Healthcare providers today are facing a daunting reality: a deluge of clinical data amidst rising patient demand and a shortage of clinicians. The transition from paper charts to digitized records has generated a massive amount of patient data, yet a staggering 97% remains untapped. This represents a significant missed opportunity for improving care and outcomes.
Physicians, struggling under the pressure of heavy patient loads amidst a national clinical workforce shortage, continue to rank working with EHR systems as the second most challenging part of the job. In internal medicine, 49% of physicians report feeling burned out, with EHRs as the primary contributor.
This overload is more than just a personal burden; it’s a systemic issue that contributes to an estimated 7.4 million diagnostic errors in emergency departments each year, affecting as many as 2.5 million patients. Over two-thirds of these errors are attributable to just 15 diseases, several of which are easily identifiable with the right data present.
These diagnostic errors are created, at least in part, by the Clinical Insights Gap. The Clinical Insights Gap is the blindspot that exists when there is vast amounts of patient data that bury critical clinical evidence, known as Clinical Insights, necessary to make decisions. Clinical Insights impact the entire health system from patients through hospital administration. Physicians and health systems need technology to help them turn patient data into decisions through closing the Clinical Insights Gap and presenting Clinical Insights at the point of care.
Patient Safety
The sheer volume of data in patient charts can often obscure critical information, making it difficult for physicians to diagnose and treat patients effectively. This can lead to patient safety risks such as misdiagnoses, untreated conditions, and adverse drug interactions. Clinical Insights are essential for making informed decisions about patient treatment plans and diagnoses, ultimately driving up care quality and reducing patient safety risks.
Dr. Colin Findlay, a hospitalist at Sentara Health, encountered a patient admitted for uncontrolled heart failure and rapid atrial fibrillation. Suspecting medication nonadherence, he reviewed previous hospital progress notes, but found no indication of the underlying cause. However, a Clinical Insights tool being piloted at Sentara revealed a different story. By analyzing the patient data inside of the EHR, the Clinical Insights tool identified a missed diagnosis of hyperthyroidism. This condition, if left untreated, can cause a rapid heart rate.
“I wouldn’t have even known to look for that diagnosis,” said Dr. Findlay. “I missed it in my initial assessment, and I would have likely missed it throughout the patient’s stay. Without Regard, physicians may be unaware of diagnoses that impact the reason patients are in the hospital. If we miss these diagnoses due to copious documentation and a clunky EHR, that limits our ability to provide high quality care.”
Financial Impact
Healthcare systems are grappling with rising costs and shrinking budgets, making revenue generation and protection a top priority. By leveraging Clinical Insights at the point of care, hospitals can ensure that physicians submit accurate and complete documentation at the point of care. This leads to several positive financial outcomes, including:
- Reduced auto denials: More detailed clinical documentation can help prevent claims from being denied automatically.
- Fewer CDI inquiries: Accurate and complete clinical documentation can minimize the need for costly CDI reviews.
- Enhanced revenue: Detailed diagnoses and care plans can help hospitals capture more revenue by ensuring that all billable services are accurately coded and billed.
Dr. Joseph Evans, the current Vice President and Chief Health Information Officer at Sentara Health, sums the value up as: “It’s about helping us get paid for the work we provide. To ensure revenue integrity, we need accurate and complete documentation.”
Operational Efficiency
In today's challenging healthcare landscape, hospitals are facing a perfect storm of physician shortages, burnout, and tightening budgets. To navigate these pressures, operational efficiency is more critical than ever. Clinical Insights platforms can play a vital role in supporting operational efficiency by:
- Standardizing physician notes: This can improve communication and collaboration between healthcare providers.
- Streamlining workflows: By pulling together relevant patient information in one easy-to-access location, Clinical Insights can save physicians valuable time.
- Reducing CDI queries: Detailed and specific clinical documentation supported by the necessary evidence can minimize the need for costly CDI reviews.
Dr. Russell Cameron, former CMO at Penn Highlands, shared his experience: “Doctors usually needed to look through all parts of the record to make a diagnosis. Just toggling between the screens took time. With Regard, all of that information is curated into a single view with hyperlinks to the original source.”
Closing the Clinical Insights Gap
The future of care hinges on the ability of health systems to harness the massive amounts of data generated by every patient interaction. With the vast majority of patient data currently sitting unused, the clinical insights gap presents both a challenge and an opportunity.
By adopting AI-powered tools that bridge the clinical insights gap, health systems can ensure their physicians can access the full spectrum of patient information needed to make accurate, timely decisions. This not only improves patient outcomes and enhances safety but also boosts operational efficiency and protects hospital revenue.
In today’s challenging economic climate, where efficiency and outcomes are paramount, clinical insights are no longer a nice-to-have. It’s a necessity – for clinical and financial sustainability, for physicians, and for the future of patient care.