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Information System Implementation Optimizes Medical Coding.

Hong-Ling Lin1, Shu-Meng Cheng2, Dai-Fang Hsu1

  • 1Medical Records Office, Tri-Service General Hospital, Taipei City, Taiwan (ROC).

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|August 24, 2019
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Summary
This summary is machine-generated.

Taiwanese hospitals successfully navigated challenges from Diagnosis Related Groups (DRGs) and ICD-10 implementation by integrating digital tools and a specialized coder model, optimizing workflow and coding quality.

Keywords:
Diagnosis-Related GroupsHospital Information Systems

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Area of Science:

  • Health Informatics
  • Healthcare Management
  • Medical Coding

Background:

  • Taiwan implemented Diagnosis Related Groups (DRGs) in 2010 and the International Statistical Classification of Disease and Related Health Problems, 10th Revision (ICD-10) in 2016.
  • These implementations introduced significant challenges in medical cost reimbursement for healthcare institutions.

Purpose of the Study:

  • To evaluate the impact of integrated digital health informatics solutions and a specialized medical coder work model on overcoming DRGs and ICD-10 implementation challenges.
  • To assess the optimization of workflow, coding quality, and efficiency in a Taiwanese medical center.

Main Methods:

  • Introduction of an ICD e-dictionary and a DRGs cloud computing system.
  • Integration of these systems into the existing hospital information system.
  • Development and implementation of a medical coder specialization work model.

Main Results:

  • Successful mitigation of adverse effects associated with DRGs and ICD-10 implementation.
  • Significant optimization of medical coding workflow and overall efficiency.
  • Enhanced coding quality achieved through specialized training and system integration.

Conclusions:

  • The strategic integration of digital tools, including an ICD e-dictionary and DRGs cloud system, is effective in addressing reimbursement challenges.
  • A specialized medical coder work model significantly improves coding quality and operational efficiency.
  • These innovations enabled a northern Taiwanese medical center to successfully adapt to new healthcare regulations.