HCC Engage

Introduction

Hierarchical Condition Categories (HCCs) are a methodology for assigning payment value to chronic conditions. The payment value is based on a risk adjustment factor (RAF) being assigned to each of a patient’s chronic conditions included on a billing claim in a calendar year. The provider must also have supporting documentation for all billed conditions showing they are Managing, Evaluating, Assessing, and Treating all reported patient conditions. This can be referred to as having “MEAT criteria” documented.

HCC Engage is a Natural Language Understanding (NLU) application focused on automatically identifying the most common documentation opportunities in the outpatient setting at time of documentation capture. By providing real-time feedback to physicians, HCC Engage aims to improve quality of clinical documentation and reduce the number of concurrent and retrospective (coding) queries by educating physicians of the documentation requirements at the time of report creation. Feedback will be based on the content of the current document being created.

Getting Started

To get started, you must install Fluency Direct (FD).  Click on the FD Icon to open the application.

FD11 DesktopIcon

Signing In

If you are signing in for the first time or if you have signed out, the Control Bar will be available for you to sign in.  Enter your Login Name and Password and click the Sign In button to access Fluency Direct. 

FD11 ControlBar SignIn

Clicking the Forgot Password link will open a web page asking for the user's email address. Once entered, they can click the Send account Details button and they will receive an email that includes their Username, Account, and User Type along with a link which will allow them to reset their password."}Forgot Password?

  FD11 ControlBar SignIn ForgotUsernamePassword  

When logging in for the first time, or if you have requested a password change, you will receive a notification and the application will prompt you to change your password.  This does not apply to all users and is dependent on your configuration.  

To change your password, you will be prompted to enter your current password.  You can then enter a new password and confirm that password.  As you enter your password, the Password Requirements will confirm that they are met.  You can then click Save to change your password.

FD11 ChangePassword

Signing Out

Sign Out - Log out of Fluency Direct using the Sign Out option; this option will not exit the application, it will remain running on your desktop but you will no longer be logged in. 

Quit - To exit the application completely (the Control bar will no longer be available on your desktop), select Quit from the Control Bar menu. When you start the application the next time, you will remain signed in. 

Sign Out and Quit - To log out of the application and close it, select the Sign Out option, then select the Quit option.  This will ensure that no other user can login as you. 

 

Workspace

When you open Fluency Direct (FD) you will see the Splashscreen, which also displays the version number that you are running in the lower left corner. You can check this at any time by going to Help > About.

FD11 Splashscreen

FD Control Bar

After opening the Fluency Direct application, the Control Bar will appear on the desktop.

FD11 ControlBar

You can drag the Control Bar to any location on the screen, or you can dock it on any edge of the screen, whichever you prefer. To dock the Control Bar, click and drag to a screen edge (the screen edge will become highlighted when you near it). Drop it where you want the Control Bar to be docked. Fluency Direct will remember the location of the Control Bar and will open in the same position each time you log in.

Ribbon

The Ribbon on the Control Bar is where interactions will occur. The number indicates how many messages are available.  

Engage11 ribbon

New messages will accumulate in real time as they are triggered based on the physician's documentation. A status indicator will notify the user if messages are up to date or currently being processed. Messages can be viewed in two different ways, in the "Drawer" or "Sidebar."

CAPD Drawer

Click the Ribbon to view the available cards. The drawer can be used with the Control Bar in floating, docked, or micro mode. The Drawer can be closed by clicking the ribbon or arrow at the bottom of the drawer.

Engage 11 drawer hcc 11.4 capd drawer

 

Using HCC Engage

After you sign into Fluency Direct, the control bar ribbon will display a check mark indicating a good connection. Once you select a patient, that patient's identifying number will show in the control bar.

Once you sign into Fluency Direct, the control bar will display your name and a ribbon along the left-hand side.

In FD 11.1 and earlier, if there are messages, the ribbon will be red and the number displayed shows how many cards are in the drawer.

Engage11 ribbon

If there are no messages, the ribbon will be gray and will display a white check, (see the illustration below).

In FD 11.2 and later, the ribbon has three states.

