The largest health system in Arizona wanted to improve clinical documentation quality and capture patient risk as early in the patient's stay as possible. The non-profit health system partnered with Regard and its Proactive Documentation solution to find key information buried within the EHR, surface it at the point of care, suggest diagnoses, and generate more standardized assessments and care plans. The ongoing partnership supports an enterprise-wide clinical documentation initiative across 33 hospitals to drive revenue integrity and consistent clinical care quality.

Key results

• 31% improvement in CC/MCC capture, comparing Regard-facilitated vs. non-facilitated encounters over an 11-month period
• 6.4% increase in case mix index
• Enterprise-wide deployment across 33 hospitals and more than 500 hospitalists
• Regard built into standard onboarding for every new hospitalist

Download the full solutions brief »

The challenge

As a large health system, the lack of standardized documentation practices made it difficult to move the needle on quality and revenue integrity. Leaders wanted to ensure their more than 500 hospitalists' documentation accurately reflected patient complexity and acuity — and they wanted that enhanced documentation in real time, not retrospectively.

The solution

The health system chose to partner with Regard to help hospitalists increase their CC/MCC capture appropriately, without requiring significant workflow changes or additional time.

How Regard works

• Review. Regard reviews the entire medical record for every patient.
• Insights. Regard catches errors and recommends diagnoses to ensure a complete patient view.
• Draft. Regard proactively drafts the clinical note before physicians see the patient and updates the draft in real time after the encounter.

How Regard promotes clinical documentation quality

• Scans years of patient data in seconds, surfacing the most critical and relevant insights
• Automates clinical documentation using real-time data
• Standardizes the assessment and plan to drive documentation improvement initiatives

An adoption playbook built to scale

Rolling out any technology to 500+ hospitalists across 33 hospitals takes more than training sessions. Regard collaborated with practice managers and directors to schedule physician training efficiently and with minimal disruption to patient care. The health system supplemented that with educational materials in its central repository and hosted town hall meetings to solicit provider feedback — where physician champions explained how Regard helped them improve their documentation and provide better patient care.

To promote sustained buy-in, leaders made two structural moves: they incorporated Regard into the onboarding process as a standard tool for all hospitalists, and they incentivized physicians with value-based bonus payments for using the technology.

The results

During an 11-month period comparing Regard-facilitated versus non-facilitated encounters, the health system saw a 31% improvement in CC/MCC capture and a 6.4% increase in case mix index — evidence that documentation now reflects the true complexity of the patients its hospitalists treat.

In conclusion

Through its partnership with Regard, the health system learned it must take three steps to promote successful enterprise-wide clinical documentation improvement:

1. Standardize key elements of clinical documentation.
2. Leverage physician champions and solicit provider feedback regularly.
3. Incorporate innovative technology into onboarding workflows for all hospitalists.

The ongoing partnership continues to evolve as the health system explores opportunities to expand the technology across cardiology, acute surgery, and outpatient settings.

Download the full solutions brief »

Ready to see how Proactive Documentation enhances patient care and protects hospital revenue? Request a demo