Clinical Documentation Specialists

How AI Impacts The Role of Clinical Documentation Specialists

November 06, 2019 | 03.00 PM EDT

Artificial Intelligence (AI) enhances healthcare management from both business and technological perspectives. Typically, healthcare professionals are often racing against time to deliver better healthcare outcomes. They constantly work with advanced tools and technologies to ensure improved productivity and efficiency since several lives depend on it. AI simplifies complex healthcare processes and workflows including clinical documentation and decision-making. For instance, Machine Learning (ML) and Natural Language Processing (NLP) support providers and healthcare institutions to infer valuable data-driven insights from petabytes of patient data.

Automated Clinical Documentation

Documentation is critical for providers to diagnose illnesses and administer a suitable treatment for patients over the long-term. A physician is now made responsible with data entry and other administrative tasks as opposed to a documentation specialist involved in Health Records Management. It has an adverse effect on healthcare delivery and patient care over the long term. AI-driven clinical documentation is a comprehensive and continuous process that includes the entire patient data flow from the provider-patient engagement to the Electronic Health Records (EHR) data integration. AI-driven applications like CascadeMD can help resolve the practical challenges in medical record-keeping, especially for a Clinical Documentation Specialist.

Optimized Data flow

Healthcare institutions generate a large volume of structured and unstructured data. A Clinical Documentation Specialists (CDS) team works closely with different providers involved in a patient’s treatment to collect, categorize and compile a comprehensive health record. AI-driven applications allow providers to share their dictation notes and other medical documents on the cloud in adherence to data security standards. Likewise, they can support the CDS team to capture, analyze and archive patient data from varied sources within short turnaround time. Eventually, AI promotes optimized data flow between different healthcare stakeholders in the healthcare ecosystem.

Clinical Documentation Improvement (CDI)

Clinical documentation has a huge impact on the quality of healthcare delivery. As a result, Centers for Medicare and Medicaid Services (CMS) devised federal regulations including HIPAA to ensure the privacy and security of patient data. Providers and healthcare institutions adopt Clinical Documentation Improvement (CDI) solutions powered by Artificial Intelligence to enhance Health Records Management in compliance with HIPAA standards. For instance, HIPAA-compliant clinical documentation app like CascadeMD helps acquire, process and integrate patient data with existing Electronic Health Records (EHR) systems. It supports confidentiality, integrity and authorized accessibility of petabytes of patient data in adherence to federal regulations.

Clinical Inferences

More often, patients undergo a series of treatments that involve different providers and healthcare professionals. It’s essential for providers and healthcare institutions to have access to a repository of medical records of their patients to provide better healthcare. AI helps process large volumes of data and draw clinical inferences from them with better accuracy. It streamlines the clinical documentation workflow and draws valuable insights from patient data that helps deliver personalized healthcare in a comprehensive manner. A Clinical Documentation Specialist (CDS) can leverage AI-driven apps such as CascadeMD to conduct in-depth research on patient’s medical records and analyze their specificity and accuracy in line with the existing clinical documentation standards.

Artificial Intelligence assists and augments their performance and productivity while minimizing inaccuracy and inefficiency. It is important for the healthcare industry to complement and add value to human effort with AI for better healthcare.