Our New Normal Gives HIM a Chance to Shine

With a positive change in mindset, HIM and coding teams have an opportunity to not only recover, but prosper and be better than ever!

While HIM professionals are dealing with current challenges including reduced patient volume, layoffs and furloughs and working from home, we should all be focused on recovery—preparing for the new normal.

Throughout the transition, hospitals will remain focused on avoiding contamination—fewer patients allowed in waiting rooms, non-urgent procedures sent to ASCs, prompt care clinics and physician offices. Many of those facilities may need more sophisticated coding expertise than they required in the past. Telemedicine will continue to expand, along with increased demand for coders who are trained to code those services. 

We anticipate a surge in non-emergency or elective healthcare treatments or procedures such as preventive care visits, chronic disease management and elective surgeries that were postponed to free up physical space and clinical workforce needed for surge care access during the crisis. Surveys from the AMA, eHealth, The Advisory Group, Canaccord Genuity and others predict that as restrictions to patient access are lifted and the availability of vaccines and therapeutics increases, patient volumes will begin to return to previous levels.

We need to change our perspective. Traditional approaches to hospital-based coding volume must be critically reviewed. The pandemic may be the shock needed to produce a long overdue review and change in telehealth, inpatient, outpatient and ASC coding services. 

• Evolve with the trends. Expect continued erosion of hospital procedural volume as ambulatory facility volume steadily increases. Adopt an aggressive plan to expand coding into the ASC and office-based procedure arenas.
• Cross-train your coding staff. Develop a broad range of expertise to prepare for dramatic shifts in patient volume by type of visit.
• Update your revenue cycle infrastructure. Ensure that your EHR, chargemaster, CDI and encoder are updated to effectively manage the changes in the types and locations of patient visits.
• Govern wisely. Build a new multidisciplinary collaborative leadership model to develop a new coding workflow. Include stakeholders from inpatient, outpatient, ambulatory and other departments depending on your hospital’s case mix. This team should function as the HIM-sponsored “board of directors” for mapping out a new coding process.

This pandemic will end. No one knows when. Everyone in the entire revenue cycle of healthcare providers is stressed and apprehensive. One of my favorite inspirational quotes is by hockey great Wayne Gretzky in response to a sports reporter’s question, “What is the difference between a good hockey player and a great hockey player?” Gretzky replied, “A good hockey player always goes to where the puck is. A great hockey player goes to where the puck is going to be.”

The American HIM community has a history of overcoming obstacles and embracing challenges. This may be the biggest challenge that we have ever faced. We all need to assess our own personal situation, stay in tune with what is happening in our industry, and keep open communication with our peers and colleagues. Based on those parameters, we can then determine where the puck is going, prepare ourselves to be there and do something great with it.