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In this Business Profile, Paul Weygandt, MD, JD, vice president of physician services, talks about the importance of integrating clinical documentation improvement (CDI) with patient care in real time, and how Nuance is turning the EHR into a tool valued by physicians.
Nuance is the market leader in creating clinical understanding solutions that drive smart, efficient decisions across health care. More than 500,000 clinicians and 10,000 healthcare facilities worldwide leverage Nuance’s award-winning, voice-enabled clinical documentation and analytics programs to support any clinical workflow on any device.
Nuance’s healthcare division is reinventing the healthcare experience. Through our voice, language, and CDI powered by J.A. Thomas & Associates (JATA) offerings, we create a more human conversation with many systems, devices, electronics, apps, and services. That translates to more satisfied physicians, healthier patients, and a better bottom line.
Engaging physicians to support appropriate reimbursement remains one of the toughest challenges. CDI offers an opportunity to enhance both reimbursement and patient care through better coordination and real-time access to data. However, surveys show that disruption of physician workflow is the biggest barrier to CDI, followed closely by difficulty working with EHRs and other technologies. Historically, the EHR has been data-rich but information-poor, as far as many caregivers are concerned.
We are now at the tipping point, where the EHR begins to make physicians more efficient in both information entry and information extraction—if organizations can engage physicians to use these solutions. The best way to garner this engagement is to integrate CDI with clinical quality and let physicians lead the way.
Real-time identification of clinical patterns—at the point of care—allows physicians to improve clinical documentation from the start, rather than through the traditional retrospective system where physicians are asked to clarify a diagnosis for billing purposes alone. Physicians are trained to dictate their clinical impressions in their own words, and natural language processing allows those words to be instantly converted into structured text.
The next big step is then making that text readily available to others as actionable information and applying intelligent systems to that information.
Nuance uniquely supports clinical workflow and physician-patient interaction while enhancing the quality of information entered into the EHR, which we believe is the key to future success.
The clinical language understanding (CLU) technology developed by Nuance allows physicians to express the subtleties of a clinical opinion—perhaps the most essential component of a physician’s professionalism—easily within their natural workflow and within a patient’s record. This opinion can then be instantly analyzed and its content used to support clinical care at the time of service.
By seamlessly integrating essential clinical processes that used to be sequentially addressed, Nuance brings together capture of the physician’s clinical impression with all the downstream uses of that information that are vital to the success of healthcare organizations and meeting regulatory compliance. Real-time, computer-assisted physician documentation at the point of care naturally integrates elements of CDI, coding, quality monitoring, and analytics, offloading extensive rework from clinicians. The impact on physician workflow and professional satisfaction is profound, allowing physicians more time with patients and providing accurate clinical information in a manner long expected by the profession.
Specifically, CLU converts the patient care narrative from text (which physicians need to describe clinical conditions that vary from patient to patient) into discrete data elements that can be measured and mapped—something that back-end users need for conducting epidemiology, clinical research, coding, compliance, analytics, and billing—thus, bringing together two disparate worlds.
The ideal vendor should:
Focus on clinical care, not just the revenue cycle. You want a vendor that understands clinical quality, physician workflow, and how to engage physicians in a collaborative process to improve patient care. This perspective becomes particularly important as we move toward accountable care.
Have a long history of engaging physician leadership and practicing physicians in accurate documentation and CDI. This unique capability provides far greater impact, because it breaks down the traditional barriers between the clinical and revenue cycle functions.
Introduce CDI programs to physicians not as part of revenue cycle improvement, but as part of patient care and outcomes-oriented solutions. One great example: Physicians judged on quality are often very concerned that outcomes are severity adjusted. How do you do that? By accurately documenting acuity in the medical record.
Bring physicians in early in the process, to identify their needs and help them make the connection between proper terminology and better patient care. Nuance—through its clinically focused Dragon Medical 360 documentation solutions and more than 20 years of clinical documentation expertise from Nuance’s JATA—not only gains support of physicians but also typically spurs 4 to 8 percent improvement in one key revenue cycle metric: case-mix index.
Selecting CDI or coding solutions should always begin with a high-level discussion of desired clinical outcomes and workflow considerations, with a focus on ultimate benefit to patients.
Visitors to our website can download two HFMA reports, HFMA’s Executive Survey: Clinical Documentation Meets Financial Performance and HFMA’s Educational Update: Navigating Today’s CDI Landscape: 10 Strategies for Success, that speak directly to the importance of CDI and its vital links to both clinical quality and revenue cycle enhancement. Go to www.nuance.com/go/hfmareport.
Publication Date: Sunday, June 01, 2014
TriMedx helps health systems control costs and uncover savings opportunities by optimizing the clinical engineering function.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow.
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
Emad Rizk, MD, president and CEO of Accretive Health, discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management.
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
Jim Bohnsack, vice president, solution & corporate development for Conifer Health Solutions, explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements.
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Steve Scibetta, senior director of channel sales for Ontario Systems' healthcare product line, shares insights into effectively managing receivables.
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Elena White, vice president of risk, quality, and network solutions for Optum, discusses how healthcare providers can leverage data and technology as they enable risk in their organization.
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
Somnia President and CEO Marc Koch, MD, MBA, explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
PMMC President Roger L. Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC's products help clients adapt to a changing financial environment.
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Greg Burgess, Founder and Chief Product Officer at Burgess Group shares insights and opportunities for payment integrity in the rapidly changing healthcare IT landscape.
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
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