Healthcare data management

Wendi Klein, Director of Marketing & Communication, North America, A2iA

Since reform and regulation have stirred the industry, it has become an even more complex environment, though the goal is to streamline processes. In the wake of healthcare reform, healthcare IT has been forced to comply with new regulations, and healthcare IT needs have shifted. The U.S. government has set forth dates and deadlines by which providers and payors must meet certain milestones, placing emphasis on obtaining meaningful use of patient data, the availability and recovery of data to increase productivity and enhance patient care, as well as the industry’s transition from ICD-9 to ICD-10.

Given this complex and changing environment, healthcare IT providers must focus on implementing solutions that will meet users’ needs today and in the future, while maximizing existing spending to deliver an ROI. But with so many vendors trying to make a name for themselves, how can one stand out from the competition yet still deliver technology that meets government mandates?

CCHIT certified solutions, for example, are becoming more and more common since this is how the Department of Health and Human Services deems a system a "qualified EMR." However, many CCHIT solutions today still require manual document sorting and data entry because of the complex nature of healthcare documents. Hospitals and clinics alike are looking for ways around this, as it is no secret that manual document handling is a time consuming and expensive task, and even allows for breaches in privacy with the involvement of third-parties.

By partnering with technology companies that provide advanced indexing and data lifting capabilities, CCHIT certified solutions can address these pain points by removing the human interaction and allowing for higher levels of productivity, consequently differentiating themselves from the competition. By allowing complex and even handwritten documents such as provider notes, clinical documentation, lab results or prescriptions to enter the workflow, automatic routing to EHR, EMR or PM solutions can occur, and the data can be automatically located and lifted. Tangible results are seen almost immediately, and the CCHIT solution stands out from seemingly similar applications by providing a greater level of automation for all documents, regardless of their type or complexity.

Once these complex documents are incorporated into the EHR, EMR or PM solution, the next steps, like coding and billing, can occur. According to a recent study, between 5 and 15 percent of a coder’s time is spent reading health information, and 50 percent of a record clerk’s time is spent looking for information. ICD-9 is currently an accepted set of codes to be used for reporting diagnoses and procedures on healthcare transactions, although it must be replaced by ICD-10 no later than October 2013.

Because ICD-10 contains nearly 5 times as many codes and sub-codes, the conversion from ICD-9 to ICD-10 is predicted to decrease productivity by a minimum of 25 percent for three to six months after the transition as coders adjust to new methodology, and become a more costly endeavor than Y2K in terms of both time and money.

Although the deadline to transition to ICD-10 is not until 2013, many have already started to look for solutions to counteract the predicted loss of efficiency. Computer Assisted Coding, or CAC solutions, can help, but many are still asking, “How will coders remain productive as they learn the new codes and sub-codes so that providers can submit and receive payments, and payors can process claims, at the same level of accuracy and speed that they are today?”

Because of these fears and the anticipated decrease in efficiency, there is a large opportunity for technology that can aid in the transition process. Newer, advanced solutions can bring greater levels of automation, help to increase processing times and accuracy, and even save money. By enhancing CAC solutions with capabilities that can automatically locate and lift medical terms and diagnoses from both printed and handwritten documents, such as providers notes and clinical documentation, the research process is sped up and manual labor decreased as codes are automatically assigned. All coded documents can then be indexed and routed with virtually no human interaction to the appropriate EHR, EMR or PM solution, speeding productivity, guaranteeing automation, and aiding in the research and coding process.

Healthcare data management is a complex world, and no one knows what changes are on the horizon. Current solutions can certainly aid in productivity, but combining them with the capabilities of newer, advanced technology, today’s pain points can be lessened, automation improved, and tomorrow’s fears calmed.

What do you think?