Oregon Health & Science University Hospital: Revolutionizing Medical Coding with AI
Oregon Health & Science University Hospital, a renowned 576-bed teaching hospital and Level I trauma center in Portland, has been at the forefront of healthcare innovation. However, like many healthcare facilities, OHSU faced a significant challenge – a shortage of medical coders. This shortage not only impacted coder case volumes but also hindered operational efficiency.
Tammy Bickle, the director of revenue cycle at Oregon Health & Science University Hospital, recognized the urgent need for a solution. The hospital was planning for growth, including the expansion of additional beds, which would further exacerbate the shortage of coders. The backlog of cases was resulting in longer billing turnaround times, increased coding-related denials, and ultimately, lost revenue for the hospital.
In an effort to address these challenges, OHSU decided to explore AI-driven autonomous coding as a solution. The hospital partnered with CodaMetrix, a vendor specializing in AI-powered radiology coding, to automate the radiology coding cycle. The goal was to eliminate the backlog of cases, improve coding accuracy and efficiency, and alleviate the pressure on the coding team.
The implementation of AI-driven autonomous coding had an immediate and impressive impact. The automation rate for radiology reached 92%, reducing the coder workload by nearly 28%. Coding-related denials for autonomously coded cases were 70% lower than manually coded cases, leading to a substantial decrease in denial rates. High-cost imaging category denials dropped by 65% with automation.
Bickle shared valuable advice for other healthcare organizations looking to implement autonomous coding technology. She emphasized the importance of embracing innovation and change, even in the face of past failures. By involving key stakeholders, providing clear communication, and assuring the coding team of their continued importance, OHSU successfully implemented AI-driven coding.
The success of autonomous coding in radiology has paved the way for OHSU to explore automation in other service lines, further enhancing operational efficiency and improving coder work-life balance. The hospital’s commitment to embracing new technologies and prioritizing the well-being of its coding team has led to transformative results in revenue cycle management.
In conclusion, Oregon Health & Science University Hospital’s journey towards AI-driven autonomous coding serves as a testament to the power of innovation in healthcare. By leveraging cutting-edge technology to streamline processes and improve outcomes, OHSU has set a new standard for medical coding excellence.
