Myra Davis

Key Strategic Insights = A Successful OP CDI Program The challenge of value-based care starts with a collaborative approach, when launching an Outpatient Clinical Documentation Integrity (OP CDI) program. Here are some key strategic insights to success: 1. Engage with Population Health Understand Pain Points: Begin by understanding the specific challenges faced. This fosters collaboration. Tailored Questions: Use customized questions to facilitate productive discussions and ensure alignment with needs. 2. Effective Software Implementation Manage Patient (Pt.) Volumes: Implement software solutions to efficiently handle pt. volumes. OP CDI Calculator: Utilize a calculator to determine Full-Time Equivalent (FTE) needs. Data Analytics and Reporting: Emphasize the importance of continuous improvement via data analytics. 3. Workflow Creation Establish Robust Workflows: Create strong workflows before integrating reviewers. 4. Collaboration & Communication Promote Strong Collaboration: Encourage robust communication between key stakeholders. Leverage Software: Use technology to reduce physician burnout & streamline communication. 5. Patient-Centered Approach Address social determinants of health (SDOH) & ensure accurate documentation of conditions and care plans. Patient Outcomes: Keep patient care at the center of all doc. & workflow processes. 6. Regulatory Compliance Adhere to Guidelines: Follow regulatory requirements such as CMS guidelines on Hierarchical Condition Categories (HCC) coding to avoid penalties and enhance credibility. 7. Measurable Outcomes Set Clear Goals: Aim for measurable outcomes like improved HCC recapture rates, enhanced RAF scores, better HEDIS measures, and addressing SDOH needs. 8. Stakeholder Engagement Involve All Stakeholders: Ensure that executives, clinicians, and other relevant parties are involved in planning and implementation process. Success Stories Recently, I helped several CDI directors validate their cases for OP CDI programs within Accountable Care Organizations (ACOs). By engaging with population health leadership, we identified key issues such as RAF gaps and HEDIS measures, and tailored processes to address them. For instance, a CDI director I guided successfully identified HCC and HEDIS recapture as their biggest pain points. With strategic solutions in place, they are now ready to implement the project for the 2025 budget yr., aiming to improve their HCC recapture rate by 20%, leveraging data analytics for outcomes and improvement needs. Benefits of Implementing These Strategies Align Risk Stratification: Properly align risk stratification with chronic conditions and healthcare needs. Quality Measures: Improve quality measures and address SDOH. Collaborative Team: Ensure success with a collaborative team supported by technology. Overall, these strategic actions will enhance patient care and operational efficiency. #Healthcare #Leadership #CDI #PatientCare #ValueBasedCare #HealthcareInnovation

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Implementing an electronic health record (EHR) or migrating to a new one is a complex process. It requires you to keep track of timelines and stay on budget – all while keeping clinicians happy and not interrupting patient care. In its latest report, Gartner® notes that when implementing a new EHR “healthcare provider CIOs can avoid setbacks and position for success by undertaking an organizational readiness assessment and mitigating risks during the strategy and planning phase.” Access the complimentary Gartner® report, Gauge Readiness and Mitigate Risk to Succeed in EHR Implementations, to learn more. Read the report: https://bit.ly/3KCgZVY #EHR #EHRmigration #EMR #EMRmigration #healthcare #interoperability #digitalhealthenablement

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Behavioral healthcare has many facets. Can your #EHR handle your complex needs? Core's recent blog post shares valid food for thought. 

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To keep up with the evolving health care landscape, organizations need to prioritize access as a fundamental part of their value proposition to patients. Inspired by successful retail strategies, health care can streamline processes to eliminate barriers to care and enhance service delivery, increasing both value and patient satisfaction. Check out this blog that outlines how this transformation necessitates a clear definition of access, effective use of consumer insights, and ongoing efforts to refine services.

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The best patient-focused apps, and digital front doors, will do very little to help with patient satisfaction (and retention) if the hospital/clinic doesn't first improve its internal processes and culture. It's the carpenter, not the hammer. If only this weren't true... #healthcare #patientexperience #patientsatisfaction #customerexperience #consumerism #patientportals #digitalhealth #ehr #emr #customerretention https://lnkd.in/g5wkKE_X

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Challenges and Solutions for Inpatient Capacity Management - HIT Consultant Title: Challenges and Solutions for Inpatient Capacity Management #CriticalChallenges In a recent report on inpatient capacity management, several critical challenges were identified. These challenges include inefficient patient flow, lack of real-time data, and inadequate communication among healthcare teams. #InefficientPatientFlow One of the major challenges in inpatient capacity management is inefficient patient flow. This can lead to bottlenecks in the system, increased wait times, and decreased patient satisfaction. Healthcare IT solutions can help streamline patient flow and optimize resource utilization. #LackofRealTimeData Another challenge highlighted in the report is the lack of real-time data. Without access to up-to-date information on bed availability, staffing levels, and patient status, healthcare providers may struggle ai.mediformatica.com #health #management #report #staffing #discharge #healthsystems #healthcare #leantaas #insights #provider #staffingshortages #aipowered #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/4dv4UyJ)

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This November 19th, I'll be joining symplr's Chief Nursing Informatics Officer Allison Morin to discuss how healthcare organizations can turn outcomes data into actionable improvements that drive meaningful change. Here's a quick overview of some of the key takeaways we'll be covering: • Explore the 3 crucial steps to increase your quality program’s influence on operations • Learn effective techniques for identifying quality problems and initiatives • Master the art of goal setting: Prioritize efforts for maximum impact while avoiding low-yield changes • Gain insights on sharing quality data with executive stakeholders for improved decision-making Learn more and register below: bit.ly/3Cg5Bhz #HealthcareOperations #HealthcareLeadership

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Hopeful this will drive impact industry wide.

