Measuring Performance in Physician Documentation

Performance evaluation strategy is 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 and then leverage data to compare seed performance and ultimately find the right “prescription” based on soil composition and hundreds of other factors.

I remember when proper corn planting protocol was two feet apart and two inches down. Some years it rained too much and other years it was dry, but for the most part the family garden thrived annually with some common sense and 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.

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 which I believe is solvable and a matter of time. Presently, the information an average hospital has access to can allow significant insight into organizational improvement opportunities.

A different approach to performance evaluation strategy

Healthcare leaders across the revenue cycle must think differently with how they measure performance. That is an overgeneralization 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 that 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 conference in San Antonio five years ago. In general, it is fun to work with smart people who love what they do. I am 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. Questions such as:

  • Benchmarking is 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 three questions is a firm “NO!”

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. 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 and another phase of growth. The good news is that we know how to plant seeds and grow a successful garden. The skills required to investigate and articulate clinical findings to physicians is rare and valued. Where do we go next and how do we accomplish more? I am not sure anyone has all the answers, but I met many people and organizations at the ACDIS conference that do have answers.

So, what’s next? The next generation of achievement requires the industry to adjust how they look at the farm. Healthcare 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 that made the trip to Orlando. It is an awesome experience each year and establishes a compass for us as a service partner.

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