RE: cdi_talk digest: April 02, 2014
Karen and Paul,
We implemented 3M CAC last June. I agree with both of your sentiments! We have also had many technical issues and down time since installation. As an "early adopter", we were told this is common. I am so glad to help 3M get the kinks out of their product while our productivity crashes and the CDSs become stressed with too much technology that doesn't work consistently or well. Sorry, that sounds snarky. I guess someone needs to help in R&D. I'll take one for the CDI team:). Not meaning to diss 3M. They have many GREAT products.
I am considering pulling the plug on it from a CDI perspective (and not even sure if this is possible). I cannot speak form a coder's perspective but I feel CAC (whatever brand) cripples the critical thinking that goes into looking at the record. Part of the work of CDI is to identify what is missing, not what is present. The codes are flying at them ( and not always the correct codes) and it is distracting and impacting work flow, especially with unseasoned CDSs. I did decide that all new CDS staff could not use the CAC until they were more experienced. With the delay in ICD-10, I am going to take another look at the pros and cons of this tool.
Thanks,
-Jane
p.303-603-9581
c 720-305-7765
We implemented 3M CAC last June. I agree with both of your sentiments! We have also had many technical issues and down time since installation. As an "early adopter", we were told this is common. I am so glad to help 3M get the kinks out of their product while our productivity crashes and the CDSs become stressed with too much technology that doesn't work consistently or well. Sorry, that sounds snarky. I guess someone needs to help in R&D. I'll take one for the CDI team:). Not meaning to diss 3M. They have many GREAT products.
I am considering pulling the plug on it from a CDI perspective (and not even sure if this is possible). I cannot speak form a coder's perspective but I feel CAC (whatever brand) cripples the critical thinking that goes into looking at the record. Part of the work of CDI is to identify what is missing, not what is present. The codes are flying at them ( and not always the correct codes) and it is distracting and impacting work flow, especially with unseasoned CDSs. I did decide that all new CDS staff could not use the CAC until they were more experienced. With the delay in ICD-10, I am going to take another look at the pros and cons of this tool.
Thanks,
-Jane
p.303-603-9581
c 720-305-7765
Comments
CAC will 'probably' be a viable product at some time in the future. I feel that IF a CDS understands some of the basic coding rules and DRG structures, it can be somewhat helpful to use a CAC.
My flow is thus:
1. Review the principal diagnosis assigned by CAC - correct if needed
2. Review all significant 2ndry codes assigned, vet, delete, add, as needed. CAC will often assign a 2ndry code incorrectly based on the HISTORY of the H&P - example, Pt has H/O SEPSIS 3 months PTA, the code for 038.9 is incorrectly assigned.
3. Also, CAC will assign codes from Path Report, some Labs and RAD results.
On the PLUS side, a good portion of the codes assigned by CAC are valid, and I can retain those for my case.
IMO, CAC is very much a mixed bag at this point.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.637.9002
evanspx@sutterhealth.org
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Thursday, April 03, 2014 8:05 AM
To: Evans, Paul
Subject: RE:[cdi_talk] cdi_talk digest: April 02, 2014
Karen and Paul,
We implemented 3M CAC last June. I agree with both of your sentiments! We have also had many technical issues and down time since installation. As an "early adopter", we were told this is common. I am so glad to help 3M get the kinks out of their product while our productivity crashes and the CDSs become stressed with too much technology that doesn't work consistently or well. Sorry, that sounds snarky. I guess someone needs to help in R&D. I'll take one for the CDI team:). Not meaning to diss 3M. They have many GREAT products.
I am considering pulling the plug on it from a CDI perspective (and not even sure if this is possible). I cannot speak form a coder's perspective but I feel CAC (whatever brand) cripples the critical thinking that goes into looking at the record. Part of the work of CDI is to identify what is missing, not what is present. The codes are flying at them ( and not always the correct codes) and it is distracting and impacting work flow, especially with unseasoned CDSs. I did decide that all new CDS staff could not use the CAC until they were more experienced. With the delay in ICD-10, I am going to take another look at the pros and cons of this tool.
Thanks,
-Jane
p.303-603-9581
c 720-305-7765
-----Original Message-----
From: CDI Talk digest [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, April 02, 2014 10:00 PM
To: cdi_talk digest recipients
Subject: cdi_talk digest: April 02, 2014
CDI_TALK Digest for Wednesday, April 02, 2014.
