May 21, 2019

CAC – Focusing on improving your metrics with a successful implementation

Daisy Roberts

Computer assisted coding (CAC) technology offers many opportunities for improvement of workflows and outcomes across your coding and clinical documentation improvement (CDI) operations.  Beyond the typical productivity gains, have you outlined your objectives with a full review of your current state against the technology potential?  As with any major health information technology install, define baselines & goals early to ensure you are yielding the outcomes anticipated.

  Focus on your dashboard:

  • Candidate for Billing (CFB) – You would certainly not expect to negatively affect your coding CFB with install…but this can occur briefly at go-live without careful preparation.  Long term you would expect to decrease coding CFB with the overall efficiencies this technology can deliver.
  • Case Mix Index – with improved documentation review capability capturing additional secondary diagnoses, many facilities result in positive gain.
  • Provider Query efficiency / Improved documentation capture – looking at increased query meaningful response rates and total query impact in DRG/CMI shift.
  • Coder & CDI productivity improvement.

Keep your eye on quality:

  • Coding & CDI quality need to be carefully monitored. Ensuring quality is not lost and gains are realized with coder & CDI collaboration.
  • Secondary diagnosis capture rates impact your CC/MCCs, in addition, keep an eye on the favorable impact to SOI/ROM targets.
  • Quality Indicators – difficult to manage HACs, PSIs, & potentially preventable readmissions. Look at the ability to identify and review early.

CAC metrics to monitor:

  • User Acceptance/Adoption rates – Methods of code entry identification utilized to show appropriate and efficient use of the technology.
  • Precision and Recall rates – measures to ensure appropriate engine configuration and document set-up leading to the computer suggested codes. You need to track these averages from day 1 of go-live.

How do you ensure your CAC implementation achieves expected results?  I have always said that CAC ought to stand for “change agent critical” – position yourself with strong project management and change management to ensure CAC implementation and optimization success – and pay careful attention to accurate metrics evaluation and monitoring from the start.  Doing so will ensure you are yielding these achievable results.

As Wilshire continues to assist clients with CAC technology, we see that these previously published/discussed tenets for CAC implementation success continue to ring true.

  • Accurate scoping
  • Strong project management
  • Robust change management
  • Customized training
  • Attentive monitoring

The full potential of computer assisted coding can be realized with proper preparation and implementation management.  Wilshire’s team can aide your organization in identification and realization of tangible CAC results.  Contact us– we are happy to share our experiences!

Daisy Roberts

Senior Strategic Advisor

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