary information. After a case has been reviewed, it goes into another quiet period for 12hrs to make sure it doesn’t immediately get reprioritized again,” Justin continued.

Lauren then talks about query hesitancy and asks Diana about CDSs not querying as much even when Iodine AI says a query is needed. Diana’s reply:

"One of the things we are looking for is a complete, intact medical record that tells the story of the patient and the sooner we get the documentation in, the better. And with denials coming up the way they are, you want continuity of them in the medical record. It’s a shift from getting querying away as a penalty into more as a prompt and querying sooner."

At the end of the episode, Justin says Iodine and Concurrent are always changing, adding new functionalities, platforms, and configurations—Retrospect being an example.

In this episode of Iodine Intelligence, Fran Jurcak, Chief Clinical Strategist at Iodine Software and Kati Beisel, Director of Health Information for Integris Health, which is Oklahoma's largest state-owned not-for-profit health care system and ranked one of the top 25 health care systems in the US, discuss the difficulties associated with solving the challenges presented by mid-revenue cycle leakage.

There are many costs associated with mid-revenue cycle leakage both immediate and long-term. Not only that, but the negative impact can also be felt throughout an organization. Everything from day-to-day operations, budget planning, resource allocation, patient outcomes, and staffing initiatives suffer from ineffective processes and systems.

Fran Jurcak took a moment to speak to the significant issue of quantifying costs, noting that it is not a perfect process. “There continues to be anywhere from 4 1⁄2 to half a million dollars lost in revenue in the average 250 bed hospital. So, fairly significant loss based upon workflows even after investments in areas to try and diminish that leakage,” stated Jurak.

Beisel concurred, adding that Integris Health has “been scrutinized in the mid-revenue cycle quite a bit in recent years and I think that’s for good reason because there is so many places for revenue to leak in the process.” She goes on to mention common areas of loss including physician documentation, staffing shortages, coding requirements, and reporting methods.

Despite the significant challenges associated with implementing processes and software to improve CDI and reduce mid-revenue cycle leakage, both women agreed that the work is important. Noting that every dollar and dime counts, Beisel spoke of the need to reinvest in talent to better serve patients and communities while improving quality of patient care.

Additional points of conversation included potential solutions, Iodine’s various software solutions, and Integris Health systems journey to date.

There are six domains of health care quality outlined by the IOM (Institute of Medicine.) These include Safe, effective, patient-centered, timely, efficient, and equitable. Fran Jurcak, Chief Clinical Strategist, Iodine Software, and Deborah Jones, Director of Clinical Documentation Improvement at Brigham and Women’s Hospital, spoke with Lauren Hickey on how documentation accuracy can help achieve quality processes and outcomes in health care.

People want to go where they are going to get the best care, so having the ability to determine which hospitals offer optimum quality is essential. “All of this documentation translates into publicly reported information that is driving hospital reputation and consumer decisions about where they will receive care,” Jurcak said. “It’s about ensuring that the world can see the level of care you provide, and what level of acuity patients are experiencing, and whether or not they have positive outcomes.”

More and more, these quality outcome metrics and reimbursement are tied together. Penalties, payment, and accreditation withholdings could occur if healthcare organizations do not meet specific benchmarks. Without proper accreditation, healthcare organizations may not be able to offer certain services.

Jones said that in Boston, where Brigham Health is one of many renowned healthcare institutions, they constantly need to prove to their consumers that they are delivering the best care. “First and foremost, it’s about documentation accuracy; ensuring the basic CDI, that all conditions are being monitored and treated are capturable.”

Improvements in quality ranking and scoring of documentation allow systems to capture an accurate patient’s clinical picture. “There are conditions that are now important to these methodologies in terms of identifying risk that historically in the documentation world we didn’t worry about,” Jurcak said. “Today, it’s about capturing the true clinical picture about what’s happening to patients so you can best reflect yourself as an organization to the outside world.”

Iodine created a documentation accuracy index to determine if what’s in the medical record is happening to the patient. This index can solve documentation issues, close gaps, and increase reimbursement.

Take your CDI efforts to new heights. Discover how technology can serve as a catalyst for success, unlocking the next level of performance for your CDI program and elevating its impact. Uncover key metrics to monitor and track, enabling you to effectively demonstrate the value and success of your CDI initiatives within your healthcare organization and solidifying its position as a critical component of revenue integrity and achieving recognition for quality care delivery.

Every year Iodine Software conducts a client wide cohort study measuring various key metrics in the clinical documentation integrity space and the impact that Iodine has had. In this month's episode we're joined by Iodine's Chief Customer Officer, Brad Wensel, and Chief Operating Officer, Joshua Toub, to review the most recent cohort study of 2022 data and explain the metrics, methodology and discuss the most recent findings.