Taking flight: How the right metrics can improve computer-assisted coding

Recently, I boarded a Delta Boeing 757 plane. The plane held 180 passengers with a cruising speed of 517 mph. My flight to Portland, Oregon lasted just under two hours, of which I slept for more than an hour. By contrast, Wilbur Wright covered 852 feet in 59 seconds on that day in 1903 when the Wright brothers completed the first four sustained flights with a powered, controlled airplane.

It’s hard for the modern day traveler to imagine that the airplane and way of life we understand today wasn’t always the case. What enabled the evolution of the aviation industry from the first recognized flight of the Wright brothers to the kind of aviation travel we have today? Airplanes were measured based on things such as speed, range and altitude. These metrics were tracked and improved over time. Additionally, the market drove great innovation when more advanced airplanes were needed. Like airplanes, computer-assisted coding (CAC) needs to be measured and tracked in order to improve. Over the course of our “Understanding the Numbers” blog series, Jason Mark and I will address the following subjects in detail.

The Importance of Measuring

The common phrase “you can’t know where you are going until you know where you’ve been” applies to CAC. If you don’t know how your enterprise or hospital is doing, how can you know where you need to improve? And not only is it important to know where to improve, but who within your organization needs to improve and who understands, excels at using, and is maximizing the use of CAC. Being able to see CAC metrics at an individual, facility and even entire health system level helps to establish the right baseline so one can track performance and improvement. Through our blog series we will show how measuring individual performance of a CAC system is crucial to helping coders improve.

Using the Right Metrics

Suppose that Boeing and other airplane companies chose to consistently measure the wrong metrics. What if they measured the distance and abilities of the colors of the materials of each plane instead of the composition? They would have thought that certain colors flew better instead of understanding the composition of metals and materials. Measuring the wrong things doesn’t help you get to a better place but can, in fact, hurt more than help. Furthermore, measuring only some good metrics but failing to recognize the importance of a holistic approach to a CAC system can hurt as well. For example, if an organization chooses to pay attention to only productivity measurements such as average minutes per chart, the organization might think it met its goals when minutes per chart go down. But what if the final codes per visit went down dramatically? This could mean the coding is less complete. In this data-blog series, we will explain 3M’s measurements for CAC and go into detail on what each measurement is, why it is important and what you can do with it.

Listening and Responding to Changes

Great aviation innovations were made during WWI and WWII because the market demanded it. As the United States has prepared for and made the transition to ICD-10, the market demanded that medical record coding be innovated. ICD-9’s nearly 20,000 codes compared to about 140,000 codes in ICD-10 meant that new technology was required to manage and track the additional codes. Innovation in medical record coding includes insights such as how the codes for each organization are being entered – are coders using CAC components or are they direct coding from memory? Is the amount of direct coding an acceptable level or is it too high for comfort with the increase in codes and the new specificity in ICD-10? In future blogs, we will go into greater detail about insights we can glean from the data and why it matters more now than ever before.

Clarissa George is a business analyst at 3M Health Information Systems.

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