Engage11 ribbon check

Your messages are up to date. There is no new information for you to act on.

Engage11 ribbon bell

You have new messages to act on. These include, but are not limited to, NLU/AI-generated nudges in CDI or On-demand Provider Notifications in HCC. In general, this is lower-priority information that was computer generated and not communicated by a human being.

Engage11 ribbon bell ring

You have new High Priority messages to act on. These include, but are not limited to, queries sent by a CDI specialist or human-generated provider notifications in HCC.

FD will periodically check for new messages. The presence of three animated dots below the checkmark or bell icon indicates this action.

Click the ribbon to expand the drawer and see the cards for each message.

Cards in the drawer may have a red stripe down the left-hand side.

  • Cards without a stripe contain content from the NLU/AI. This includes the On Demand Provider Notification. These cards will also display a "hollow" bell icon on the ribbon. Note: You can configure the ODPN to generate a card with a stripe. Contact your 3M Support representative to configure this option.
    hcc 11.9 non priority content
  • Cards with a stripe contain high-priority content, that is, content created and sent by a human.
    hcc 11.9 priority content

To dismiss a card from the drawer, click the X in the upper right-hand corner.

hcc 11.6 dismiss message2

Using the HCC Review

The top card in the drawer will be the HCC Review. This card will list any suggested diagnoses, suggested billing diagnoses, or any missing supported evidence for indicated diagnoses.

hcc 11.9 non priority content

Hover over each line in the card to show a balloon explaining that particular piece of content.

hcc 11.6 review explanation2

NLU will identify conditions as well as evaluate whether or not evidence of treatment (i.e., MEAT criteria) is also documented. Additionally, the NLU may detect documentation of an ICD-10 diagnosis that qualifies as an HCC. These conditions do not require additional evidence or MEAT criteria be documented.

For a complete list of conditions, please see HCC NLP Content.

When you click the heading, you see a menu with options:

hcc 11.6 review options3

  • Insert list at cursor location: Inserts the list of diagnoses where the cursor is located in a document.
  • Insert list with codes: Same as above, but the insertion includes relevant HCC codes.
  • Copy diagnosis list: Copies the list of diagnoses to the clipboard.
  • Copy diagnosis list with codes: Same as above, but includes relevant HCC codes.
  • Dismiss all from summary: Removes all suggestions for that heading from the HCC Review card.

Viewing HCC Review details

To view complete HCC Review details click Show supporting evidence.

At the top is the demographic information for the patient, including name, MRN, age, sex, MRN, and encounter number (if known). Below the demographics are two tabs.

The first tab will be a note or comments from the HCC auditor. This text is not editable, but does include a link to the AAFP reference site for use.

hcc 11.6 evidence auditor

The second tab is the evidence found in the documentation by NLU to support the information displayed in the HCC Review card.

hcc 11.6 evidence documentation

Click each entry in the Diagnoses panel to see the highlighted evidence supporting the finding.

When you are finished, click Close.

Additional cards

Depending on the NLU results, other cards may be displayed for the patient. In each case, you can click the details icon (the question mark) to view the details of the finding.

hcc 11.6 other evidence

Some cards will allow you to make changes directly to the documentation.

To update the documentation:

  1. Select an option from the list presented.
  2. Click Update.

The change will be made and the card will disappear. If you want to ignore the recommendation, either dismiss the card or click Ignore.

Other cards may display information for your reference. Again, you can click the details icon to view the evidence associated with the card or click the X icon to dismiss it.

Explicit mention of HCC

Purpose: For a complete list of conditions, please see HCC NLP Content.

How to send feedback

If you have a question, have suggestions or problems regarding HCC content, or are experiencing a technical issue, there is a way to provide feedback directly to M*Modal.

hcc 11.4 send feedback

To send feedback:

  1. Click on the control bar (on your name) > Help > Send Feedback.
  2. Choose the type of feedback you want to send.
  3. Enter the information for your selected type of feedback as requested.
  4. Some types of feedback ask if someone can contact you if additional information is needed. If you are willing to be contacted, select Yes.
  5. Click Send.