Hagedon Business Process Redesign within HIM

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Business Process Redesign Within HIM Coding:

Business Process Redesign Within HIM Coding

Objectives:

Objectives What is Computer Assisted Coding? Current state of the coding environment Desired future state coding environment Vendor Analysis Implement software and new Business process

What is Computer-Assisted Coding?:

What is Computer-Assisted Coding? Technology that gathers pertinent codes from documentation and presents those codes to a Coder for validation Two types of Computer-Assisted Coding (CAC): Natural Language Processing Structured Text

Benefits of CAC:

Benefits of CAC Improved coder productivity Improved coding accuracy Improved data integrity Coding compliance Physician relations Coder retention Nuance Healthcare. (2013). How to conduct a thorough CAC readiness assessment. Retrieved from http://www.nuance.com/ucmprod/groups/healthcare/@web-enus/documents/collateral/nc_026447.pdf

Current Coding:

Current Coding

Current State:

Current State Put together a multi-disciplinary project team Understand the current business model Documentation method Current Technology Impacted Interfaces Required documents Defined designated record set

Documentation Types:

Documentation Types Structured Unstructured Narrative Hybrid Nuance Healthcare. (2013). How to conduct a thorough CAC readiness assessment. Retrieved from http://www.nuance.com/ucmprod/groups/healthcare/@web-enus/documents/collateral/nc_026447.pdf

Current State:

Current State Understand the current business model cont. What noncoding -related tasks does the coder perform? How does the coder interact with physicians and financial staff? Smith, G. & Bronnert , J. (2010). Transisioning to CAC: The skills and tools required to work with computer-assisted coding. Journal of AHIMA 7 (81).

Future State Goals:

Future State Goals Documentation = Structured data or captured through NLP New job descriptions for coders to become Editors or Validation specialists. Easier to provide telecommuting options Improved relations between coders and physicians Improved productivity, accuracy, data integrity, compliance, and coder retention

How to get to desired future state:

How to get to desired future state Enlist the help from the multi disciplinary project team Develop a comprehensive change management plan Develop a communication plan that identifies, who, what, when, where, how, and why. Send out RFPs with a requirements definition and conduct a comprehensive vendor analysis

Vendor Analysis:

Vendor Analysis What solutions they offer (Encoder, compliance, clinical documentation improvement, CAC) How will CAC integrate with all other vendors? Is the CAC able to integrated or does it need to be interfaced into current products such as the encoder? Do current vendor contracts need to be updated? Identify service level agreements with vendors Downtime solutions

New CAC product:

New CAC product Do a site visit if possible Collaborate with other vendor customers Review vendor materials Review KLAS and other professional resources

Developing the Future-State of Coding:

Developing the Future-State of Coding Once the vendor has been selected: Involve Coding staff Develop data mapping Develop new process flows Develop new key performance metrics, goals, and standards Include all impacted departments Develop training materials and delivery methods Test the software Implement the new process

Developing Future State of Coding:

Developing Future State of Coding Management Update Job descriptions Work with HR for new compensation Contract coders Higher education

Follow-up:

Follow-up It is necessary to follow-up post implementation to ensure that the new software and business process redesign are working appropriately. Compare measurements post-implementation to those pre-implementation such as productivity, accuracy, cash-flow turn around time and so forth.

Conclusion:

Conclusion When implementing a software solution such as CAC it is essential to redefine business processes in order to be successful. Automating paper processes does not make them a good process.

References:

References Nuance Healthcare. (2013). How to conduct a thorough CAC readiness assessment. Retrieved from http://www.nuance.com/ucmprod/groups/healthcare/@ web-enus/documents/collateral/nc_026447.pdf AHIMA. (2010). Automated coding workflow and CAC practice guidance. Journal of AHIMA 7 (81). AHIMA. (2009). Working smarter with computer-assisted coding. AHIMA today, the Convention Daily Newsletter . Smith, G. & Bronnert , J. (2010). Transistioning to CAC: The skills and tools required to work with computer- assested coding. Journal of AHIMA 7 (81).

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