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Artificial Intelligence Meets Medical Coding

Medical billing and coding is an integral component of healthcare. The medical coding outsourcing market alone is projected to reach16.9 billion dollars by 2021. 

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Healthcare Business Review | Tuesday, November 17, 2020

FREMONT, CA: Medical billing and coding is an integral component of healthcare. The medical coding outsourcing market alone is projected to reach16.9 billion dollars by 2021. However, coding accuracy is an ongoing challenge. To maximize efficiency and accuracy of the medical coding process, companies are testing the possibilities of Artificial Intelligence (AI) applications. The current problem is coding accuracy, and AI applications are improving the efficiency of the coding process.


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The emerging technology, Computer-Assisted Coding (CAC), which works on Machine Learning and Natural Language Processing (NLP), is all set to transform the medical coding process. The CAC automatically identifies and extracts information from documents. It also analyzes the documentation and automatically recognizes [vendor_logo_first]relevant medical codes. In addition to processing codes and high volumes of data, AI can also reduce the standard work hours and human errors. AI helps providers address gaps in medical coding information. The AI reviews documentation and then guides the provider to adjust the documentation to ensure it accurately reflects the patient’s condition.

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Former University of Cambridge Department Head of Estates Joins Anenta to Establish and Run New Facilities Management Division

Anenta, one of the UK’s leading healthcare waste management service providers, has appointed Karen King, former Department Head of Estates at the University of Cambridge, as Head of its newly formed Facilities Management (FM) division. King joins the business which supports over 20,000 public and private sector sites throughout England, including GPs, Pharmacies and hospitals.  King, who was previously responsible for the University of Cambridge Department of Physics portfolio of buildings – including the new world-class Ray Dolby Centre – will develop Anenta FM Services leading its delivery of soft and hard FM services to new and existing customers. Launching first in London and then Cambridgeshire, before rolling out nationally, Anenta FM Services is committed to working with local specialist companies to deliver a faster response, better local knowledge, greater flexibility, and more competitive pricing. This approach is designed to deliver a more sustainable solution that minimises environmental impact while keeping more money in the local economy.  Anenta's specialist FM team will help it stand out in the sector by identifying and removing unnecessary services that customers frequently pay for as part of dated, legacy contracts.  Utilising its proprietary technology, bespoke FM solutions, expertise in best practice, compliance and statutory requirements, Anenta FM services aims to shake up the market. This will be delivered by improving service levels and identifying savings that can be returned to clients. As part of this approach, Anenta FM services will implement contracts where whole-life costs are factored in, including mobilisation, planned preventative maintenance, reactive repairs and lifecycle savings.  Providing greater transparency and delivering reduced business disruption, this approach will ensure customer equipment lasts longer, resulting in fewer breakdowns or expensive emergency repairs. It also means that business-critical equipment will be replaced at the right time, avoiding the likelihood of catastrophic failure. Hard FM services provided by Anenta FM Services will include electrical, mechanical, plumbing and heating maintenance, along with fire safety, emergency lighting and gas servicing. Its soft FM offering will encompass cleaning, waste management, grounds maintenance, pest control, window cleaning, furniture purchase, office moves and health and safety, aligning services with the needs of the building. Commenting on her appointment, Karen King, new Head of Anenta’s Facilities Management division, said: “We aim to make an immediate impact by doing things differently at Anenta. Our focus will be on delivering transparent solutions that factor in whole-life costs as well as necessary work and maintenance. Unlike competitors that tender for contracts based on lowest headline prices, which fail to factor in real world costs, we’ll deliver tenders based on true lifetime value.  “By working with specialist local businesses overseen by our team of FM management experts, we believe we can build better solutions, improving levels of service, and lowering customer costs compared to the big national players.”  William Cunningham-Davis, Anenta’s Director of Development & Partnerships, added: “Karen brings with her many years of industry expertise and knowledge allowing us to build an FM solution that's both agile and highly effective. Combined with our technology and sector know-how – which has already saved our clients over £13m, plus a further £35m through efficiency improvements – we believe we can shake up the sector and give customers a better and more comprehensive service.” An industry expert, Karen King has served on the Premises and Facilities Management Editorial Advisory Board for five years and is part of the judging panel for the PFM awards. For more information about Anenta FM Services email karen.king@anenta.com , or call Karen King direct on 07861390821. Visit https://www.anentawaste.com/sectors/facilities-management-estates-services/ for full details. ...Read more

