Clinical Documentation Improvement Summit: Advancing the Documentation Journey. August 1 2, 2016 Washington, DC

Transcription

1 AGENDA Clinical Documentation Improvement Summit: Advancing the Documentation Journey August 1 2, 2016 Washington, DC MONDAY, August 1, 2016 Time Topics 7:30 8:30 a.m. Registration 8:30 8:45 a.m. Welcome/Opening Remarks 8:45 9:45 a.m. Keynote Title and Description Coming Soon Robert Anthony, Deputy Director, Quality Measurement and Value-Based Incentives Group, Center for Clinical Standards & Quality, CMS 9:45 10:45 a.m. Keynote The Thaw of ICD-10-CM/PCS: FY 2017 Code Updates Now that the code freeze has lifted, October 1, 2016, will bring thousands of code updates to ICD- 10-CM and ICD-10-PCS. In this keynote address, the speaker will share the code updates that will impact the world of CDI, including changes to CCs and MCCs, changes in documentation needs, DRG impacts, and more. Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer, AHIMA 10:45 11:15 a.m. Networking Break 11:15 a.m. 12:15 p.m. TRACK 1 Beyond Inpatient CDI CDI in the Physician Office Setting: A CDIP Shares a Physician Office Journey and Success In this session, the speaker will illustrate how Clinical Documentation Improvement (CDI) programs can be successfully implemented in the Physician Office setting with minimal disruption to daily operations. Further, participants will understand how the provider/cdi collaboration guides this journey towards improved documentation and quality care. Lisa L. Campbell, PhD, CDIP, CCS, CCS-P, Physician Practice Resources, Inc TRACK 2 CDI Program Success Measuring the Impact of CDI Efforts The role of CDI continues to evolve as documentation improvement efforts extend beyond direct financial impact; however, key performance indicators used to measure the impact of CDI efforts have remained stagnant. This session will discuss the importance of monitoring key performance indicators that can support process improvement in the domains of productivity, querying effectiveness and financial impact. Cheryl Ericson, RN, MS, CCDS, CDIP, AHIMA-Approved ICD-10-CM/PCS Trainer, ezdi *Invited Speaker 1

2 Time Topics 12:15 1:30 p.m. LUNCH 1:30 2:30 p.m. TRACK 1 Beyond Inpatient CDI The Role of Outpatient CDI in Risk Adjustment and HCCs Each member of a Medicare Advantage program has a risk adjustment score and this is based on the identification of hierarchical condition categories (HCCs). HCCs are qualifying chronic conditions identified in provider documentation. The risk adjustment determines reimbursement back to providers. The key to the assignment of HCCs is the provider documentation and the role of outpatient CDI is critical in this process. TRACK 2 CDI Program Success CDI and Coder Collaboration Maximizing Documentation Quality and Revenues As the US healthcare system transitions to ICD- 10, it will be critical for CDI specialists and coders to work collaboratively. ICD-10 is a new language for both providers and payers, and the two teams, CDI specialists and coders, will work most effectively by mastering ICD-10 documentation and coding rules together. Bonnie Cassidy, MPA, RHIA, FAHIMA, FHIMSS, Precyse Kathryn DeVault, MSL, RHIA, CCS, CCS-P, FAHIMA, AHIMA-Approved ICD-10- CM/PCS Trainer, UASI 2:40 3:40 p.m. TRACK 1 Beyond Inpatient CDI From Soup to Nuts: Bringing Your Physician Advisor Program to Life Physician engagement is essential in today s changing healthcare environment. As the evolution of healthcare reimbursement bundles care delivery across the continuum, physician leaders will be instrumental in negotiating a successful initiative. Key outcome measures, which are used to define the quality of care within the inpatient setting, including 30-day mortality rate, 30-day risk readmission rates, and patient safety indicators are risk adjusted to accurately represent the population being treated. James Fee, MD, CCS, CCDS, AHIMA- Approved ICD-10-CM/PCS Trainer, Enjoin, and Michael Teague, MD, SFHM, Our Lady of the Lake Regional Medical Center TRACK 2 CDI Program Success Managing CDI in the Changing Landscape of Healthcare Clinical Documentation Improvement (CDI) programs have a variety of reporting structures and CDI leaders often have other key roles within their organization that result in competing priorities. Keeping pace with the changing landscape of healthcare and Clinical Documentation Specialists focused on achieving operational excellence has increased the challenges faced by CDI leaders. Trinity Health has been focusing on providing greater support to their CDI leaders in the field this past year to assist them with efforts to improve their operations. Judy Moreau, RN, MBA and Andrea Eastwood, RHIT, BAS, Trinity Health 3:40-4:00 p.m. Networking Break

