Clinical coders in push for national AI guidelines

The Health Information Management Association of Australia is leading the way in setting up a taskforce to guide the process.

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The Health Information Management Association of Australia (HIMAA) put the call out last week for interest from the sector in setting a course for the role of AI in clinical coding. 

Within days, HIMAA CEO Sallyanne Wissman had received some 70 expressions of interest, with almost half of those wanting to join a taskforce that will develop a national industry guideline. 

The other half indicated their interest in being kept informed about the taskforce and its activities, Ms Wissman said.  

She said the establishment of the taskforce was an attempt to get on the front foot with how AI might be used in the future in clinical coding, an industry already facing significant workforce shortages. It was appropriate for HIMAA to lead this given it was the peak industry body, she said. 

“My view is, if we do nothing, then the technology solutions will dictate how AI will happen with clinical coding, as opposed to the industry hopefully having some influence,” she said. 

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“Things like, what are the parts of the coding process that are that are good candidates for AI, and what are some of the guardrails. 

“I think AI works best where it’s used in a complementary manner that is mindful of the importance of the human element of the expertise particularly around the [quality] assurance of clinical coding. 

“Clinical coding is dependent on the clinical documentation, and is a complex classification system with a set of Australian coding standards that aren’t easy to replicate.” 

The taskforce was announced as part of a national clinical coding workforce summit held by the HIMAA in Sydney last week. 

Ms Wissman said feedback from a consultation paper she published last year had put AI top of the list in terms of the key challenges that the workforce and industry were considering, including those working in the clinical coding and health information management sectors. 

“It’s been an issue for some time and know that there are different demands from the health sector itself,” she said. 

“Health service executives are wanting to know how they can use AI to address their workforce shortage around clinical coders. 

“It’s such an important function because it drives funding to the hospital sector, the acute care funding for both public and private hospitals.” 

There is already interest brewing, she says, with AI pilots underway in New Zealand, NSW and Queensland, and technology companies have “got various solutions that they are co-designing and piloting and things like that”.  

A number of those companies were invited to the workforce summit to provide updates. 

Given HIMAA’s position as the peak industry body representing the clinical coding competencies, practice standards, and workforce, HIMAA is facilitating an industry response to coordinate and facilitate the guard rails and guidelines for how AI should be applied to clinical coding. 

According to the Clinical Coding and AI Industry Taskforce expressions of interest document, it will be responsible for developing and publishing an Industry Guideline for the development and adoption of AI to the clinical coding process in Australia that considers: 

• Ethical principles to inform the deployment of AI for clinical coding.  
• Practical considerations for developing, purchasing, implementing, and monitoring AI tools for clinical coding. 

The taskforce will also steer industry consultation to inform the Industry Guideline. 

“The clinical coding process is a good candidate to have AI applied to it in contexts where there is full native digital inpatient clinical documentation,” the document states. 

“Activity is occurring that is being led by technology providers, in response to industry demand, to apply AI to the clinical coding process. There are many considerations to be considered in terms of people, process, and technology to produce accurate, reliable AI generated or enhanced ICD-10-AM codes in accordance with the Australian Coding Standards.” 

Expressions of interest in the taskforce close on 22 May. For more information see here.