With The Financial Health of Hospitals At Stake, AI-Powered CDI Can Provide A Critical Revenue Boost
By Chetan Parikh, CEO, ezDI.
The financial implications of the COVID-19 pandemic are generally considered to be secondary to the health crisis, but there’s more overlap between them than you might think. A viewpoint published in the Journal of the American Medical Association cites the challenge of running a financially solvent hospital in the face of staffing shortages, overwhelming demand, and a pause in the outpatient and elective procedures that often make up the bulk of a hospital’s revenue.
While the situation looked dire when the article was published in May 2020, the health crisis across most of the country has only intensified. For health systems themselves to survive the pandemic, they’ll need to take a hard look at revenue cycle management best practices and implement new efficiencies whenever possible.
A proven way to inject much-needed efficiency is to rely on technologies such as artificial intelligence to automate tedious manual processes and improve the speed and accuracy of humans as they perform complicated tasks. One of those complex areas is clinical documentation.
Clinical documentation has always been a bit of a black box, with every provider documenting patients’ clinical issues differently and using shorthand that only they understand. This information is critically important, but it’s all stored in the form of unstructured data, and 56% of healthcare professionals believe it’s obstructing clinical workflow optimization.
Now that almost all clinical documentation lives in an electronic health record, the goal of standardization is pushing facilities to evaluate the documentation that accompanies each encounter. Payers are adding to the pressure, denying reimbursement to providers that fail to adequately prove the necessity of services. New payment models that incorporate risk scoring have also made it critical for providers to document underlying issues during visits, creating an additional layer of complexity — and an additional opportunity for solutions that can facilitate the process.