CDI 2.0: Optimising CMI and risk-adjustment value through data analytics and provider education
Abstract
Accurate clinical documentation is vital for any healthcare facility. Documentation in the record plays a critical role in reimbursement, case mix index, risk adjusted quality outcomes, length of stay days, etc. The need for Clinical documentation improvement (CDI) specialists is high. In this article, we discuss the success we have had by transitioning from a traditional approach to capture severity reporting (CDI 1.0), which relies heavily on the concurrent review of medical records by the CDI team, to a patient population driven and provider focused approach (CDI 2.0).
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Author's Biography
Kalee Vincent , MBA, RHIA, CDIP, CCDS-O, CCS is a system enterprise clinical documentation improvement (CDI) educator at West Virginia University Medicine in Morgantown, WV. Kalee has 17 years of experience in the field of health information management. She works closely with physicians across the entire healthcare system, providing education in both group settings and individually, as needed. In addition to her years of coding and clinical documentation experience, she has also worked with the Heart and Vascular Institute (HVI) Research Division to provide expertise and support on the Medicare files in analyses.
Terrance Govender , MD, is the Vice President of Medical Affairs at ClinIntell and brings with him more than 20 years of clinical and healthcare management experience, the former being in the subspecialties of trauma surgery and emergency medicine. After leaving full-time clinical practice, he spent time in healthcare consulting, where he led the CDI practice of a large national consulting firm before joining ClinIntell. Govender has extensive experience with the development and implementation of several CDI programmes. He has successfully leveraged his clinical experience, business acumen and passion for data analytics to empower physicians to attain optimal severity-reporting data for their unique patient population via appropriate, accurate and compliant clinical documentation. Govender speaks frequently on the topic of severity reporting and believes that leveraging advanced analytics and data is the efficient way forward in a dynamic healthcare environment. At ClinIntell, Govender is responsible for product development and clinical content contributions, severity-reporting subject matter expertise and overall client success.
Citation
Vincent, Kalee and Govender, Terrance (2024, September 1). CDI 2.0: Optimising CMI and risk-adjustment value through data analytics and provider education. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 9, Issue 1. https://doi.org/10.69554/GXID3081.
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