1. Computer Assisted Coding and CDI
2. Re: Computer Assisted Coding and CDI
3. Re: Computer Assisted Coding and CDI
4. RE: Computer Assisted Coding and CDI
5. RE: Computer Assisted Coding and CDI
6. RE: Computer Assisted Coding and CDI
7. Oh how I wish I could review a big fat paper chart!
----------------------------------------------------------------------
Subject: Computer Assisted Coding and CDI
From: "Shelia Bullock"
Date: Wed, 02 Apr 2014 00:00:00 -0400
X-Message-Number: 1
Does anyone have Epic and 3M 360 who use the 360 product for their CDI program? We are in implementation stage. Would appreciate ideas and tips that you learned along the way. Thanks Shelia Bullock, University of MS Med Ctr
----------------------------------------------------------------------
Subject: Re: Computer Assisted Coding and CDI
From: "Linda Rhodes"
Date: Wed, 02 Apr 2014 11:36:51 -0400
X-Message-Number: 2
Hi Sheila,
We use 3M and just implemented CAC 2 weeks ago. i would be glad to discuss with you offline.
Thanks,
Linda
Linda Rhodes RN, BSN, CCDS
Manager Clinical Documentation
Improvement
New Hanover Regional Medical Center
Wilmington, North Carolina 28402
Office # 910-815-5544
Cell " 910-777-8344
e-mail : linda.rhodes@nhrmc.org
"I have a Code for that"
Visit Capsuleslive for more information on ICD-10 implementation
>>> CDI Talk 4/2/2014 12:00 AM >>>
Does anyone have Epic and 3M 360 who use the 360 product for their CDI program? We are in implementation stage. Would appreciate ideas and tips that you learned along the way. Thanks Shelia Bullock, University of MS Med Ctr
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
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Copyright 2013
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----------------------------------------------------------------------
Subject: Re: Computer Assisted Coding and CDI
From: "Donald Butler"
Date: Wed, 02 Apr 2014 12:15:51 -0400
X-Message-Number: 3
We also just implemented a few weeks ago. Please feel free to contact me.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation Advisor Program Vidant Health, Greenville NC DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )
>>> "CDI Talk" 4/2/2014 11:36 AM >>>
Hi Sheila,
We use 3M and just implemented CAC 2 weeks ago. i would be glad to discuss with you offline.
Thanks,
Linda
Linda Rhodes RN, BSN, CCDS
Manager Clinical Documentation
Improvement
New Hanover Regional Medical Center
Wilmington, North Carolina 28402
Office # 910-815-5544
Cell " 910-777-8344
e-mail : linda.rhodes@nhrmc.org
"I have a Code for that"
Visit Capsuleslive for more information on ICD-10 implementation
>>> CDI Talk 4/2/2014 12:00 AM >>>
Does anyone have Epic and 3M 360 who use the 360 product for their CDI program? We are in implementation stage. Would appreciate ideas and tips that you learned along the way. Thanks Shelia Bullock, University of MS Med Ctr
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
---
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Subject: RE: Computer Assisted Coding and CDI
From: "Maritano, Karen M. :LPH Care Management"
Date: Wed, 2 Apr 2014 09:34:32 -0700
X-Message-Number: 4
3M's marketing amazes me for such a poor product. We have had their computer assisted program for a year and a half now. I have been a Clinical Documentation Specialist for 9 1/2 years now and much experience using the encoder for reviews as well as the DRG Expert.
This product gives wrong codes all the time and, in general, has taken me so much more time. Totally decreases my productivity. There are a couple decent features but not enough IMHO to warrant purchase and use.
ICD-10 now being on hold changes things but I have often wondered if CAC could function at all considering all the mistakes for ICD-9. Also we have frequent upgrades approx every 2-3 weeks where we can't do our reviews at all for about an hour to two hours. This is followed, prob 90% of the time, by many glitches and CAC keeps going down rest of day.
I would grade my overall experience with CAC as an F.
