How CDI helps you transition to value‑based care with Anthony Oliva
Episode 6
Anthony Oliva, DO is the Vice President and Chief Medical Officer at Nuance. A family medicine doctor by training, he began his career in the Air Force after residency which kickstarted his passion for total quality management.
When he entered the hospital world, he was quick to get involved in the quality measure controls and a physician leadership role. After he received his master's in medical management and did a fellowship, Oliva began his first full-time position in 2002 at Bayhealth in Dover, Delaware as Chief Medical Officer.
3:14 “I became very interested in the impact of clinical documentation improvement on the outcomes in quality measures… I had become very interested in trying to use… severity-adjusted outcome measures to help move medical staff performance.”
Episode summary
Dr. Oliva shares an example in 2004 at Bayhealth in Delaware where they quickly saw how even early CDI systems could improve outcomes.
5:48 “The first quarter after implementing the CDI program I was just running my normal data and saw about a 75% improvement in our severity-adjusted, risk-adjusted mortality. And the lightbulbs went on right then and there.”
After the hospital implemented its CDI program, it was able to capture more of the severity of its patients which increased the expected mortality. Dr. Oliva highlights how this moved the needle for the hospital and revealed that the staff was underrepresenting and not capturing the true image of how sick their patients were.
Over the course of his career, Dr. Oliva has seen how natural language processing and Artificial Intelligence (AI) allows providers to get ahead of coding issues and reduce resource-heavy reviews on the back-end; helping them to drive appropriate reimbursement and better understand their patient populations and performance.
12:00 “If you’re not looking in your road map towards technology as part of your CDI journey, then you’re going to fall behind pretty quickly.”
Dr. Oliva emphasizes that
Ambient clinical intelligence (ACI)
will transform the future of healthcare.
With ACI, providers are empowered to focus on their patients instead of a screen, while still enabling automated, high-quality clinical documentation and clinical guidance all within the day-to-day workflow of their Electronic Health Record (EHR).
26:06 “What ambient does is it says, I can bring the physician and the patient back together and let technology take the words and the conversations of those parties in the room and distill them into what will look like a note.”
Dr. Oliva emphasizes that providers need to maximize fee-for-service revenue while optimizing outcomes — and the simplest way to do this is through comprehensive clinical documentation.
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