A New Era for Clinical Coding: Navigating Change in the Face of a Global Pandemic

As dawn broke on 2020, the UK’s clinical coding departments were running like well-oiled machines, bustling offices filled with activity, and the sound of keyboards clicking away. The industry was poised on the brink of a new decade, ready to embrace the proposed changes, including the implementation of autocoding, SNOMED CT, and ICD-11. Classroom training for clinical coding and exams were scheduled, booked, and eagerly anticipated. The concept of remote working was still somewhat novel, a luxury afforded to a select few.

Then, in a flash, the world as we knew it was irrevocably altered.

The Unforeseen Catalyst: Global Pandemic and its Impact on Clinical Coding Industry

When the global pandemic struck, it shook the foundations of both our personal and professional lives. The impact on the coding industry was profound and far-reaching. Offices, once buzzing with activity, were now deserted, transformed into ghost towns overnight. The once ubiquitous paper medical records became potential health hazards, fueling an urgent shift towards fully electronic healthcare records (EHR) systems. The traditional model of clinical coding exams and classroom training was abruptly disrupted, forcing trainers and examiners to adapt quickly, seeking out more innovative, online, and cost-effective solutions.

Remote Revolution: Transition and Adaptation in the Clinical Coding Landscape

In hindsight, the transition to a remote clinical coding industry, though daunting at first, has proven remarkably smooth. This unexpected shift prompts a question – why wasn’t this approach considered feasible earlier?

As we adapted, we began to see silver linings. Many coding managers reported a surge in productivity, a decrease in absenteeism, and a boost in morale, particularly among those who appreciated the newfound flexibility (parents of young children, we see you!). Remote working also brought financial benefits for many, with savings from reduced commuting and the luxury of more time for personal pursuits, from hobbies to honing their culinary skills.

The shift to online platforms like Microsoft Teams for clinical coding training and the prospect of online exams in 2021 provided a beacon of hope in a challenging year. The shift to remote working also broadened horizons, enabling NHS coding managers to cast a wider net, drawing in high-calibre coders from across the UK who were previously inaccessible due to geographical restrictions.

The Flip Side of Remote Work: Mental Health and Connection Challenges in Clinical Coding

However, it wasn’t all smooth sailing. The seismic shift in working conditions took a toll on mental health, an issue that has been increasingly spotlighted across various industries. The solitary nature of clinical coding was exacerbated by the lockdown, and many coders reported feeling isolated and disconnected from their teams. While some managers and clinical coders addressed these concerns proactively through weekly well-being checks, WhatsApp groups, and regular virtual team meetings, many are yet to fully adapt to this new challenge.

Operational Impact: The Pandemic’s Influence on NHS Trusts and Clinical Coding Contracts

The pandemic also had a profound operational impact, particularly following the directive from NHS Chief Executive Simon Stevens and NHS Chief operating officer Amanda Pritchard on 17th March 2020. The directive stated that all NHS trusts were to be placed on block contracts from April-July 2020, later extended to March 2021 due to a resurgence in infection rates. This had significant implications for the coding industry.

The once prevalent Payment by Results (PbR) approach has now faded into the annals of history. The shift has sparked questions about the future of coding – are trusts losing interest in the financial implications of coding? Has our profession’s importance been diminished? These are questions only the Clinical Commissioning Groups (CCGs) can answer. Has coding’s role been demoted to merely data input for data warehousing and trend analysis? It’s clear that the pandemic has shifted the industry’s focus.

As we look ahead to the return to offices, conduct training in classrooms, and administer exams in-person, there’s hope that the industry will retain the lessons learned during the pandemic, embracing technology and the benefits of flexible work arrangements and blended training approaches.

The Continued Relevance of AI Clinical Coding and SNOMED in a Post-Pandemic Landscape

The advent of AI clinical coding and SNOMED, discussions that have been ongoing since my early days as a trainee, take on new significance in the light of recent events. As trusts transition to fully or ‘paper light’ electronic patient record (EPR) systems, the focus shifts to realizing the potential of mapping terminology to classification codes.

The clinical coding industry is charting a new course, driving towards more robust reporting and clinical systems. This shift is part of a broader national strategy, aiming to implement systems like SNOMED across multiple healthcare providers. Though the journey is gradual and the path fraught with challenges, the unique skill set that clinical coders bring to the table makes them ideally equipped to navigate the future, no matter what it holds.

Concluding Thoughts: Pandemic Lessons and the Promise of the ‘New’ Normal in Clinical Coding

In conclusion, the COVID-19 pandemic has transformed the clinical coding industry in unexpected ways. While the journey has been challenging, it has also provided opportunities for growth, adaptation, and innovation. As we move forward, it’s clear that the lessons learned during this time will shape the future of the industry, helping us better serve healthcare providers and, ultimately, patients. The ‘old’ normal may be a thing of the past, but the ‘new’ normal holds promise and potential for even greater advancements in the field of clinical coding.

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