Memorial Herrman Streamlines Systems

Reporting

Another significant benefit is that HIM now has the ability to easily produce reports on our query process, including the number of queries, query rate, response rate and query turnaround time. We can identify the physicians who are not responding, and measure the impact on reimbursement of their unanswered queries. The “Top Reasons for Query” report is particularly useful, because it enables us to look at patterns to discern educational opportunities. For example, if there is a high volume of CHF queries, we can bring that information to the Cardiology Section meeting and highlight where the physicians need to provide additional specificity in their documentation.

In addition, we have seen an improvement in the coordination and interaction between coders and CDI Specialists. We can compare the querying patterns of the two groups, review the data together, and determine which diagnoses and treatment areas require additional focus.

Next stop: CDI

Memorial Hermann is eager to build on the results achieved using the electronic query software for inpatient coding, and is now leveraging that experience with the facility’s CDI program.

“We view this experience as a single, major documentation improvement project. Using the query software has brought to light the opportunities for us to assess and re-design our processes on the front end,” says Carol Paret, Chief Community Benefits Officer and Privacy & Security Officer at Memorial Hermann. “For example, our documentation specialists are now centralized; thanks in part to the data produced by the query application, we have re-tooled their job descriptions and workflow.”

An immediate next step is to have the CDI specialists begin using a version of the software called eCDI that is designed specifically for such programs. “The eCDI tool will allow for the creation of a unique CDI database— separate from the coding database—that will improve data capture at the front end. It will also enhance our e-query processes, especially the query closeout process. These improvements will result in more accurate capture and reporting of front-end query data,” says Joy Coletti, MBA, RN, CDI trainer for Memorial Hermann Healthcare System.

The eCDI tool automatically assigns cases to CDI Specialists based on Memorial Hermann’s facility-specific rules. “Most of MHHS’s cases are assigned geographically, by nursing unit, but the software also enables an individual facility to assign by service line, so that, for example, cardiology cases can be directed to a CDI nurse with a strong cardiology background,” Coletti says.

“The eCDI tool will also allow the CDISs to utilize electronic Clinical Documentation Worksheets, instead of paper worksheets, to capture their clinical data, fully automating data capture on the front end. This will enhance daily follow up and transfer of cases to another CDIS, in the event of illness or vacation,” says Coletti.

Finally, let’s not forget ICD-10

Not a surprising finding, but according to a 2010 ACDIS survey, 81% of respondents expect to see an increase in query volume when the new ICD-10 system is live. We believe having the query software in advance will make the transition on October 1, 2013 quite a bit easier for us at Memorial Hermann.