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Setting the Record Straight: How PINC AI™ Stanson is Separating Fact from Fiction in Healthcare Automation

Key takeaways:

  • Coding automation in healthcare is advancing rapidly, and artificial intelligence (AI) serves as a vital element of its progression, with PINC AI™ Stanson’s Hierarchical Condition Category (HCC) clinical decision support (CDS) alerts playing a crucial role in improving accuracy and efficiency in the medical coding process.
  • As with many groundbreaking innovations, there are misconceptions about the implications of AI technology for coders and clinicians.
  • In this blog, the experts at PINC AI™ Stanson deep dive into the misconceptions and uncover the truths surrounding AI’s integration in healthcare.

In an era of remarkable technological advancements, healthcare automation stands at the forefront of transforming the medical landscape. PINC AI™ Stanson, a part of Premier’s technology platform PINC AI™, is a prime example of a solution that is designed to seamlessly integrate artificial intelligence (AI) and cutting-edge technologies to help increase efficiency, lower costs and reduce low-value and unnecessary care.

However, amidst the promise of these advancements, there are lingering misconceptions about how AI technology will impact coders and clinicians. As with any groundbreaking technology that upends the status quo, there are concerns about the potential consequences associated with utilizing new innovations. Below we are setting the record straight and debunking four common myths to illuminate the true potential of healthcare automation.

Fiction: AI will eventually replace clinicians in making medical decisions.

Fact: While AI has been used to make significant strides in the healthcare field, it will never replace clinicians in making complex medical decisions. Instead, AI can serve as a valuable tool to complement clinicians and help accelerate the decision-making process. For example, one of the key benefits of using PINC AI™ Stanson is its ability to automate coding, leading to more accurate and efficient documentation. This helps alleviate the burden on healthcare providers, streamlines administrative tasks and ensures accurate billing and record-keeping.

PINC AI™ Stanson can also help eliminate challenges that exist in documentation improvement, such as capturing detailed patient information and context. AI technology can address these challenges by offering natural language processing (NLP) capabilities, helping to extract essential clinical details from provider notes. This helps ensure comprehensive and precise coding.

It's important to note that while PINC AI™ Stanson can enhance efficiency and accuracy, it does not replace a clinician’s invaluable knowledge and expertise in understanding the intricacies of each patient's condition and formulating personalized treatment plans. By working hand in hand with AI, clinicians can harness the power of technology to help improve patient outcomes and deliver more effective care.

Fiction: AI will eliminate jobs for healthcare coders and clinical documentation improvement (CDI) specialists.

Fact: Much like clinicians, AI does not aim to eliminate jobs for healthcare coders or CDI specialists; rather, it will enhance and streamline their workflow. PINC AI™ Stanson’s AI models draw from extensive and diverse datasets that include medical records and coding guidelines.

Since AI alone cannot fully comprehend the nuances of medical documentation, the PINC AI™ Stanson team involves human experts during model development and validation, ensuring a more precise and contextually aware coding process. This collaboration is designed to allow AI to handle repetitive and time-consuming tasks, enabling coders to focus on more complex cases, data analysis and quality assurance, ultimately leading to more efficient and accurate healthcare coding practices.

Fiction: AI will make healthcare more expensive.

Fact: PINC AI™ Stanson’s Clinical Decision Support (CDS) has the potential to significantly reduce costs associated with Hierarchical Condition Category (HCC) coding.

PINC AI™ Stanson’s HCC alerts can assist healthcare providers in accurately identifying and documenting chronic conditions, leading to more precise risk adjustment and appropriate reimbursement. By automating the coding process and improving accuracy, AI can streamline administrative tasks and help reduce the need for manual intervention, ultimately saving time and resources.

Additionally, AI's ability to analyze vast amounts of patient data efficiently can aid in early detection and prevention of diseases, further reducing long-term healthcare expenses. Overall, AI aids in improving efficiency and effectiveness while simultaneously helping to drive down costs.

Fiction: AI doesn’t require any updates.

Fact: The healthcare industry is subject to constant regulatory changes, necessitating ongoing adaptations and updates to AI models. PINC AI™ Stanson’s AI models are actively monitored and updated to help maintain accuracy and stay up to date with the latest trends in the field. This helps ensure that PINC AI™ Stanson solutions remain both compliant and relevant, bolstering the quality of care provided to patients and fostering innovation in healthcare practices.

It's time to ignore the falsehoods.

By combining AI technologies with human expertise, PINC AI™ Stanson aims to optimize the HCC coding process, improving efficiency, accuracy and productivity. At the core of PINC AI™ Stanson's approach are two innovative HCC coding solutions: CodingGuide and CodingCare. These solutions are designed to seamlessly integrate alerts into the electronic health record (EHR) workflow, effectively prompting providers to add necessary codes. With CodingGuide, providers receive actionable HCC guidance, helping to streamline administrative tasks and ensuring accurate reimbursement. Meanwhile, CodingCare builds upon CodingGuide by actively involving coders and documentation improvement specialists in both pre- and post-encounter documentation.

Emphasizing collaboration, continuous learning and quality assurance, PINC AI™ Stanson effectively addresses many of the challenges associated with HCC coding. As the healthcare industry embraces AI, this dynamic partnership between technology and healthcare professionals promises to revolutionize healthcare delivery, ushering in an era of unprecedented advancements and elevating the overall patient experience.

Learn more about how PINC AI™ Stanson can get your healthcare organization on the path to automation.

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