3 4 5 p.m. TRACK 1 Beyond Inpatient CDI Mastering Physician Engagement: An Interactive Session on Achieving Shared Outcomes This session will cover physician learning styles and how they affect physician behavior change. How those learning styles intersect with the Theory of Planned Behavior and ways to leverage that intersection for improved physician engagement. This session will also cover achieving Shared Outcomes. Shared Outcomes are goals based on a shared vision of the problem, share vision of success and shared indicators of success. Achieving Shared Outcomes is the basis for a data driven Physician Engagement Maturity Model which can be used to improve relationships with physicians. Practical ways to use the maturity model will be shared during the session. John Showalter, MD, MSIS, University of Mississippi Medical Center, and Leigh Williams, MHIIM, RHIA, CPC, CPHIMS, University of Virginia Health System TRACK 2 CDI Program Success Improving Documentation to Optimize Coding Mortality rankings are becoming increasingly important for hospital quality measures. From in-house mortality reviews, the Quality department discovered comorbidities were not consistently being documented, resulting in improper coding. This lack of documentation resulted in an inaccurate capture of patient acuity. With buy-in from the Neurology service line, a multidisciplinary team was formed of attendings, residents, nurses, quality improvement specialists, and CDI staff to determine needs of all stakeholders to improve mortality ratios through proper documentation and coding. Cathy Glover, RHIT; Brittany Brooks, MPH; and Matthew Smith, MD, WVU Medicine Day CEUS

4 TUESDAY, August 2, 2016 Time Topics 7:30 8:30 a.m. Registration 8:30 9:30 a.m. TRACK 1 CDI Challenges and Solutions The Case for CDI Solutions in a Post-ICD-10 Environment HIM leadership had their hands full this past year preparing and responding to the ICD-10 implementation. Most decision makers had little time or resources to invest in CDI technology or to focus on streamlining workflows and automating clinical record specificity. However, since the transition to ICD-10 data analysis has identified clinical documentation deficiencies. It is imperative that decision makers begin implementing innovative solutions such as CDI technology to decrease denial rates and optimize reimbursement. Pam Hess, MA, RHIA, CCS, CDIP, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer, himagine solutions TRACK 2 Advancing CDI through Technology How Mission Health Transformed Their CDI Program with Advanced Innovative Case Finding Technology Mission Health transitioned to a technology that used natural language processing (NLP) combined with sophisticated algorithms to automate record review concurrent to the patient stay. The software presented CDI specialists with cases flagged with possible CDI opportunities, eliminating time consuming case finding. In addition, the technology highlighted the specific language within the medical record as evidence of documentation gap(s), language that could be used to create physician queries. Krystal Haynes, RHIA, CCS, CDIP, and Brett Senor, MD, Mission Health System 9:40 10:40 a.m. TRACK 1 CDI Challenges and Solutions Challenges in Clinical Documentation Improvement Illustrated by Clinical Case Studies This presentation offers perspectives from a physician and from a coder, with respect to nuances inherent in clinical documentation. Complex clinical case studies encompassing several medical specialties will be utilized as a teaching tool to illustrate the complexity of clinical documentation improvement and the apparent disconnect between the clinical language and the ICD-10-CM/PCS code sets. The clinical case studies will include MS-DRG relative weights, in order to illustrate that slight nuances in documentation can greatly impact inpatient reimbursement. This is an interactive presentation, in which a discussion will follow each clinical case study. This presentation is tailored toward physicians, nurses, clinical TRACK 2 Advancing CDI Through Technology Mission Possible: Getting Control of Your Clinical Data and Documentation Clinical Documentation Improvement programs often focus on individual initiatives that aim to move the needle to improve care documentation. Optimal clinical documentation by a provider must not only be accurate, but it ideally ought to occur real time during the patient encounter. Burdening providers with additional charting requirements at a time when provider burnout is at an all-time high due to an inordinate amount of inbound tasks is less than ideal. From a practice management perspective, many other variables are contributing to draining the staff and providers time while driving down financial ROI, including navigating EMRs that are not optimized for clinical workflows, bolting together disparate technologies, and using more and more FTEs to

