Performance analysis challenges in healthcare are unique. The healthcare universe believes in big data benefits but struggles to share and leverage important data. Interoperability is a separate topic, one that I believe is solvable and is a matter of time. Presently, the information an average hospital has access to can allow significant insight into organizational improvement opportunities. In this article, we’ll look at the challenges that come with measuring performance in physician documentation.

Performance evaluation strategy: an industry by industry challenge

The annual Fortune article highlighting the 500 largest companies is one of my favorite reads each year. The company editorials increasingly read like science fiction stories. Oil and gas industries are using big data analytics to improve drilling performance and safety intelligence. Agriculture companies like Monsanto and DuPont use technology to plant seeds more accurately. They then leverage data to compare seed performance to ultimately find the right “prescription” based on factors such as soil composition.

I remember when proper corn planting protocol was 2 feet apart and 2 inches down. Some years it rained too much; other years it was dry. But the most part, the family garden thrived each year with some common sense and some hard work. I can also imagine that same family garden being developed each year with the end in mind and the data to make educated guesses.

A different approach to performance evaluation strategy

Healthcare leaders across the revenue cycle must think differently with how they tackle performance measurement. That is of course a generalization, as there are many leaders asking difficult questions and doing their part to invoke change that matters. At the annual ACDIS Conference last month, I spoke with dozens of people who are leading or participating in innovative studies/programs/pilots with the goal of improved outcomes. I had several takeaways from every session and appreciate the outstanding effort that went into those presentations.

The conversations with clients and strategic partners have advanced significantly from my first ACDIS conference in San Antonio 5 years ago. In general, it’s fun to work with smart people who love what they do. I’m encouraged both by the amount of undiscovered opportunity that exists and the positive “want to” attitude of so many.

To reach that new pinnacle, it is imperative that we leverage data to answer the right questions. This includes questions such as:

  • Benchmarking is no doubt useful. But is it the best method to grade our performance?
  • Do the standard CDI metrics provide the best structure to meet goals and provide long lasting change?
  • Are we empowering physicians to take pride in their documentation?

I believe the answer to all 3 questions is a firm no.

Planting seeds for the right answers

Benchmarking is helpful, but certainly has inherent flaws that can lead to bad information and/or poor strategy. CDI metrics are necessary and helpful. But far too often organizations are sending the same queries to the same physicians for the same diagnosis. It’s crucial to empower physicians by establishing metrics that make them more valuable in the marketplace for compliant documentation.

The potential of what can be accomplished by leveraging information we already have to answer the right questions is exciting and almost limitless. The industry is ready for disruption, quality measurement metrics, and another phase of growth.

The good news is that we know how to plant seeds and grow a successful garden. We also have the skills available that are required to investigate and articulate clinical findings for physician practice improvement. Those are rare and valued.

But where do we go next and how do we accomplish more? I don’t have those answers. But I met many people from diverse organizations at the ACDIS conference who do.

Looking toward the future

So, what’s next? The next generation of achievement requires the industry to adjust how they look at the farm. Health care leaders need to ask, “How do we grow the healthiest plants?” A new highpoint requires an understanding of millions of other gardens and a new method of evaluating and demonstrating results.

It will also demand the industry has the courage to not accept the status quo. I want to thank all the amazing consultants and institutions we serve who made the trip to Orlando. It is an awesome experience each year and establishes a compass for us as a service partner.

We’re here to empower you

Harmony Healthcare’s Clinical Documentation Improvement solutions support your organization with interim expertise optimize reimbursements and prevent future denials.

Discover how our solutions can help your organization:

  • improve clinical documentation to mitigate lost revenue and retain future revenues
  • identify clinical documentation and revenue integrity opportunities for optimal reimbursement
  • streamline the CDI process with robust analytics and automated worklist triage for improved efficiencies and optimized reimbursements

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