TLDR: Cleveland Clinic is significantly expanding its partnership with AKASA to implement advanced Generative AI (GenAI) tools across its U.S. facilities. This initiative aims to revolutionize medical coding and clinical documentation integrity (CDI) within the mid-revenue cycle, promising increased efficiency, accuracy, and financial performance. The AI-powered solutions are designed to streamline complex processes that traditionally consume significant time and resources, with early results showing substantial improvements in coding capture and accuracy.
Cleveland Clinic has announced a major expansion of its strategic partnership with AKASA, a leading provider of revenue cycle automation, to deploy cutting-edge Generative AI (GenAI) tools for medical coding and clinical documentation integrity (CDI) across its U.S. locations. This collaboration marks a significant step towards leveraging artificial intelligence to optimize the intricate mid-revenue cycle, the critical phase between patient care and billing.
Traditionally, Cleveland Clinic’s revenue cycle staff face a daunting task: reviewing over 100 clinical documents per patient case, including progress notes, discharge summaries, and pathology reports. From these, they must select appropriate codes from a vast library of more than 140,000 options, a manual process that can take up to an hour per patient encounter. The introduction of AKASA’s GenAI-powered solutions is set to transform this labor-intensive workflow.
The core of this expansion involves an AI coding assistant tool, which has demonstrated remarkable capabilities. It can read clinical documents in under two seconds and process over 100 documents in just 1.5 minutes. This tool is engineered to go beyond simple keyword matching, understanding complex clinical contexts and adapting to the nuances of patient complexity, thereby supporting comprehensive, efficient, and accurate coding practices. Cleveland Clinic has already begun rolling out this AI coding tool across its U.S. facilities.
In addition to the coding assistant, both organizations are piloting a second AI tool focused on Clinical Documentation Integrity (CDI). This tool aims to further enhance documentation accuracy by ensuring clinical narratives align precisely with coding requirements, ultimately improving the quality and completeness of patient records.
Leaders from Cleveland Clinic emphasize the transformative potential of AI. Rohit Chandra, Cleveland Clinic’s chief digital officer, stated, “AI can be transformational for healthcare, not only in patient care, but for helping health system operations run more smoothly and efficiently. We are looking forward to sharing this technology with our revenue cycle teams and continuing to innovate in this space.” Dennis Laraway, Cleveland Clinic’s executive vice-president and chief financial officer, added, “Because we treat some of the highest acuity patients in the country, our revenue cycle activities are incredibly complex. With our collaboration with Akasa, we are bringing AI-powered enhancements to our mid-revenue cycle.”
AKASA CEO and co-founder Malinka Walaliyadde highlighted the rigorous testing involved: “We chose to pilot this technology with Cleveland Clinic because we wanted to test our AI against some of the most complex patient encounters in the world. We are proud to now be rolling it out, as well as collaborating with Cleveland Clinic’s coders and CDI specialists in developing additional products to make the revenue cycle process easier and more efficient.”
Early results from the implementation have been highly encouraging. In the first 60 days of production with the AKASA mid-cycle Optimization Suite, Cleveland Clinic observed higher ICD-10 capture and case mix index, improved severity of illness, risk of mortality, and Hierarchical Condition Category (HCC) capture. Furthermore, the AI-flagged recommendations saw an acceptance rate of approximately 50%. Nick Judd, Senior Director, Revenue Cycle Management – HIM at Cleveland Clinic, reported a significant 40% improvement in present on admission (POA) capture, directly impacting various quality and risk adjustment outcomes.
The partnership also prioritizes building workforce trust. Bob Gross, Executive Director of Financial Decision Support and Analysis at Cleveland Clinic, stressed that trust is built through education, demystifying the technology, and clearly defining its capabilities and limitations, ensuring that the final decision-making authority remains with human coders and CDI specialists.
Also Read:
- AWS Bolsters HIPAA Compliance for Generative AI, as Partners Achieve Key Competencies
- Epic’s Sumit Rana Spearheads Generative AI Integration Across Over 100 Healthcare Applications
Looking ahead, Cleveland Clinic sees potential to extend GenAI beyond current applications, exploring automation for denial appeals and interpreting medical necessity for prior authorizations, signaling a long-term commitment to AI-driven innovation in healthcare operations.