5 Time Topics documentation improvement specialists and coders. Wilbur Lo, MD, CDIP, CCA, Jzanus Consulting, and Melissa Koehler, RHIT, CDIP, CCS, CCS-P, M*Modal execute tasks that ought to be automated. Sanaz Cordes, MD, healthfinch 10:40 11 a.m. Networking Break 11 a.m. 12 noon Keynote Understanding the Continued Evolution of CDI As CMS moves towards reimbursement models that support healthcare collaboration (i.e., Accountable Care Organizations and Bundled Payments), CDI efforts are expanding beyond the adult inpatient population into other settings. Additionally, CMS s emphasis on quality of care (i.e., pay for performance, rather than the quantity of care) is also affecting CDI efforts as clinical validation become increasingly important to ensure the clinical scenario is accurately translated into coded data. This session will examine how changing CMS reimbursement methodology is affecting the delivery of patient care as inpatient services become less profitable for organizations promoting the growth of outpatient CDI. Cheryl Ericson, RN, MS, CCDS, CDIP, AHIMA-Approved ICD-10-CM/PCS Trainer, ezdi 12 noon 1:15 p.m. LUNCH 1:15 2:15 p.m. TRACK 1 Quality and CDI Potentially Preventable Complications (PPCs): A Quality Metric You Need to Know Potentially Preventable Complications (PPCs) is a classification methodology used to analyze and identify a set of diagnoses that are potentially preventable during an inpatient episode of care. PPCs have evolved from a demonstration project in three states to current use by state health departments (or movement towards utilization) in greater than six states a trend that is expected to grow as states look for measures to reduce healthcare expenditures. Cheryl Manchenton, RN, BSN, 3M Health Information Systems-Invited Speaker TRACK 2 Advancing CDI Through Technology Five Ways to Empower CDI Specialists with CAC Even the most top-notch CDS team, physician advisors and coding experts benefit from a technology boost to reach organizational goals. CAC is a critical part of CDI program success and can be effectively leveraged to build a high performance team. Steve Bonney, EVP, Records One and Kelly Whittle, MS, Whittle Advisors 2:25 3:25 p.m. TRACK 1 Quality and CDI The Impact of Documentation on Quality Measures: Beyond the CC and MCC Participants will benefit from the quality measures presentation by developing an understanding of the significance of sound data collection for the purposes of clinical data storage, mortality and TRACK 2 Advancing CDI through Technology How Technology Innovations Are Increasing the Impact of CDI Programs Technology for CDI is being utilized in new ways within inpatient settings and will be essential to enable outpatient CDI. Natural language processing is being leveraged to examine medical

6 Time Topics quality scoring, and review and critique by outside agencies such as Health Grades. Elizabeth Dickerson, MPA, RHIA, CCS, The Claro Group records for clinical content, identify cases that need review, and feed CDI workflow. This approach opens up a larger volume of cases to CDI review and could break through one of the key barriers to large-scale outpatient CDI the resources needed to review charts in significant quantity to find opportunities and improve results in a meaningful way. Technology solutions can also apply query templates to auto-generate rulebased physician queries. Mark Morsch, MS, Optum360 3:25 3:45 p.m. Networking Break 3:45 4:45 p.m. TRACK 1 Quality and CDI CDI Synergy: A Paradigm for Teamwork and Improved Quality Measure Reporting The presentation will provide the audience with a paradigm for a progressive workflow to improve clinical documentation designed to align appropriate selection of ICD codes with accurate quality measure data. The presentation exemplifies a deviation from best practice while maintaining sound documentation improvement principals (CMS, AHIMA, ACDIS), ultimately achieving the objective of creating synergy amongst the Clinical Documentation Improvement teams. TRACK 2 Advancing CDI through Technology Revamping CDI to Improve a Safety-Net s Documentation and CMI Truman leveraged natural language processing technology (the same type of technology used by CAC products) to help parse through all the data in the EMR. This allowed CDI specialists to work smarter, faster and more efficiently. Truman saw near immediate returns from this overhaul. Seth Jeremy Katz, MPH, RHIA, Truman Medical Centers Paula Hathorn, CDIP, CCS, CPC, CPC-I, AHIMA-Approved ICD-10-CM/PCS Trainer, University of Virginia Medical Center Day 2: 6.0 CEUS