The Evolving Role of The Imaging Director

When I first entered leadership in radiology, being a successful imaging director was largely about being a strong clinical and operational leader. You needed to understand your modalities, manage your staff, maintain your equipment, control your budget, meet regulatory requirements, and make sure patients moved efficiently through the department. Those responsibilities have not gone away. If anything, they have become more complex. What has changed is everything that has been added to them. Today’s imaging director is still responsible for the clinical operation. But the role now reaches into information technology, workforce strategy, capital planning, construction, finance, regulatory compliance, patient access, data analytics and increasingly, artificial intelligence. Decisions that once may have involved selecting a piece of imaging equipment can now require months of planning involving IT infrastructure, interfaces, cybersecurity, construction, service agreements, software licensing, data storage and integration with other hospital systems. Staffing is a good example of that evolution. Earlier in my career, staffing was not nearly the challenge it is today. There were more technologists available and competition for staff was significantly different. Today, particularly since COVID-19, we face technologist shortages while also adapting to a workforce looking for schedules that better fit their lives—four 10-hour shifts, three 12-hour shifts, Baylor shifts and other alternatives. Technology has undergone an equally dramatic transformation. Imaging services is now one of the most technology-dependent areas of the hospital. Picture archiving and communication system (PACS) is only the beginning. Quality-control applications, analytics, advanced processing, AI, interfaces, servers, data storage and integration with the electronic medical record have become part of our daily environment. That means an imaging director no longer has the luxury of saying, “That’s an IT issue.” We do not have to be IT engineers, but we need to understand enough to ask the right questions. How will the system interface with PACS and the EMR? Where will the application reside? Who provides the server? How much storage will be required? What happens during downtime? What are the ongoing licensing and support costs? Even adding a single new imaging service demonstrates how involved the role has become. Consider implementing amyloid brain PET/CT imaging for Alzheimer’s disease evaluation. On the surface, it may sound as simple as developing a protocol and adding a new exam to the schedule. In reality, the imaging director has to understand the entire process from beginning to end. Do we have access to the appropriate radiopharmaceutical, and what purchasing or vendor agreements are required? Do we have the necessary software to process the study, and does that software need to be purchased, installed, interfaced, or integrated into the existing imaging environment? Are the technologists trained to perform and process the examination? Are the radiologists prepared to interpret it? How will the exam be built in the EMR and billing systems? Are the appropriate charges established, and do we understand the requirements necessary to obtain reimbursement? “Successful imaging leadership still comes down to people—supporting our teams, making thoughtful decisions and never losing sight of the patient at the center of it all.” A new service is not truly ready simply because we can acquire the images. We have to make sure we can perform it, process it, interpret it, charge for it, and get reimbursed for it. Missing any one of those pieces can mean investing significant time and money into a service that cannot function as intended. That is why today’s imaging director needs enough knowledge of technology, clinical operations, contracts, IT infrastructure, physician workflows and revenue cycle to see how all the pieces fit together. That understanding matters financially as well. I have inherited projects where significant expenses were overlooked during the initial planning. Few things are more difficult than returning to hospital leadership for additional funding after a project was approved based on what everyone believed was a complete cost. Understanding the technology behind the project has therefore become part of responsible financial leadership. A recent hospital acquisition demonstrated just how broad the imaging director’s role has become on an even larger scale. Our organization assumed responsibility for a small rural hospital and began transitioning it into an urgent care and diagnostic center. From an imaging perspective, that meant much more than assuming responsibility for another department. We had to transition employees into our processes and policies, establish new sites and cost centers within the EMR, upgrade software and storage, migrate imaging studies into PACS, review contracts and integrate the operation into a larger health system. The technology was only part of the challenge. Bringing employees into a new organization requires leadership. You cannot simply walk in and say, “This is how we do it now.” You need to understand their processes, recognize what they may already be doing well and determine whether some of their practices could improve the larger organization. Most importantly, people need to feel that they are becoming part of the team rather than simply being absorbed by it. Capital planning requires the same long-term perspective. I work from a five-year plan based on equipment age, functionality, emerging technology and potential new service lines that could benefit the communities we serve. Imaging equipment represents some of the largest capital investments a hospital makes, and replacing aging equipment can compete directly with opportunities to introduce new services. Even the best plan must remain flexible because an unexpected equipment failure can quickly take priority over planned capital spending. Patient access is another responsibility that extends well beyond scanner availability. Scheduling may be a patient’s first meaningful interaction with imaging services. Every imaging examination has different preparation requirements, clinical considerations, arrival times and expectations. Giving scheduling teams the knowledge and tools to communicate those differences correctly can directly influence the patient’s first impression of their imaging experience. Leading multiple locations adds yet another dimension. A director cannot be everywhere, which makes developing strong managers and supervisors essential. Those leaders need the ability to handle local issues while also knowing when something needs to be elevated. It also makes succession planning critical. If we advance in our own careers, we should not leave behind a department that was dependent upon us to succeed. Part of leadership is developing the people who can lead after us. Despite all of this complexity, my most important leadership lesson is to lead with a servant’s heart. Be willing to help. Treat people with respect. Make sure they know you have their back, and help them understand not only what decisions are being made, but why. When employees understand productivity, expenses, supply stewardship and how organizational performance affects the resources available to their department, they become partners in improvement rather than simply employees following instructions. Looking ahead, I expect enterprise imaging, automation and artificial intelligence to make the role even more complex. Radiologist shortages and greater reliance on teleradiology are already changing workflows. Technologies capable of identifying higher-risk studies and prioritizing radiologist worklists may become increasingly important in improving turnaround times and getting critical studies interpreted sooner. A successful imaging director today has to be more than a clinical and operational leader. At different moments, we are asked to think like a COO, CIO, construction manager, financial analyst, technology strategist and workforce strategist. The role has become more complicated, more technical and more strategic. But at its core, successful imaging leadership still comes down to people—supporting our teams, making thoughtful decisions and never losing sight of the patient at the center of it all. ...Read more
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