Laboratory Markers of Survival
Chapter 3 Bedside Questions · 8 questions · about 8 minutes
Boards treat margin in isolation while its upstream causes (documentation that under-captures severity, quality-linked payment built from EHR configuration, and informatics-origin regulatory penalties) go ungoverned. Health IT is a small but fast-growing, scattered cost with no owner, and it is the infrastructure the 34% administrative category runs on.
Laboratory values: margin is like a lactate or a hemoglobin, accurate but non-specific. Treating the number without finding where the bleeding is coming from harms the patient.
Answer as your executive team would, with the evidence in hand. Each question has a factual answer in a system you already own.
Can you trace one of your top three quality-linked payment metrics from the bedside data element to the dashboard, and do the workflows that produce that element actually exist?
Add a note: where is the evidence, or who owns it?
Is your CDI program integrated with the EHR at the workflow level, or a parallel chart-review function?
Add a note: where is the evidence, or who owns it?
Is your clinical content designed to capture the structured elements your payers' automated systems require?
Add a note: where is the evidence, or who owns it?
Who owns Promoting Interoperability, TEFCA participation, and Cures Act compliance: a clinical informatics leader, or IT compliance?
Add a note: where is the evidence, or who owns it?
What is your total annual health IT spend (licensing, implementation, consulting, cybersecurity, analytics, AI subscriptions), and can you produce it as a single figure?
Add a note: where is the evidence, or who owns it?
When did your Diagnostician (CMIO or equivalent) and CFO last sit in the same room with a single joint agenda?
Add a note: where is the evidence, or who owns it?
Is documentation governed as a clinical instrument or a billing instrument?
Add a note: where is the evidence, or who owns it?
If a payer's denial pattern shifts tomorrow, who is responsible for diagnosing the cause within 30 days?
Add a note: where is the evidence, or who owns it?
A reflection tool from the book, not a validated diagnostic test or benchmark. Your answers and notes stay in this browser unless you choose to send them. Please don't enter patient information.
Reimbursement is not a function of what was done. Reimbursement is a function of what was documented.
The Diagnostician, Chapter 3