National Study of Clinical Documentation Improvement Leaders Finds Measuring Financial Impact for Their Provider Organization is Most Important Metric of Success

ACDIS survey, sponsored by Iodine Software, examines what defines CDI program success, how CDI leaders view their team's value, and what aspect of their program they would eliminate.

Leading enterprise AI software provider Iodine Software today announced a national study of clinical documentation improvement (CDI) leaders that uncovers a number of key insights about how they view their roles and define CDI program success. The survey was conducted by the Association of Clinical Documentation Integrity Specialists (ACDIS) and sponsored by Iodine Software.

CDI programs are a critical component of every healthcare system's revenue-cycle team, where clinical resources review medical record documentation for completeness and accuracy. 

Accurate and complete documentation is proven to increase earned reimbursement and reduce compliance risks for healthcare systems. If the clinical documentation is incomplete or unclear, CDI specialists query the provider prior to final claim submission to ensure accurate and complete billing, reducing costly and cumbersome issues that can arise during claims adjudication.

Given the ongoing revenue challenges presented by COVID-19 and other market forces, the study was conducted to understand how to best support CDI leaders as they manage their teams. 

The 2022 ACDIS CDI Leadership Council CDI Programmatics survey, which included surveys of 222 CDI leaders, found that nearly all CDI leaders (91%) track financial impact as a measure of departmental success, followed by 68% who use severity of illness (SOI) / risk of mortality (ROM) impact, and 53% who consider the observed-to-expected mortality rate. An additional 28% think observed-to-expected patient length of stay is an important metric that demonstrates CDI program success.

Additional key findings in the study include:

Measuring the Effectiveness of CDI Programs
According to the study, the four most-popular measures that identify CDI program effectiveness are:

  • query rate (81%) 
  • response rate (79%) 
  • review rate (77%) 
  • agreement rate (68%)

Most CDI Leaders Feel Valued - But Not All
Eighty-four percent (84%) of CDI leaders report that their program is valued internally by their hospital administrations; however, approximately one in 10 felt undervalued (~11%). In a recent virtual panel discussion, CDI leaders discussed why communicating the value of the CDI team is important. Additionally, these leaders indicated a need to support the CDI team by providing personal feedback to individual team members and department score cards that highlight achieved outcomes.

Optimizing Performance: CDI Leaders' Challenges to Achieving Top Performance
Respondents to the ACDIS survey reported that the biggest barrier to their CDI team reaching peak performance is a lack of staffing resources (36%), followed by physician engagement challenges (22%) and a lack of technology resources (18%). An additional 9% felt that organization priorities are not aligned properly. 

Staffing challenges have persisted in the CDI profession, as workforce shortages, budget gaps and fierce competition for talent continue to plague the industry. Physician engagement also has historically been a challenge for CDI, because stretched providers often experience significant administrative burdens that result in frustration and burnout. In recent years, physician query and AI-driven CDI tool platforms have played central roles in supporting CDI team performance to drive greater efficiency, reduce workload and drive provider engagement.

Supporting CDI to Work More Efficiently: What CDI Duties Are Most Cumbersome?
While CDI is critical to the financial health of every healthcare system, the role can include extremely tedious tasks that contribute to CDI burnout. In the ACDIS leadership survey, CDI leaders outlined what aspects of the workflow they would eliminate if they could. The number-one responsibility named varied greatly and included, in order:

  1. 49%: Wasting time reviewing cases without opportunity
  2. 20%: Tracking down physician responses
  3. 9%: Working DRG predictions

To help reduce the burdens presented by these and other listed duties, many CDI leaders are implementing in-house and third-party technology solutions that better engage providers and identify a prioritized worklist of cases to review. These CDI tools also leverage new technology that automates and augments clinical human resources and are becoming increasingly important as more work is performed virtually instead of within hospital walls.

"Based on our experience working with nearly 1,000 of the top hospitals in the U.S., Iodine Software deeply understands the market forces affecting the CDI industry, so we know they are under pressure to work more efficiently and capture more earned revenue for a hospital's bottom line," said Iodine Software Co-founder and CEO William Chan. "This study reinforces the need for AI-backed solutions that augment the great work that CDI specialists perform every day."

ACDIS discussed the study's findings with participants from dozens of provider organizations in September. The full report also is available to download.

About Iodine Software

Iodine is an enterprise AI company that is championing a radical rethink of how to create value for healthcare professionals, leaders, and their organizations: automating complex clinical tasks, generating insights and empowering intelligent care. Iodine's powerful predictive engine complements the skills and judgment of healthcare professionals by interpreting raw clinical data to generate real-time, highly focused, predictive insights that clinicians and hospital administrators can leverage to dramatically augment the management of care delivery - facilitating critical decisions, scaling clinical workforces through automation, and improving the financial position of health systems. For more information, please visit iodinesoftware.com.

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Source: Iodine Software