Karen Maritano, RN
Clinical Documentation Specialist
Legacy Health
Portland, OR
503-413-7148
Kmaritan@lhs.org
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, April 02, 2014 9:16 AM
To: Maritano, Karen M. :LPH Care Management
Subject: Re: [cdi_talk] Computer Assisted Coding and CDI
We also just implemented a few weeks ago. Please feel free to contact me.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation Advisor Program Vidant Health, Greenville NC DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )
>>> "CDI Talk" 4/2/2014 11:36 AM >>>
Hi Sheila,
We use 3M and just implemented CAC 2 weeks ago. i would be glad to discuss with you offline.
Thanks,
Linda
Linda Rhodes RN, BSN, CCDS
Manager Clinical Documentation
Improvement
New Hanover Regional Medical Center
Wilmington, North Carolina 28402
Office # 910-815-5544
Cell " 910-777-8344
e-mail : linda.rhodes@nhrmc.org
"I have a Code for that"
Visit Capsuleslive for more information on ICD-10 implementation
>>> CDI Talk 4/2/2014 12:00 AM >>>
Does anyone have Epic and 3M 360 who use the 360 product for their CDI
program? We are in implementation stage. Would appreciate ideas and
tips that you learned along the way. Thanks Shelia Bullock, University of MS Med Ctr
---
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
---
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----------------------------------------------------------------------
Subject: RE: Computer Assisted Coding and CDI
From: "Evans, Paul"
Date: Wed, 2 Apr 2014 09:42:27 -0700
X-Message-Number: 5
I am using CAC, also. If you want the name of the vendor, it is not 3M, please call my cell. Overall, the CAC is 'not ready for live time" as multiple codes are incorrectly assigned. I am a very experienced coder and I know how to use coding software. CAC is great in theory, but dangerous if one does not vet the assigned codes. I think the execution of CAC needs at least a few more years and it is not worth the $$$.
Paul
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044 San Francisco, CA 94107
Cell: 415.637.9002
evanspx@sutterhealth.org
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, April 02, 2014 9:35 AM
To: Evans, Paul
Subject: RE: [cdi_talk] Computer Assisted Coding and CDI
3M's marketing amazes me for such a poor product. We have had their computer assisted program for a year and a half now. I have been a Clinical Documentation Specialist for 9 1/2 years now and much experience using the encoder for reviews as well as the DRG Expert.
This product gives wrong codes all the time and, in general, has taken me so much more time. Totally decreases my productivity. There are a couple decent features but not enough IMHO to warrant purchase and use.
ICD-10 now being on hold changes things but I have often wondered if CAC could function at all considering all the mistakes for ICD-9. Also we have frequent upgrades approx every 2-3 weeks where we can't do our reviews at all for about an hour to two hours. This is followed, prob 90% of the time, by many glitches and CAC keeps going down rest of day.
I would grade my overall experience with CAC as an F.
Karen Maritano, RN
Clinical Documentation Specialist
Legacy Health
Portland, OR
503-413-7148
Kmaritan@lhs.org
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, April 02, 2014 9:16 AM
To: Maritano, Karen M. :LPH Care Management
Subject: Re: [cdi_talk] Computer Assisted Coding and CDI
We also just implemented a few weeks ago. Please feel free to contact me.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation Advisor Program Vidant Health, Greenville NC DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )
>>> "CDI Talk" 4/2/2014 11:36 AM >>>
Hi Sheila,
We use 3M and just implemented CAC 2 weeks ago. i would be glad to discuss with you offline.
Thanks,
Linda
Linda Rhodes RN, BSN, CCDS
Manager Clinical Documentation
Improvement
New Hanover Regional Medical Center
Wilmington, North Carolina 28402
Office # 910-815-5544
Cell " 910-777-8344
e-mail : linda.rhodes@nhrmc.org
"I have a Code for that"
Visit Capsuleslive for more information on ICD-10 implementation
>>> CDI Talk 4/2/2014 12:00 AM >>>
Does anyone have Epic and 3M 360 who use the 360 product for their CDI
program? We are in implementation stage. Would appreciate ideas and
tips that you learned along the way. Thanks Shelia Bullock, University of MS Med Ctr
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
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Copyright 2013
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Copyright 2013
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----------------------------------------------------------------------
Subject: RE: Computer Assisted Coding and CDI
From: "Maritano, Karen M. :LPH Care Management"
Date: Wed, 2 Apr 2014 16:15:41 -0700
X-Message-Number: 6
Thanks Paul
I did confirm with our CDI Manager that our CAC here is a 3M product. It makes sense that there are other vendors.
