Hello, everyone, and thank you for tuning in
to the Becker's Healthcare Podcast. We are thrilled
to be joined on-site here at Becker's Health
IT Digital Health RCM Conference in Chicago.
Today, I'm pleased to be joined with William
Chan, CEO and cofounder, Iodine Software.
We're gonna discuss how AI driven solutions are
transforming health care in the hospital revenue cycle
space. William, thank you for being here. Thank
you, Brian. It's a pleasure to be here.
So so can you tell us just to
get going here how the use of AI
in the hospital mid revenue cycle has transformed
over the past 3 to 5 years? I
think it's been a pretty pretty,
wild time in that regard. It it has
been very transformative. Yes. I'll I'll say there
there are probably
three things that kinda lead up to this.
One, I'd say, is that
documentation
and the
the need for accurate documentation has kind of
risen to the level of being a critical
set of data in health care, specifically RCM.
2nd is
the recognition by health systems and and the
like that
the old ways of doing things, I. E.
Just throwing labor at it, just Mhmm. Doesn't
work. Right? COVID pooped that out to a
great deal.
Hence, it's brought us to this point where
alternate solutions have to take place, and that
alternate solution is AI. And then within the
past 3 to 5 years,
it's been the transformational
evolution
of AI
from something that is more just of about
general automation,
that robotic process automation, RPA and all that
kind of stuff, NLP,
to something that is more
transformative,
gen AI, machine learning.
And that's where the real change has occurred.
And that continues to evolve. Right? Starting out
with gen AI, you're talking about things where
you can now summarize. You can now generate
information
accurately.
Right? Right? You can summarize documentation. You can
you can generate documentation
effectively.
The next level is really
predicting.
Mhmm. And,
this is where AI needs to get to
evolve. But you're not just predicting
things in general. You're predicting things within a
clinical context.
And AI has evolved to that point where
I think, it's starting to understand the clinical
context.
And that, I think, is the big game
changer for health care in general, certainly for
RCM.
Yeah. That's that's huge. That's a huge difference
for AI to be understanding clinical context,
has implications, of course, for RCM brought more
broadly as well. Can you talk a little
bit about just because this is such a
transformative time and there's so much happening,
What do you see where do you see
this going in the future? A little bit
more details there. But but importantly, how can
hospitals and health systems kinda keep up here?
Yeah. Because I do think there's probably a
bit of a challenge in terms
of where they're going to make investments, where
they're paying attention, what's gonna yield the the
greatest benefits to them. So can you share
some more details on that? Yeah. I think
the first part of it is that
AI is gonna lead to better and better
predictive
results.
Around RCM, I'm I'm not talking about the
clinical aspect of a c
of AI. That's a separate thing. Around
RCM, the ability to predict,
what will be an outcome from an administrative
perspective.
Should I admit the patient? Should I discharge
the patient? Does this patient have the right
level of care? Does this patient have the
most accurate documentation?
I think AI is going to be able
to transform that
and make the human practitioners of this so
much more efficient. Mhmm. How then do hospitals
keep up with all of this?
I think
it's it's akin to the public private partnership,
I I would say. Right? You want hospitals
or I think hospitals would desire to be
in partnership
with vendors, with software developers.
Because,
quite frankly,
it's the vendors who are 1,
innovating,
and 2, they're trying to keep track and
stay on top of the latest technology. That's
what vendors do.
Hospitals,
they have the source of the data.
And so that's how that's gonna feed into
the large language models and machine language models.
And they also have the clinical context that
the vendors need to understand.
So I think it's this partnership between the
vendor
and the hospital that will really allow
hospitals to kinda keep up to date, if
not stay at the forefront of this changing
technology. Yeah. It's not realistic, I imagine, for
for a hospital to be able to do
what a vendor does in terms of keeping
up with the advancement of technology. Yeah. I
I think there'd be very few hospitals that
would be able to do that. Right? I
think first and foremost, I think, it's my
belief that a hospital is there to take
care of patients Correct. And to provide the
best level of care you can. And technology
is certainly a part of that. But I
think that that partnership with a vendor will
elevate
the hospital's ability to
deploy the most recent and most advanced technology
to do that. Mhmm. I wanna get into
sort of, clinical documentation integrity here. Can you
talk a little bit about how
you think organizations should be integrating CDI and
What what what can you can you expand
on that for our listeners? Sure. I I
think the the interesting about clinical documentation and
utilization management is that it's all really a
part of the same continuum across
rev cycle. And, you know, you can look
at it from a mid rev cycle perspective,
but it's really a part of the entire
rev cycle. Documentation,
the collection of information about the patient,
is required to ensure
proper utilization management.
Has the patient got the right level of
care? Should the patient be admitted, discharged? Where
should the patient be placed? And then you've
got to make sure that the documentation of
patient while they are in the hospital is
accurate, 1st and foremost, in order to have
good patient care, better have good documentation quality.
And of course, there's the reimbursement aspect of
it. But I think all of this, from
a hospital perspective, all of this ties to
outcome.
And there are 2 things here, right? 1
is you want to be able to deliver
the best care for the patient possible.
And 2 is you want to be able
to get paid
accurately for the care that you delivered. And
I think
it's the combination
of
plus CDI
that will
collect all the information that is needed
to ensure that the patient is getting the
best care. It will also ensure that the
hospital is then getting reimbursed
at the right level for everything that they
have done with the patient
from admission all the way to discharge. And
and, you know, it just strikes me that
this sits in such a this this intersection
between the the right care, the right care
for patients, and also the the financial health
of an organization.
Curious if you could expand upon sort of
what doing this, sort of what benefits it
yields to to patients in the the organization,
but also I think
to staff. Right?
Clinicians, I I imagine too if this is
done appropriately, it can change their experience how
how they, show up to work. Can you
expand on that? Yeah. Definitely. That's that's very
true. I think there there are few things
that are,
top of mind here. First off, it's the
ability to collaborate.
The information that is collected
from a nurse during the process,
the information that is collected or needed by
the CDI specialist,
it's all the same type of information. So
a collaboration between those two departments
is critical.
The better they collaborate, the more transparent
the information is going to be, the better
the care, the better the reimbursement, so on
and so forth. The second part of it
is that all this information also needs to
be put in front of the physician, whether
it's a physician advisor managing the utilization management
process or a physician managing the patient during
the inpatient stay.
Again, the collaborative aspect allows all this information
to flow directly to the physician and back
in a much smoother manner.
And then the transparency
of all of this information
will allow things to be resolved a lot
quicker. Any issues will be resolved. You don't
want to have all this information in silos.
And that's what's been happening. All of this
information, you know, you got the silo. You
got a CDI silo. You got a physician
care silo. Right? All of these need to
be combined and information has to
flow
smoothly between all of these entities.
Yeah. And it it stands to reason that
if you achieve that, that's gonna change the
game for a lot of a lot of
different Exactly. Right. Right. You you expect
that once you are able to do that,
better patient care because everyone's talking. Mhmm. Right?
And better reimbursement because everyone's got the right
information that ultimately flows into the bill that
gets dropped. Excellent. Well, William, I think that's
a great place for us to conclude. It's
been a pleasure speaking with you today. Alright.
Thank you, Brian. I also wanna thank our
podcast sponsor, Iodine Software. You can tune into
more podcasts from Becker's Healthcare by visiting our
podcast page at beckershospitalreview.com/podcast.