Solventum™ 360 Encompass™ Clinical Documentation Integrity System

Solventum’s advanced prioritization algorithm analyzes unstructured data using natural language processing to identify the following types of high-priority reviews:

• Organization-specific focus DRGs, including those that trigger bundled payments
• Cases for which there are multiple principal diagnoses or those without a complication or comorbidity (CC) or major complication or comorbidity MCC
• Cases related to pediatric populations
• Cases for which the length of stay doesn’t correlate with the patient’s severity of illness or risk of mortality
• Discharges for which there is a pending query
• Records with auto-suggested diagnosis and procedure codes and an auto-suggested working DRG
• Cases that include an automated query to the physician computer-assisted physician documentation (CAPD)
• Documentation that includes clinical indicators of a condition without a corresponding diagnosis
• Cases where there may be an early-warning quality indicator that may need a documentation review
• Documentation of quality work for industry methodologies specific to DRGs in the codeset with custom edit configuration using Solventum™ 360 Encompass™ Audit Expert—Inpatient Prebill Review

Solventum 360 Encompass System not only prioritizes cases, but it also provides insight and clinical logic into why each case is a priority opportunity. Users can customize and define the types of cases for review as well as assign custom hierarchies of worklists (e.g., based on system, facility, team or user). Solventum 360 Encompass System also uses machine learning to continually update and improve CDI priorities based on new documentation. Customizable self-service reports allow CDI teams to continually monitor and improve outcomes, impact of the program, and accuracy of the algorithm and priority cases.

Solventum 360 Encompass System identifies potential quality flags concurrently, helping organizations ensure accurate value-based reimbursement related to the following:

• Patient Safety Indicators (PSIs) from Agency for Healthcare Research and Quality (AHRQ)
• Elixhauser Comorbidity Index
• Hospital Acquired Conditions (HACs)
• Solventum™ Potentially Preventable Complications (PPCs) Classification System
• Solventum™ Potentially Preventable Readmissions (PPRs) Classification System
• All-Cause Readmissions (ACRs)
• AHRQ’s pediatric quality indicators (PDIs)
• AHRQ’s neonatal quality indicators (NQIs)

As with Solventum's other artificial intelligence engines, Solventum 360 Encompass System provides users with details about each identified quality indicator, such as the inclusion/exclusion criteria, methodology and reason for inclusion. Quality and CDI teams can act immediately to correct documentation or enhance care planning in real time. The Advanced Code Sequencing feature within 360 Encompass automates the process of ordering diagnosis codes in an optimized sequence to generate a code set that best shows the complete clinical picture of a patient. It elevates codes that impact quality measures, including Elixhauser higher in the sequencing order.

For hospitals to meet the rising demands of competition, compliance and patient care, they must have an efficient and accurate revenue cycle management system.

But what does that really look like?

It looks like a single platform coding and clinical documentation, quality and CAPD. This single platform allows visualization into nudges delivered to physicians and the clinical evidence opportunities it presents to CDI teams, by working from the same content and reducing duplication. It looks like facility and professional services coders using one application, putting an end to disjointed workflows and communication breakdowns. It’s timely, complete query responses from physicians and full confidence that HCCs are captured. It’s big-picture insights so hospitals can stay ahead of market changes.

It looks like your teams, workflows and applications focused on improving patient care using the Solventum 360 Encompass System combined with Solventum™ CDI Engage One™ and our Solventum advanced CDI services.