Improving coding efficiency across British Columbia
Snapshot of Lower Mainland Consolidation
British Columbia's Health Information Management (HIM) program is a lower mainland consolidated (LMC) service, supporting Providence Health Care, Provincial Health Services Authority, Fraser Health, and Vancouver Coastal Health.
Each year, this team processes more than 250,000 acute care, 300,000 surgical day care and 1.1 million emergency visits.
The challenge: Create a more efficient coder workflow
Despite this robust infrastructure, the HIM team faced challenges, very similar to other coding teams across the country. Coder shortages and tight submission deadlines placed pressure on the team, while the lack of standardized documentation, error-prone manual entry of patient information and the need to navigate multiple systems caused delays and frustration. The data quality process can be labor-intensive, and retroactive error resolution meant time-consuming rework. As a result, coded data was often submitted with a delay of 30-60 days, reflecting the challenges of managing increasing patient volumes and expanding submission requirements.
The solution: Leverage computer-assisted coding (CAC) technology
The journey toward a CAC solution began in the fall of 2019. The team, led by Monique Rasmussen, Regional Director of Coding & Informatics, initiated an Environmental Request for Information, carefully defining their approach and scope, and began engaging with Solventum, formerly 3M Health Care, to understand the capabilities of available products. A comprehensive governance structure and RFP committee were established and a business case was developed. After a thorough evaluation, Solventum was selected as the successful contract recipient, offering the Solventum™ 360 Encompass™ Computer-Assisted Coding System.
Among its many features, Solventum 360 Encompass offers:
The result: Increased coding efficiency
User satisfaction surveys:
After going live with Solventum 360 Encompass, user satisfaction was assessed through surveys to capture feedback on ease of use, productivity, workflow adjustments and feature utility, stratified by coding experience and duration of system use:
Overall satisfaction rate of 84%
Most useful for internal medicine and long inpatient stays charts involving multiple procedures where it quickly surfaced key information and reduced the need for manual searching
Ability to highlight key details in operative reports made it easier to extract procedures
To assess the effectiveness of the new system, the LMC HIM team developed a rigorous evaluation framework based on Canada Health Infoway’s Benefits Evaluation model. The evaluation focused on three key metrics:
1. Coding speed and volume:
Measured using the Coding and Informatics Workload Indicator and Coding Coordinator Dashboard.
2. User satisfaction:
Assessed through surveys distributed to sites operational with Solventum 360 Encompass for at least two months.
3. Coding specificity, accuracy, completeness and productivity:
Evaluated through a controlled clinical coding exercise, comparing performance with and without CAC.
To further assess data quality and productivity, a single set of cases was recoded twice in controlled environments—once with CAC in a production environment and once without CAC in a staging environment. A Data Quality Specialist then reviewed the charts to determine the type of discrepancy. The results were compelling: average coding time per chart without CAC was 16.86 minutes, compared to 11.48 minutes with CAC, representing a 47% increase in coding efficiency in the controlled test environment.