Autonomous coding is gaining traction in healthcare. Still, questions remain around whether its results can be trusted.
During an October Becker's Hospital Review webinar sponsored by Solventum (formerly 3M Health Care), three Solventum leaders discussed the importance of clinical expert input for successful coding outcomes and how organizations can evaluate autonomous coding offerings with expert-guided input in mind. The panelists were:
- Brinton Frisby, business director, autonomous coding
- Thomas Polzin, director of AI technologies
- Jean Stoner, computer-assisted coding content supervisor
Three key takeaways were:
- The need for autonomous coding solutions is multi-faceted and increasing. This need stems mainly from a shortage of qualified coding resources, staggering numbers of patient charts to code, constantly changing regulatory and compliance requirements for human coders to keep up with and escalating demands to streamline coding and billing.
Against this backdrop, a 2023 KLAS report showed that 11% of survey respondents identified coding as the area where automation is most needed and 40% stated autonomous coding is the top area where their organizations plan to invest in the next 12-24 months.
- Solventum's solution is a comprehensive workflow, not just an automation tool. As the culmination of several decades of coder assistant and validation platforms, Solventum's current solution is the latest iteration of the preceding Solventum™ 360 Encompass™ System. It includes Code Confidence and Chart Confidence modules, which inform users of the confidence level of the underlying code automations.
If the solution has full confidence in the auto-generated chart codes, it deems them as "final coded ready" and passes them off to the next step in the billing process. "[The solution] determines if a chart is qualified for automation; if it's not qualified, it's determined as needing a manual review," Mr. Frisby explained. "We streamline the manual review by telling the coder all of the reasons why it failed the automation."
- What sets Solventum's solution apart is its grounding in expert guidance. There are numerous autonomous coding vendors on the market that tout the benefits of their AI-powered tools.
What distinguishes Solventum's autonomous medical coding solution from competitors is not only that it is an end-to-end process rather than a standalone tool, but also that its supporting infrastructure is fundamentally informed by cross-field subject matter expertise.
"It is our belief that a successful solution needs to marry clinical coding expertise with expertise in AI technologies," Mr. Polzin said. He pointed out this is because autonomous coding requires clinical and technical reasoning across all documents within a patient-physician encounter at the same time due to coding dependencies. "You cannot confine reasoning to a single document."
In this regard, the quality assurance role of Solventum's clinical coding experts — who work shoulder-to-shoulder with Solventum's data scientists — across code generation, code evidence and chart confidence is crucial, Ms. Stoner said.
"We provide a complete [coding] picture of the entire encounter for our customers — we even have a process where each customer can set the percentage [of confidence level] where they would like to do their own QA," she explained.
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