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As home health leaders continue to identify areas where artificial intelligence (AI) can be most beneficial to their businesses, some are beginning to utilize these tools to reduce the time burden of the Outcome and Assessment Information Set (OASIS).
Payment and outcomes are directly impacted by OASIS data collection, making accurate OASIS data collection crucial for home health providers. Yet for many clinicians, OASIS data collection can be a major pain point due to its complexity and time demands. Providers who have turned to AI-powered tools report “dramatic” efficiency gains. Still, experts note that some “fine tuning” remains to be done before the technology reaches its full potential.
“OASIS is probably one of the more complicated admission documents in post-acute care,” David Jackson, CEO of Choice Health at Home, told Home Health Care News. “There are hundreds of questions surrounding a patient’s condition. It’s a document that’s done on every patient, and can take up to three hours to complete on a more complex patient. Generally, most organizations allot two to three hours for the assessment and documentation. For good reason, it’s a thorough document, and a full assessment of the patient’s health condition.”
Tyler, Texas-based Choice provides home health care, hospice, home care, palliative care and rehab services in Arizona, Colorado, Kansas, Nevada, Oklahoma, Texas and Utah.
Beau Sorensen, chief operating officer of First Choice Home Health & Hospice, pointed out that due to the sheer volume of information that clinicians have to capture, it can be very easy for errors to occur.
“Most clinicians are paid on a per-visit or salary basis, so it makes sense for them to, just from a personal standpoint, say, ‘let’s get through this as soon as we can,’” he told HHCN. “Then things tend to fall by the wayside, and don’t get captured in a way that is really effective.”
Founded in 1996, Orem, Utah-based First Choice Home Health & Hospice serves the Wasatch Front region. In addition to its core home health and hospice offerings, the provider delivers a variety of Medicare Part B services, including outpatient therapy and Clinical Laboratory Improvement Amendments (CLIA) laboratory services.
Last year, attendees of a Medbridge webinar were polled on OASIS data collection strategies. Of the 160 respondents, only 1.3% described themselves as “very confident” in the accuracy of OASIS data collected at their agencies.
For Choice Health at Home, the decision to implement AI tools for OASIS management was an opportunity to strengthen best practices around the process.
“As we assessed the utilization of AI around the OASIS document, similar to the implementation of [electronic medical records] (EMRs) over a decade ago, there’s this opportunity to make best practice more concrete,” Jackson said. “We thought about, ‘how can this enable best practice at the clinical level and improve care?’”
How providers use AI for OASIS
Currently, AI has been utilized for 3,000 Choice Health at Home start-of-care visits. The company uses Apricot — which leverages generative AI — and was created by Accentra Home Health and Hospice CEO Trent Smith.
Apricot creates an AI-drafted OASIS form using the patient’s referral document, medication lists and more. However, the tool isn’t a stand-in for clinicians, according to Jackson.
“It doesn’t make decisions for the nurse, and it doesn’t supersede their decisions,” he said. “It will cue the nurse around decisions they’ve already made, and the guidelines around the decisions that are in the OASIS document. It drastically reduces the documentation time. Our goal with AI is to enhance the ability of the nurse to make good, sound decisions and decrease barriers between the nurse and the patient.”
Similarly, implementing AI tools helped First Choice Home Health & Hospice cut down on the time it took clinicians to complete the OASIS process. The company uses Olli Health, an AI platform that handles home health coding and OASIS review.
The tool reviews documents received from First Choice Home Health & Hospice’s referral sources and identifies the most important information before summarizing it for the clinician. The platform also checks for inconsistencies. Upon finding them, it alerts the clinician and offers suggestions for the agency.
The company also uses Enzo, a home health-focused AI-documentation tool.
AI’s future in OASIS
Sorensen believes that OASIS is one of the best use cases for AI.
“This is really something that is tailor-made for artificial intelligence,” he said. “It can read these documents very quickly and glean all the insights that it needs to get out of those documents. Additionally, it can take things that are just not seen by the clinician that might be in those documents, gather that together, and offer a recommendation. It dramatically reduces the time that’s needed for those reviews, as well as for the clinician themselves.”
Despite the major benefits, there is still work to be done to maximize the potential of AI utilization for OASIS. For instance, Jackson pointed out that the current EMRs that are used by home health providers aren’t always equipped to incorporate AI tools.
“Those systems were built prior to the implementation of AI, so they’re grappling with how to embrace this new technology,” he said.
On his end, Sorensen explained that AI isn’t completely error-proof.
“On the intake documentation, there is still some fine tuning that needs to be done,” he said. “Sometimes it pulls diagnoses that are not necessarily the right one. Because these packets are so large, it may pull in a primary diagnosis that used to be the primary, but it’s actually not the main reason why they’re on home health. It does then highlight where it’s getting those diagnoses, so you can jump right to that point in the document.”
Ultimately, Jackson believes that the ROI on investing in AI for OASIS has been the overall improvement of the patient and clinician experience.
“It’s enhancing the clinical quality and the lives of our clinicians, and that it’s dropping barriers between them and the patient, and improving the patient, clinician experience that ROI is priceless,” he said.
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