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I just sat through a fantastic demo by Kristin Losh at Oracle Health showcasing Validic's remote care solution embedded in the Oracle Health EHR workflow, leveraging HealtheRegistries, Millenium, PowerChart, HealtheCare, and Patient Mobile App (Validic HealthBridge). Keeping clinicians in the chart saves them time, streamlines documentation, and keeps patients and care teams aligned, and connecting the data with the pop health solution helps close care gaps. Use cases discussed were: 🩸 Diabetes 🫀 Hypertension 🫄 OB (Gestational Diabetes or Hypertension) 🏠 Timely Discharge/Acute Care at Home 💔 Heart Failure 🫁 COPD 📉 Weight Management ♾️ ...and more! If you're looking at incorporating realtime patient data in the EHR clinical workflow for Epic or Oracle, let us show you how Validic has built the most robust, native implementation for hybrid/virtual patient-centered personalized care. Book a demo here: https://lnkd.in/e8Esqkm4 #digitalhealth #personalizedcare #remotepatientmonitoring #healthit #telehealth

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Today I want to talk about "Little Build, BIG Wins". So often we focus on the complex and sexy projects and implementations and overlook the small enhancements that when deployed, have the power to impact not only our end-users and patients, but as demonstrated in the example below, our entire Commonwealth of Virginia! Improving Immunization Record Accuracy for Newborns in Virginia 💉 At Sentara Health, we're always looking for ways to enhance healthcare processes and improve outcomes for the communities we serve. Recently, we identified a challenge that because, as standard practice, newborns are assigned generic names (e.g., "Girl Mom’s Name") in their health record, it creates an issue with matching vaccination data to the state’s immunization registry—especially for Hepatitis B vaccines. Here’s how we solved it: We introduced a new system that holds Hep B vaccine records for 30 days to ensure that the baby’s legal name is added to the chart before sending it to the Virginia Department of Health (VDH). A filter was put in place to block any vaccine records with incomplete names, and failed records are automatically retried once the legal name is updated. This change, implemented on May 14, 2024, has already had a significant impact—by September 30, 2024, over 4,600 vaccinations have been sent to VDH with the correct information, helping to streamline immunization tracking and reduce manual reconciliation. What this means for the community: ✅ VDH can now build accurate, comprehensive immunization records for each child. ✅ This solution reduces errors and manual effort, leading to more efficient vaccine tracking. ✅ Healthcare providers benefit from better data integrity, improving care for our youngest patients. We're proud to be part of the solution and are excited that VDH has shared this improvement with health systems across Virginia. Together, we’re helping create a stronger, more connected healthcare ecosystem for all. Thank you to Anissa Jones, Audra Wilkins and teams for taking on this "Sentara" issue, and finding a way to help our entire state improve health every day!! Sarah Richardson Dawn Whitney Rebecca Woods, MHA, SHIMSS, PM Centers for Disease Control and Prevention Virginia Department of Health Sentara Health Plans Joseph Evans, MD, FACP Amy Rosa Tim Skeen Bluebird Leaders This Week Health #HealthTech #Immunization #PublicHealth #Innovation #HealthcareSolutions #PatientCare #Virginia

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The HCAHPS Survey is evolving, and your strategy needs to keep up. NRC Health's latest article explains the new changes and our CAHPS Insider Live webcast offers actionable tips. Check them out here: https://bit.ly/4euy4yB #PatientExperience #NRCHealth #HealthcareInnovation

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What is the bottom line if you have financial responsibility for a provider group? Your competitors have the ability to know your contracted rates for everything you do. That's the bad news. The good news is that you can know theirs to help you in your next negotiation.

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https://lnkd.in/gsc2iZat Discreet ER downgrades are creating even more financial challenges for hospitals, impacting revenue and requiring careful monitoring. My colleague @Brian Kenyon shares his thoughts on ways hospitals can identify downgrades and leverage analytics to mitigate revenue loss. Proactive management can safeguard financial health in an increasingly complex landscape. Thanks Brian, for sharing your insights with us! #Downgrades #Management

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well worth the read if you are in managed healthcare.

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Change Management and Quality Improvement are always top of mind!

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To lead effectively amid the 2025 Medicare Advantage and Part D Final Rule changes, leverage data-driven compliance measures, employing predictive analytics to anticipate and prevent regulatory breaches. Champion ethical marketing practices, employing sentiment analysis to ensure transparency and authenticity in communications. Forge partnerships with community organizations to enhance access to behavioral health services, utilizing geospatial analysis and machine learning to optimize resource allocation. By pioneering these strategies, healthcare analytics leaders can navigate regulatory complexities while ensuring equitable care delivery. #DataDrivenCompliance #EthicalMarketingr #EquitableCare #PredictiveAnalytics. https://lnkd.in/eq3vf6qs

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📘 Struggling with Prior Authorizations? Our eBook, "A Comprehensive Guide for Taking the Pain Out of Prior Authorizations," offers 5 key facts, effective strategies, and insights on new regulations and technology that can help streamline the process. Learn what doctors wish patients knew and how to navigate the future of Prior Authorizations with ease. Download your copy today: https://buff.ly/3zdBi9A #ebook #priorauthorization #medicalpractice #healthcare #regulations #ehr #emr #prognocis #prognocisehr

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Great article by Priti Choksey Shah on the importance of integrating Clinical Documentation Integrity (CDI) and Utilization Management (UM) in hospitals. #HealthcareInnovation #RevenueManagement #AIinHealthcare #HospitalEfficiency #CDI #UM

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