Whether we are in favor of or opposed to AI, it is here and emerging into the health care
space. There is a push to incorporate AI into electronic medical records (EMRs) to
make documentation easier and more streamlined. As well as to save time for
clinicians and to create consistency within patient records themselves to hopefully offset
losses from Medicare chart audits. All of which are worthwhile pursuits and make sense.
In hospice we see a race among EMR providers to utilize AI to reinforce their
capabilities and to remove some human variables.
If we look beyond the AI interface with EMRs we appear to be AI infancy or maybe
toddler years in health care. There are potential benefits and ramifications to the
growing filed and utilization of AI. AI can review billing records in seconds, it can create
clinical notes within minutes from the clinicians’ spoken word and it can point out errors
quickly. Currently, hospices have billing/coding people who assign and check
documentation for accurate coding. AI can do this in a fraction of the time saving
hospices time and manpower only needing human intervention for billing that may be
more complicated or not easily resolved. The same can be said of chart auditing.
Internal resources are dedicated to auditing records looking for errors, creating reports
and communicating with staff to make necessary changes. With parameters set in AI, it
can do these same audits quickly and efficiently devoid of normal human error such as
distractions, tiredness etc. If we go on to another level, what if a hospice is tagged with
a Medicare audit and must submit records for review to decide on payment or
repayment. If a hospice uses and external resource such as a consulting firm to review
their records and submit a report prior to record submission to Medicare, it can take
many hours per record and cost a significant amount in unplanned expenditure. Now
factor in the use of AI to do this task internally and a hospice could in essence save time
and money in responding to audits. Imagine if the 3 Medicare intermediaries who are
tasked with reviewing records submitted by hospices implemented the use of AI. They
too would see a need for less staff and could review records much quicker than the
current 30-60 days. Thus AI has the potential of creating a snowball effect in all sectors
of hospice resulting in downsizing of staff in certain departments, government agencies
and consulting firms.
Although we are not there yet and many may not be ready to embrace the emergence
of AI, it is coming whether we are ready or not. The possible changes and impacts
denoted above may not be on our door step but they are certainly in the drive way.
Once it comes knocking, it is definitely going to create a wave affect and changes in
hospice that can only be imagined at this point. Now is the time to think ahead, be
proactive, assess what is already available and what is up and coming so hospices can
determine their next steps of readiness and hopefully determine their own fates in
resource and staff management.
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