Karen
Karen Maritano, RN
Clinical Documentation Specialist
Legacy Health
Portland, OR
503-413-7148
Kmaritan@lhs.org
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, April 02, 2014 9:42 AM
To: Maritano, Karen M. :LPH Care Management
Subject: RE: [cdi_talk] Computer Assisted Coding and CDI
I am using CAC, also. If you want the name of the vendor, it is not 3M, please call my cell. Overall, the CAC is 'not ready for live time" as multiple codes are incorrectly assigned. I am a very experienced coder and I know how to use coding software. CAC is great in theory, but dangerous if one does not vet the assigned codes. I think the execution of CAC needs at least a few more years and it is not worth the $$$.
Paul
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044 San Francisco, CA 94107
Cell: 415.637.9002
evanspx@sutterhealth.org
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, April 02, 2014 9:35 AM
To: Evans, Paul
Subject: RE: [cdi_talk] Computer Assisted Coding and CDI
3M's marketing amazes me for such a poor product. We have had their computer assisted program for a year and a half now. I have been a Clinical Documentation Specialist for 9 1/2 years now and much experience using the encoder for reviews as well as the DRG Expert.
This product gives wrong codes all the time and, in general, has taken me so much more time. Totally decreases my productivity. There are a couple decent features but not enough IMHO to warrant purchase and use.
ICD-10 now being on hold changes things but I have often wondered if CAC could function at all considering all the mistakes for ICD-9. Also we have frequent upgrades approx every 2-3 weeks where we can't do our reviews at all for about an hour to two hours. This is followed, prob 90% of the time, by many glitches and CAC keeps going down rest of day.
I would grade my overall experience with CAC as an F.
Karen Maritano, RN
Clinical Documentation Specialist
Legacy Health
Portland, OR
503-413-7148
Kmaritan@lhs.org
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, April 02, 2014 9:16 AM
To: Maritano, Karen M. :LPH Care Management
Subject: Re: [cdi_talk] Computer Assisted Coding and CDI
We also just implemented a few weeks ago. Please feel free to contact me.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation Advisor Program Vidant Health, Greenville NC DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )
>>> "CDI Talk" 4/2/2014 11:36 AM >>>
Hi Sheila,
We use 3M and just implemented CAC 2 weeks ago. i would be glad to discuss with you offline.
Thanks,
Linda
Linda Rhodes RN, BSN, CCDS
Manager Clinical Documentation
Improvement
New Hanover Regional Medical Center
Wilmington, North Carolina 28402
Office # 910-815-5544
Cell " 910-777-8344
e-mail : linda.rhodes@nhrmc.org
"I have a Code for that"
Visit Capsuleslive for more information on ICD-10 implementation
>>> CDI Talk 4/2/2014 12:00 AM >>>
Does anyone have Epic and 3M 360 who use the 360 product for their CDI
program? We are in implementation stage. Would appreciate ideas and
tips that you learned along the way. Thanks Shelia Bullock, University of MS Med Ctr
---
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Copyright 2013
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The contents of this e-mail (and any attachments) are confidential, may be privileged and may contain copyright material. You may only reproduce or distribute material if you are expressly authorized by us to do so.
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Copyright 2013
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----------------------------------------------------------------------
Subject: Oh how I wish I could review a big fat paper chart!
From: hugh.stephenson@yahoo.com
Date: Wed, 02 Apr 2014 20:31:23 -0400
X-Message-Number: 7
I have yet to work with a user friendly EHR and a CDI software that lives up to its Marketing. Over the last five years our government has spent more than 20 billion taxpayer dollars to install electronic health record technologies, many of which apparently cannot implement a change in diagnosis codes that the rest of the world implemented years ago. ICD-10 readiness for providers is about much more than the availability of mere technical functionality; it’s about having the support necessary to successfully achieve ICD-10 compliance, which includes things like training and business processes. That the government felt compelled to delay the ICD-10 transition reflects not a failure of healthcare providers, but a failing health information technology industry that’s unable to support providers in navigating change.
Healthcare providers need and deserve technology partners that will step up and do what it takes to ensure their success in meeting the complex demands of our changing healthcare system: from the ICD-10 transition to the meaningful use program; from the transition to risk-based payments to the demands of care coordination. The government needs to stop subsidizing dysfunction by accommodating technology vendors that time and time again leave providers high and dry.
