The Clinical Documentation Improvement (CDI) industry has been transformed by new technologies since its inception in the mid 2000s. Today, CDI nurses act like air-traffic controllers with sophisticated software systems at their fingertips, quickly scanning, identifying and resolving opportunities for clinical documentation improvement within thousands of patient charts. The days of walking the floors with a stack of paper sticky-notes and chocolate bars are pretty much gone.
With new technologies available, hospitals are expanding CDI coverage, as they struggle to accurately and consistently translate care provided into diagnostic coding terms necessary for proper payment and publicly reported quality outcomes. Hospitals lose significant reimbursement dollars when physician documentation is not consistency and quickly clarified for coding purposes.
Along with having to earn their due twice over, hospitals are reacting to new and intense marketing pressure. Patients are demanding greater transparency in healthcare. Armed with physician report cards and hospital quality scores, they make decisions based on hospital and physician rankings, rather than their primary care doctor’s referral.
In 2020, CDI will become even more responsible for the hospital’s sustainability. As a result, hospitals will continue to invest in CDI technology to capture full reimbursement for services and ensure publicly reported coded data tells a story of excellent care. As thea leader in mobile query platforms, we see the following trends propelling the CDI industry forward:
1. CDI prioritization
At Artifact Health, we are seeing hospitals and health systems combine our mobile physician query solution with CDI prioritization tools. Together, these tools become powerful success drivers for CDI programs by guiding record review selection, identifying high-value query opportunities and ensuring queries are answered quickly and 100% of the time. CDI prioritization will continue to grow in 2020 helping drive greater efficiencies at hospitals and health systems.
2. Outsourcing of physician query templates
Increasingly, health systems are moving away from developing and maintaining their own physician query templates. Instead, they are opting to outsource standardized template libraries that can be shared electronically across CDI and coding staff. Artifact Health formed the first alliances to provide expert-reviewed and maintained template libraries for mobile query delivery with the American Health Information Management Association (AHIMA) and HCPro. AHIMA and HCPro’s Association of Clinical Documentation Integrity Specialists (ACDIS) together set industry guidelines for compliant clinical documentation querying and have developed extensive template libraries formatted for mobile query delivery.
3. Outpatient CDI
CDI will continue to expand into outpatient areas in 2020. With mobile physician query delivery, we’ve noticed more CDI specialists working remotely and spending less time on patient floors. This workflow shift in itself is a growing trend. Now, hospitals can more easily scale CDI into outpatient areas. Further, as hospitals and health systems learn to succeed under risk-based population health models, they must expand CDI programs into outpatient to optimize reimbursement.
4. Importance of physician engagement in CDI
Hospitals will continue to place physician burnout high on their priority list, especially around technology and EMR usage. Physicians typically find responding to documentation clarification queries burdensome, taking on average 10-15 minutes to answer one query. Making it fast and easy for physicians to respond to queries is a logical step toward addressing burnout and engaging physicians in CDI initiatives. Artifact Health customers report increased physician satisfaction with the speed and ease of mobile query delivery.
In 2020, we predict the CDI industry will continue to grow with advanced technologies as hospitals and health systems close the gap on missed opportunities for full reimbursement and accurately reported quality outcomes. Further, provider organizations will rely more heavily on CDI expertise as they adopt value-based programs that require them to tell the patient story correctly to justify quality care and reimbursement.