The Cleveland Clinic will be furthering its artificial intelligence ambitions by deploying generative AI tools meant to make medical coding more accurate and efficient.
In partnering with generative AI outfit AKASA, Cleveland Clinic will be implementing a number of AI-powered technologies during the mid-revenue cycle – the phase between patient care and billing, where documentation and coding occur.
The ultimate goal is to streamline the process and save time. The health system said its revenue cycle staff typically reviews more than 100 clinical documents per case, including progress notes, discharge summaries and pathology reports. They then select codes from more than 140,000 options.
Cleveland Clinic said this process can take up to an hour per patient encounter.
WHAT'S THE IMPACT
If implementation goes smoothly, coders will be able to use a coding AI assistant tool that supports comprehensive, efficient and accurate coding practices.
A second AI-powered technology is being piloted by the two organizations, focused on clinical documentation integrity (CDI).
These AI tools, said Cleveland Clinic, are intended to speed up this process and ensure the most appropriate codes are being used. The AI coding assistant can read a clinical document in less than two seconds and process more than 100 documents in 1.5 minutes. In addition, the technology is designed to understand clinical context, beyond keywords, and adapt to a patient's complexity.
The AI being implemented can learn from real-world documentation practices and recognize the nuances at individual health systems, which allows the technology to analyze more complex and challenging patient cases, like inpatient hospital encounters.
These capabilities are designed to enhance coders' efforts to best represent a patient's clinical course, risk and complexity of care.
Cleveland Clinic has begun rolling out this tool and will implement it across its U.S. locations over the coming weeks.
THE LARGER TREND
Cleveland Clinic is also making a push for AI abroad. Earlier this month, it was announced that the health system will be teaming up with AI-focused technology group G42 to drive AI-powered advancements in healthcare, both in the U.S. and globally.
As part of this initiative, the organizations will form a joint task force to evaluate and accelerate potential projects and collaborative opportunities aimed at advancing AI adoption in healthcare.
The collaboration will explore and implement AI-driven healthcare initiatives they think have the potential to enhance medical innovation and drive operational efficiencies.
More than half of health system leaders and insurance executives are calling AI an "immediate priority," and 73% of organizations said they were growing their financial commitments to the technology, according to a 2023 Define Ventures survey.
Seventy-three percent of organizations have established governance structures, which can align AI incentives with organizational values.
There's $9.8 billion in potential savings through AI-powered automation in the revenue cycle, according to statistics provided by TruBridge, a consultant and IT services provider, at the HFMA annual conference in Nashville in June 2023. Nine percent of all claims are rejected in error or from prior authorization denials; 23.9% of denials are due to eligibility issues.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.