Complete and accurate coding not only can affect patient treatment but also how well physicians and hospitals perform on quality measures.

Date: 06/20/2017

Responding to coders’ queries about missing or unclear information in a patient’s medical record is now simpler and faster, thanks to an app available on mobile and desktop for providers at Howard County General Hospital, The Johns Hopkins Hospital and, just recently, Johns Hopkins Bayview Medical Center.

Called Artifact, the app is being rolled out in stages through the health system, with Howard County having served as the pilot site. Since its introduction, response rates to queries have jumped, says Redonda Miller, president of The Johns Hopkins Hospital.

“I’ve heard very positive feedback, and that’s rewarding, because it’s time to focus on doing things for our frontline providers. We respect and appreciate how busy they are,” she says.

Complete and accurate coding not only can affect patient treatment but also how well physicians and hospitals perform on quality measures. A hospital’s ranking by U.S. News & World Report is based in part on metrics established by the Centers for Medicare and Medicaid Services (CMS) that assess observed patient outcomes against expected outcomes. Say a 77-year-old man enters the hospital in sicker condition than captured in the medical record. That patient’s outcomes are assessed as if he were in better health than he is, and that can make the hospital treating him appear less effective in delivering care than it is.

“Our clinical documentation folks work really hard to get the medical record right,” says surgeon Peter Greene, chief medical information officer for Johns Hopkins Medicine. “They like it that more of their queries are answered and records can be corrected quickly.”

One problem with the old workflow was that it was too easy for queries to fall off the radar, says Daniel Brotman, director of The Johns Hopkins Hospital’s hospitalist program. “Doctors were not always aware of the time sensitivity, that it has impact reputationally. Getting details right before that first bill goes to CMS is critical to show how we’re managing patient care in terms of quality.”

Greene, Brotman and Johns Hopkins Medicine IT worked with Artifact Health, the company that makes the app, to customize it to meet a “wish list” for physicians. Their objective was to make the query-answering process as seamless and convenient as possible. “When physicians are mission-driven, as ours are, they are sometimes less attuned to the business of medicine and can find answering queries onerous. We wanted to make it less so.”

Says Miller: “Increasing regulatory burdens can sap the joy out of practice. We wanted to streamline the necessary querying process to make life easier for physicians, so they can spend more time pursuing their passion: caring for patients.”