In the past four years, the New Jersey Department of Health has been implementing a significant population health management program aimed at improving outcomes for Behavioral Health (BH) and Maternal Health (MH) patients. The Quality Improvement Program – New Jersey (QIP-NJ) has engaged nearly every hospital in the state, distributing close to $420 million in incentive payments as of April 2024. Many who are familiar with the QIP-NJ program recognize its benefits for both patients and health systems. However, a notable challenge has been the retrospective nature of patient attribution, which limits clinical and quality teams’ ability to enhance performance for attributed patients.
Retrospective patient attribution is common in population health programs due to the reliance on historical claims and electronic health record (EHR) data. The complex inclusion and exclusion criteria require nurses and quality professionals to spend considerable time evaluating EHR charts to identify at-risk patients based on past utilization and quality measures. However, the recent advancements in Artificial Intelligence (AI) are changing this landscape.
Healthcare Innovation Solutions (HCIS), a subsidiary of the New Jersey Innovation Institute (NJII), has developed a solution that allows for prospective identification of patients likely to be attributed to hospitals under QIP-NJ and other quality programs. Their Measures Manager™ platform, specifically designed for QIP-NJ, utilizes a newly validated AI model called AutoChart AI. This model predicts potential patient attribution based on sophisticated criteria, enabling care teams to manage these patients proactively through Measures Manager’s workflow capabilities. AutoChart AI processes both structured and unstructured data in seconds using a Large Language Model (LLM) trained on over 8 billion quality and performance parameters, resulting in over 90% reduction in manual chart abstraction.
NJII Chief Operating Officer, Jennifer D’Angelo, emphasizes the importance of innovation: “Innovation is in our DNA. NJII is always looking for ways to improve the healthcare system with cutting-edge but proven technology. Manual chart abstraction is labor-intensive and costly for hospitals. With AutoChart AI and Measures Manager™, we can deliver even greater value to our healthcare partners.”
Tom Villani, PhD, NJII’s AVP of AI and Machine Learning, sees this as a crucial advancement in quality improvement and population health. He likens AutoChart AI to “ChatGPT for patient charts,” noting that it enhances productivity, reduces operational costs, and improves the experience for nurses and quality professionals involved in chart abstraction. He adds that this capability allows health systems to proactively manage patients, improving outcomes, performance scores, and potentially increasing reimbursements.
Mary Aitken RN BSN, Managing Director of HCIS and an experienced nurse in quality reporting and population health programs, advocates for this paradigm shift: “The AutoChart AI model empowers nurses to work at the top of their license. With an AI-based chart abstraction assistant, they can collaborate more effectively with population health teams to enhance patient outcomes and achieve better QIP-NJ scores within the current Measurement Year. AutoChart AI signifies a fundamental change for hospitals implementing QIP-NJ or any population health initiative reliant on retrospective attribution.”
AutoChart AI also streamlines several key aspects of population health management workflows:
- Automated chart abstraction
- Configurable algorithms for inclusion/exclusion criteria
- Prospective patient identification
- Automated CPT code generation
- Predictive surveillance capabilities
- Automated registry submissions
As hospitals continue to navigate the complexities of quality improvement and value-based care, tools like AutoChart AI and Measures Manager™ provide a much-needed shift toward proactive management. Instead of reacting to retrospective data, hospitals can now anticipate patient needs, streamline workflows, and improve care delivery.
With QIP-NJ MY5 already underway don’t wait. Learn how AutoChart AI along with Measures Manager can benefit your hospital for quality programs like QIP-NJ. Contact an HCIS team member hereContact HCIS | Healthcare Innovation Solutions, Inc. Address, Contacts, Phone or by calling 973-642-4055.