Engaging Physicians in Documentation
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©2013 The Advisory Board Company • advisory.com Engaging Physicians in Documentation Executive Summary Revenue Cycle Solutions Physician Documentation Initiative • Why documentation matters more than ever (p. 2) • Components of the Advisory Board’s Physician Documentation Initiative (p. 3)
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Engaging Physicians in Documentation. Executive Summary. Revenue Cycle Solutions Physician Documentation Initiative. Why documentation matters more than ever (p. 2) Components of the Advisory Board’s Physician Documentation Initiative (p. 3). Poor Documentation Adds Up. - PowerPoint PPT Presentation
Transcript of Engaging Physicians in Documentation
©2013 The Advisory Board Company • advisory.com
Engaging Physicians in DocumentationExecutive Summary
Revenue Cycle SolutionsPhysician Documentation Initiative
• Why documentation matters more than ever (p. 2)
• Components of the Advisory Board’s Physician Documentation Initiative (p. 3)
©2013 The Advisory Board Company advisory.com2
Documentation Matters More Than Ever
Poor Documentation Adds UpCapture Additional Revenue
Good documentation has a significant
impact on a hospital’s financial health.
The Advisory Board estimates that
an average 250-bed hospital with
insufficient documentation practices
lost $7.1M in 2013 alone. Even at top
performing hospitals, current efforts to
improve documentation aren’t cutting
it. At an average top performing 250-
bed hospital, current investments only
make up $1.6M of the $7.1M in
documentation losses.
Adapt to New Demands
The stakes are increasing every day.
The rise of value-based purchasing
and the transition to ICD-10 bring the
need to improve the specificity of
documentation. The expanding
availability of health care quality data
to insurers, regulatory agencies, and
the public means that hospitals need
to ensure that what is being reported
accurately reflects the quality of care
provided.
Revenue Loss from Missing Documentation
Average 250-bed Hospital2013 2020
-$7.1 M
• Growing administrative burden on physicians
• New payment models
• Pay-for-quality
• Increasing specificity in ICD-10
2013 2020
-$5.5 M
-$9.9 M
Revenue Loss from Missing Documentation
Top Performing 250-bed Hospital
• CDI program
• CAC
• Documentation training
-$12.8M
©2013 The Advisory Board Company advisory.com3
Engage Physicians in Documentation Now for Immediate Impact
Motivate Poorest Performers FirstWords Do Matter
Training your physicians to document
effectively is critical to your financial
success. But training is for naught if it
falls on deaf ears.
All hospitals struggle with motivating
poor documenters to change their
habits. The first step of any training
effort should be to show these folks
how what they write matters—to
them, in the form of quality scores and
increasingly reimbursement, and to
the hospital.
Benefits Today and Tomorrow
Engaging your poor documenters
today reaps immediate rewards from
better documentation under ICD-9
and sets you up to make the most out
of training for ICD-10.
Documentation Effectiveness Matrix
Engagement in Documentation Improvement
Documentation Skill
High
Low
Low High
Step 2
Sustain
Step 1Engage
How to Make the Case to Physicians
• One-on-one meeting
• Individual data
Exclusivity• Clinical knowledge
• Unbiased
• Effective messaging
Expertise
• Impact on quality
• Real life examples
• Trend identification
Evidence
©2013 The Advisory Board Company advisory.com4
Extensive Quality Data for Key Physicians and Cases
The Crimson Continuum of Care AdvantageUnderstand Your Performance
We build a customized analytics
platform for every Physician
Documentation Initiative member
based on our proven Crimson
Continuum of Care product. Crimson
Continuum of Care creates severity-
adjusted performance profiles for each
of your physicians so we can compare
performance on the full range of cost
and quality measures .
We use the analyses to investigate
potential documentation opportunities,
pinpoint individual cases with variance,
and uncover the root cause of
underperformance.
All data is severity adjusted
Investigate the drivers of performance for specific physicians and cases
Details of outlier cases, including physicians, diagnoses, severity levels, utilization and regulatory measures
©2013 The Advisory Board Company advisory.com5
Training Efforts Focused on Physicians with Greatest Potential Impact
How We Choose Target PhysiciansFocus Your Efforts
You will achieve greater success in
documentation improvement by
providing individual attention to the
physicians with the biggest
opportunities. Our primary focus is
physicians with substantial
opportunity to improve their
performance today.
We identify the physicians who have
the most power to influence
performance in problem areas and
rank them based on two
characteristics: ICD-9 opportunity and
ICD-10 risk. The result is a prioritized
list of physicians to target for further
investigation and training that will
serve you well today and tomorrow.
Documentation Opportunity Matrix
0 5 10 15 20 25 30 35 40
HIGHEST PRIORITY
Dr. ADr. B
Dr. C
Dr. D
Dr. E
Dr. F
Dr. G
Dr. H
Dr. I
Dr. J
Dr. K
Dr. L
Dr. M
Dr. N
Dr. O
Dr. P
Dr. Q
Dr. R
Dr. S
Dr. THigh
Med
Low
ICD-10 Risk
ICD-9 Outlier Cases
Intersection between ICD-9 opportunity and ICD-10 risk
©2013 The Advisory Board Company advisory.com6
Customized, One-on-one Training Motivates Key Physicians
Making a Compelling Case to PhysiciansTraining to Meet Your Needs
In some cases, group education
makes sense because an entire
specialty is affected the same way.
But for the highest-priority physicians
there is no substitute for one-on-one
training using individual performance
data and specific documentation
examples.
Our team will lead personalized, one-
on-one training sessions with key
physicians. We prepare customized
training materials that include the
physicians’ individual performance
data, examples of subpar
documentation, and specific
recommendations to improve.One-on-One, Face-to-Face
Meetings
Individual financial and quality data
Chart review Clinical expertise
Effective messaging
National TrendsHospital
PerformanceSpecialty
PerformanceIndividual
Performance
Progression of the Training PresentationBy the time they see their own charts, physicians want to solve the problem
Custom materials for each physician with their own cases and data
The Power of Personalization
What particularly hit home for me was that they actually used some of my records from the past and generated some data and could show me exactly where I could improve.”
Orthopedic SurgeonFletcher Allen Health Care
Burlington, VT
”
©2013 The Advisory Board Company advisory.com7
Follow-Up Training Sessions Help You Sustain Momentum
Targeted Training to Reach Each Part of Your TeamStay Engaged in Documentation
Ongoing training is required to fully
leverage the benefits achieved during
our initial one-on-one training
sessions.
Our documentation experts will
provide comprehensive materials for
initial study and later review a variety
of topics that will help sustain
physician engagement. We’ll give you
the tools you need to keep your staff
and physicians engaged in
documentation moving forward.
Train the Trainer
These sessions will:
• Help physician leadership or CDI staff carry forward the Physician Documentation Engagement concepts
• Show staff how to teach new physicians about documentation
• Share general documentation best practices
Refresher Meetings
These sessions will:
• Review for physicians the concepts discussed during their initial conversation
• Reinforce important messages
• Answer physician questions about documentation
“Why Words Matter”
These sessions will:
• Spread organizational awareness about the importance of physician documentation
• Emphasize the concepts taught in one-on-one sessions
• Anatomy of best practice CDI
team: set up
• How best to communicate to physicians and have an impact
• Shadowing and live-coaching with CDI team
• Coaching on working with difficult physicians
• How to look at data
• How to look at charts
• How we think about a chart compared to coding or CDI review
Additional Topics Covered
