Boosting Clinical Documentation in the Age of ChatGPT

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In the coming years, many industries, including healthcare, will undergo significant transformation with the integration of AI. One of the pioneering developments is ChatGPT, a generative AI that can be used to generate medical notes, summarize information for patients, and reduce administrative tasks. However, AI offers both promises and perils, with one concern being the possibility of hallucination, where the AI creates unrelated or incorrect information. As AI becomes more integrated into healthcare, it’s vital to acknowledge its limitations and adopt processes that mitigate potential drawbacks. The role of Clinical Documentation Improvement (CDI) professionals will likely amplify, not diminish, in the era of ChatGPT. Hospitals are capitalizing on the AI revolution to identify, on average, $800K per 100 beds in net new revenue, all fully supported by clinical indicators. This is just the beginning of AI’s potential in healthcare.

SmarterDx is a company that helps hospital CDI and Coding specialists identify clear and consistent criteria by using its proprietary AI technology to scrutinize the primary data and to ‘true up’ that data with physician notes and ICD-10-CM/PCS codes. SmarterDx complements concurrent CDI and Coding tools by acting as a Prebill safety net that scans 100% of charts to catch any opportunities. Hospitals are using SmarterDx in conjunction with existing tools to capture additional opportunities and provide insights for further program improvement.

Michael Gao, MD, the CEO of SmarterDx and an Assistant Professor of Medicine at Weill Cornell, reflects that reviewing underlying data is necessary to truly understand the patient, as patient notes would often have errors, false information, or omissions. In the era of ChatGPT, the role of CDI professionals will become increasingly important in maintaining the accuracy and integrity of patient records.

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In conclusion, while AI continues to evolve and shape medical documentation, professionals like CDI specialists and tools like SmarterDx will play an increasingly important role in maintaining the accuracy and integrity of patient records. As AI technologies continue to promise exponential growth, our task is to adapt and leverage these technologies without succumbing to their perils.

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