As home health leaders continue to identify areas where artificial intelligence (AI) is most beneficial to their businesses, some are beginning to use these tools to ease the time burden of their results and assessment information sets (OASIS).
Payments and outcomes are directly affected by OASIS data collection, and accurate OASIS data collection is essential for home health providers. However, for many clinicians, data collection for OASIS can be a major problematic point due to its complexity and time requirements. Providers looking at AI-powered tools report “dramatic” efficiency gains. Still, experts should note that some “fine tweaks” are still being made before the technology reaches its full potential.
“Oasis is probably one of the more complicated admission documents after the acute phase,” David Jackson, CEO of Choice Health at Home, told Home Health Care News. “There are hundreds of questions surrounding a patient's condition. This is a document that is done to all patients and can take up to three hours for more complex patients. Generally, most organizations allocate two to three hours for assessment and documentation.
The Tyler, Texas-based option offers home health, hospice, home care, palliative care and rehabilitation services in Arizona, Colorado, Kansas, Nevada, Oklahoma, Texas and Utah.
Beau Sorensen, Chief Operating Officer at First Choice Home Health & Hospice, noted that errors can be very easy to generate because of the vast amount of information clinicians have to capture.
“Most clinicians are paid per visit or on a pay basis, so from a personal perspective, it makes sense to them by saying, 'Let's get through this as quickly as possible,'” he told HHCN. “Things tend to fall on the roadside afterwards, so don't get caught in a really effective way.”
Founded in 1996, Utah's First Choice Home Health & Hospice serves the Wasatchfront area. In addition to providing core home health and hospice, providers offer a variety of Medicare Part B services, including outpatient therapy and laboratory services for Clinical Laboratory Improvement Modification (CLIA).
Last year, attendees at Medbridge Webinar were voted for the OASIS Data Collection Strategy. Of the 160 respondents, only 1.3% described themselves as “very confident” in the accuracy of OASIS data collected at their agency and “very confident.”
The decision to implement AI tools for OASIS management for home choices was an opportunity to enhance best practices regarding the process.
“As with the implementation of (Electronic Medical Records) (EMRS) more than a decade ago, when we evaluated the use of AI around OASIS documents, we have the opportunity to make best practices more specific,” Jackson said. “We thought, 'This will enable best practices at a clinical level and allow for better care.' ”
How providers use AI for OASIS
Currently, AI is used for 3,000 options for health in home care start-up visits. The company uses apricots that leverage generative AI and was created by Accentra Home Health and Hospice CEO Trent Smith.
Apricots create AI-drafted oasis forms using patient referral documents, drug lists, and more. However, Jackson said the tool is not a substitute for clinicians.
“It's not a decision for nurses, nor will it replace their decision,” he said. “We gather queues to nurses about decisions already made and guidelines for decisions found in the OASIS document. It dramatically reduces documenting time. The goal of AI is to increase the ability of nurses to make good decisions and reduce barriers between nurses and patients.”
Similarly, implementing AI tools helped clinicians choose the first time it took to complete the OASIS process. The company uses Olli Health, an AI platform that handles home health coding and OASIS reviews.
The tool reviews documents received from First Choice Home Health & Hospice referral sources and identifies the most important information before summarizing it for clinicians. The platform also checks for inconsistencies. Once they find them, they will alert their clinicians and offer suggestions to their agents.
The company also uses Enzo, an AI documentation tool that is at home health-focused.
The future of AI in the oasis
Sorensen believes Oasis is one of the best use cases for AI.
“It's really made for artificial intelligence,” he said. “You can read these documents very quickly and gather all the insights you need to get out of them, and even adopt what clinicians belong to those documents and can't gather them and provide recommendations.
Despite the great benefits, there is still work to do to maximize the possibility of OASIS' AI use. For example, Jackson noted that current EMRs used by home health providers are not always equipped to incorporate AI tools.
“These systems were built before AI implementation, so we're working on ways to embrace this new technology,” he said.
On his part, Sorensen explained that AI is not entirely error-preventing.
“There are still some tweaks in the intake document that need to be made,” he said. “You can sometimes elicit diagnostics that aren't necessarily correct. These packets are so large that you can elicit primary diagnostics that were previously primary, but in reality they are not the main reason for home health. You can then jump to that point in the documentation, as you're highlighting where you get those diagnostics.”
Ultimately, Jackson believes that OASIS's ROI for investing in AI is a global improvement in patient and clinician experience.
“It improves the quality of our clinical and the lives of our clinicians, lowers barriers between patients and patients, and improves the clinicians' experience of valuable ROI,” he said.
