Better insights and guidance improve clinical and financial outcomes
Using Inpatient Guidance for Dragon Medical Advisor, Halifax Health expands its documentation to include the whole patient story.
Capturing better documentation
Instead of just making it easier to capture the patient’s story at a given time, Halifax Health wanted to take a broader view of documentation that considered the patient’s entire history to see things they might not even know were missing. Read the story to learn how.
Inefficient review process for gathering patient histories. Ensure proper diagnosis capture along with the highest level of diagnosis specificity to represent patient acuity accurately.
Inpatient Guidance for Dragon Medical Advisor
Improved documentation integrity while promoting a higher quality of care.
Halifax Health provides a continuum of health care services through a network of organizations, including hospitals, urgent care, inpatient and outpatient clinics, and specialty practices within Volusia and Flagler counties in Florida. The organization offers the area’s only Level II Trauma Center and Level III Neonatal Intensive Care Unit to care for babies born earlier than 28 weeks. Halifax Health is committed to developing talented teams dedicated to providing competent, accountable patient‑centered healthcare in a financially sustainable manner.
I think it’s a good program. Inpatient Guidance is helping us to be more accurate when capturing the patient history and condition. It enables us to capture better documentation, helping with Length of Stay (LOS) and Case Mix Index (CMI).
—Dr. Ammar Hemaidan, MD
Medical Director of Hospitalist Services
Laying the foundation for change
Halifax Health first partnered with Nuance in 2018, as the organization was implementing the MEDITECH Expanse EHR. As part of its digital hospital strategy, Halifax Health worked with Nuance to augment the EHR with AI‑powered solutions. Streamlining workflows for physicians, clinical documentation integrity (CDI) teams, and coders paved the way for further improvements to patient outcomes, documentation quality, and the bottom line. To better support its physicians and advance the use of its EHR, Halifax Health implemented Dragon Medical One speech recognition and an early version of Dragon Medical Advisor (CAPD) with guidance for the physicians around the specificity of diagnoses.
Expanding capabilities and AI‑powered guidance
To address this need, Nuance introduced Inpatient Guidance for Dragon Medical Advisor, an AI‑powered solution that analyzes patient documentation across the encounter vs. only the active note. Gathering patient information in real‑time and at the point of care is critical to assessing patient acuity and driving accurate documentation.
Implementing Inpatient Guidance for Dragon Medical Advisor improved Halifax Health’s ability to capture Major Comorbid Conditions (MCCs) and Comorbid Conditions (CCs), and it helped physicians complete accurate and timely documentation. Instead of just making it easier to capture the patient’s story at a given time, Halifax Health wanted to take a broader view of documentation that considered the patient’s entire history to see things they might not even know were missing.
Average Medical CMI increase
More accurate reflection of the expected length of stay with an overall increase in GMLOS
Delivering sustained results
With Nuance, Halifax Health is able to look across the entire patient encounter, providing full coverage to ensure every note is documented with the highest level of specificity and appropriate diagnoses. The results so far include an average Medical CMI increase of .13 and an overall increase in the geometric mean length of stay (GMLOS) of 1.52, ensuring proper capture of higher severity of patient conditions reflecting higher quality of care. Inpatient Guidance also has helped Halifax Health identify undocumented and unspecified diagnoses, which led to a higher capture of CC’s and MCC’s, resulting in a positive financial impact in the first eight months of use alone.
During the COVID‑19 pandemic, the Halifax Health team used analytics to target training and promote greater usage of the solution—helping ensure critical documentation and coding were captured properly despite having less staff and resources available on site.
“What I appreciate about the system is that it is real‑time and is designed to fit into the provider’s natural workflow. Also, this covers all shifts and payer types. I cannot staff like that. Since the system looks at all payers, we have a better chance of a more accurate description of all encounters. We have seen a huge improvement in the documentation, as this proves to be an excellent training tool as well. My CDS staff can now dig deeper and catch even more,” said Debra Spargo.
As Halifax Health looks to the future, they now have solutions that will grow with them and continue to offer prolonged benefits through AI‑powered workflows.