Defining Quality as a Process or an Outcome with Fran Jurcak and Deborah Jones

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.