Bridging the Divide: Can Clinicians and CFOs Speak the Same Language?
By Nick van Terheyden, MBBS
Pity poor Henry the VIII. Historians still argue over his medical records. Though his was the most scrupulously documented medical history of his age, burning questions remain. Did he suffer from syphilis as believed for centuries? More likely he had familial diabetes, which better explains his symptoms – including his well-documented inability to heal from wounds.
Imagine if Henry’s physicians were also tasked with assigning codes and complying with the clinical documentation requirements of today. The Tudor dynasty might have had some reimbursement issues. Heads would have rolled.
Sure, bloodletting is no longer an accepted therapeutic modality. But have we really come that far in bridging the divide between the clinician’s responsibility for care and the CFO’s responsibility for financial performance? Or do finance and quality continue to be involved in a forced marriage of sorts?
Clinicians are focused on their patients. While they understand the importance of billing, they need to put their energies into diagnosing and treating patients to ensure positive outcomes. And they’re overwhelmed with data – patient test results, clinical studies, guidelines, protocols – much of which they have to sift through to find relevant, critical information. Add to that, they have the burden of learning the new coding requirements under ICD-10, with the deadline approaching around the corner.
CFOs, of course, are also focused on quality but, at the same time, must juggle that priority with issues related to reimbursement, their bottom-line and ever-changing and expanding compliance requirements. They’re continually seeking out and analyzing solutions that may be able to improve both patient health and revenue performance. At the same time, they also recognize that without physician buy-in, they cannot meet any of these goals; therefore, they are looking for meaningful ways to bring them along, without disrupting their workflows.
Information that’s deemed crucial for the clinician may not be deemed useful by the CFO, and vice-versa.
Yet finding ways to break through this language barrier between the clinical and financial perspectives will be a critical success factor for healthcare organizations in the years ahead. It’s more than just a communications issue. It’s a strategic imperative aimed at translating the narrative of care into an actionable piece of information that aids in care coordination, while also ensuring appropriate reimbursement and minimizing the potential revenue leakages that keep most hospital CFOs up at night.
Clinical documentation is at the heart of plugging these revenue leakages while also meeting quality standards. Instead of finding one-stop solutions to prevent leakages across the revenue cycle, it is much easier to build accuracy from the start rather than trying to fix the problem after the train has left the station and the process is in motion.
Regardless of the tools used, clinical documentation addresses the most important concern for both physicians and CFOs: ensuring that the most useful information is captured accurately and is made readily accessible to the decision makers (and systems) who need it. At the end of the day, we all know that quality leads to a win for all.
Nick van Terheyden, MBBS is CMIO of Nuance.