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Copyright 2012
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
Loved to read your analysis of the "benefits" of the CAC. I just got done with an audit of almost 300 records where the CDS uses the CAC to assign diagnosis and procedure codes in their CDI system. Due to the productivity expectations of the organization, the CDS tend to only look at what is in the CAC and have stopped reviewing anything that is NOT in the CAC -- nursing/ancillary notes, etc - in order to "review" the required number of charts per day.
I pointed out exactly what you said - the CDS role is to identify what is NOT documented in the record. And where is most of this information found?? Not in the CAC application!
I think part of the problem is that organizations purchase software packages and expect that this will solve the problem of not having enough CDS to review more records.
When the priority is productivity over quality, I guess this is the natural outcome - records do not receive critical analysis, just a robotic clicking of the blue and green boxes to assign diagnoses and procedures.
Wondering - are you planning on establishing policies or processes for your staff to use with your product, e.g., how much data to enter, which fields are mandatory, etcetera?
Sent from my iPhone
> On Apr 3, 2014, at 1:41 PM, CDI Talk wrote:
>
> Jane,
>
> Loved to read your analysis of the "benefits" of the CAC. I just got done with an audit of almost 300 records where the CDS uses the CAC to assign diagnosis and procedure codes in their CDI system. Due to the productivity expectations of the organization, the CDS tend to only look at what is in the CAC and have stopped reviewing anything that is NOT in the CAC -- nursing/ancillary notes, etc - in order to "review" the required number of charts per day.
>
> I pointed out exactly what you said - the CDS role is to identify what is NOT documented in the record. And where is most of this information found?? Not in the CAC application!
>
> I think part of the problem is that organizations purchase software packages and expect that this will solve the problem of not having enough CDS to review more records.
>
> When the priority is productivity over quality, I guess this is the natural outcome - records do not receive critical analysis, just a robotic clicking of the blue and green boxes to assign diagnoses and procedures.
>
> Wondering - are you planning on establishing policies or processes for your staff to use with your product, e.g., how much data to enter, which fields are mandatory, etcetera?
> ---
> CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
>
> You are receiving this message as a member of CDI Talk as: donna.kent@yahoo.com
> If you would like to be removed from CDI Talk, please send a blank email to
> leave-cdi_talk-20158641.bffe890edf46cad3025f7bda61670440@hcprotalk.com
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> Copyright 2013
> HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
Some aspects of the CAC in fact save some time, but some aspects cost time, as well.
Example: Our CAC will code an AMI if the lab test for Troponin is performed and this because the lab test has some references to values/criteria suggesting a current AMI. So, the MD and/or lab test may say 'troponin fails to meet levels suggestive of MI" and the CAC will assign 410.91.
Some good, some bad, some positive, some negative - but, not a substitute for critical analysis.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.637.9002
evanspx@sutterhealth.org
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Thursday, April 03, 2014 1:42 PM
To: Evans, Paul
Subject: RE:[cdi_talk] cdi_talk digest: April 02, 2014
Jane,
Loved to read your analysis of the "benefits" of the CAC. I just got done with an audit of almost 300 records where the CDS uses the CAC to assign diagnosis and procedure codes in their CDI system. Due to the productivity expectations of the organization, the CDS tend to only look at what is in the CAC and have stopped reviewing anything that is NOT in the CAC -- nursing/ancillary notes, etc - in order to "review" the required number of charts per day.
I pointed out exactly what you said - the CDS role is to identify what is NOT documented in the record. And where is most of this information found?? Not in the CAC application!
I think part of the problem is that organizations purchase software packages and expect that this will solve the problem of not having enough CDS to review more records.
When the priority is productivity over quality, I guess this is the natural outcome - records do not receive critical analysis, just a robotic clicking of the blue and green boxes to assign diagnoses and procedures.
Wondering - are you planning on establishing policies or processes for your staff to use with your product, e.g., how much data to enter, which fields are mandatory, etcetera?
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: evanspx@sutterhealth.org If you would like to be removed from CDI Talk, please send a blank email to leave-cdi_talk-12940161.4b24e9352adc7dfa247d8332246d4e2a@hcprotalk.com
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923