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CHICAGO -- Beyond ICD-10 implementation and the recent bad publicity electronic health records have garnered in the mass media, a few more technology trends were on the minds of attendees at the AHIMA 2012 Conference and Exhibition: health data governance, computer-assisted coding systems, and the combination of speech-recognition technology and natural language processing to use as sort of a "search engine" that mines relevant data for coders setting up claims.
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And then there's the very real notion of how all this technology will affect the human workforce that has been coding hospital claims for decades. While most vendors and AHIMA members seem to agree that ICD-10 will make more work for coders -- and that some older coders will retire rather than learn the new coding language -- jobs will be plentiful.
Yet, in a weak economy that has seen some health care providers outsource coding work already, job security jitters rattled the show floor as coders witnessed demos of new software designed to automate the coding process. Juergen Fritsch, chief scientist for speech recognition vendor M*Modal, said not every coder has embraced his company's suite of documentation automation tools that bridge the electronic health record (EHR) and coding systems.
"It's a mixed bag, I would say," Fritsch said. "There's a few that fear for their jobs, but that's a minority. Others look at this as a tool that will help them work more efficiently and help with ICD-10. And then there's others who think they'll be better positioned [in the job market] if they know how to use it, enhancing their skill set."
Getting better documentation out of EHRs starts with data governance policies.
CACS trickling down to more providers
The IT holy grail of ICD-10 implementation seems to be the setup of natural language processing (NLP)-enabled computer-assisted coding systems (CACS) systems. These systems will automatically suggest ICD-10 codes, which can be approved or changed by humans, from the clinical documentation collected by EHRs and transcripts of speech notes. It might be a mouthful to say, but it's even harder to set up on networks. Some large health systems have tackled this software workflow, but getting documentation prepared for this next age of health IT applications hasn't been simple, Fritsch said. Everyone, though, he added, sees its potential value.
Getting better documentation out of EHRs starts with data governance policies, said Michelle Dougherty, director of research and development for the association's AHIMA Foundation research arm. When HIM managers broach the seemingly esoteric subject of data governance policy with hospital leaders, they're being heard more loudly and clearly than ever, she added, because there's more legal risk to not putting such policies in place. Between HIPAA investigations and e-discovery for litigation, knowing that clinical data is collected and handled in a consistent way becomes key to mitigating financial risks.
"We would have liked to have seen these issues addressed [already]," said Dougherty, whose group plans to work with payers and providers to develop unified data governance standards and issue best-practice guidance to AHIMA members. "We have been talking about them for years ... the industry has now gotten to the point where consequences are going to happen, so it's rising in importance."