4 Steps to Grow a CDI Program Out of Spreadsheets

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By Chetan Parikh

In the past year or so, few things have been more important than tracing incidents of COVID-19 to slow the spread and flatten the curve. Unfortunately, Public Health England neglected to record nearly 16,000 positive tests at the end of September 2020, when a computer system failed to accurately transfer complete Excel spreadsheets.

It’s a cautionary tale for clinical documentation improvement, or CDI, teams that still rely on accounting software for documentation, but the potential for catastrophic failure isn’t the only shortcoming of spreadsheets. Software like Excel requires manual entry, and switching between screens to input information saps valuable time. Spreadsheets also can’t ingest data from electronic health records in real time, allowing for limited reporting capabilities and reduced visibility into the performance of coders and CDI staff.

Because spreadsheets depend on manual input, they’re also highly prone to human error. Research from Gartner suggests that poor-quality data costs organizations an average of $14.2 million per year and that spreadsheets can be a major culprit. User tracking is nonexistent — making it impossible to validate the accuracy of data — and input discrepancies and formatting errors can compromise claim submissions. These problems will only worsen over time, because spreadsheets won’t scale as volume increases and information comes from multiple sources.

Surpassing the Spreadsheet

CDI-specific tools have taken off, and lots of advantages come having with a single source of structured data. By removing the need to switch screens, hospitals and coders effectively gain back productive time, and they can further augment that time with the implementation of AI and natural language processingto read patient charts and suggest codes. With the seamless flow of data from EHRs to the CDI tool, less manual entry is necessary, and it’s possible to track providers and staff performance in near real time.

All the advantages of a CDI solution sound attractive, but the best endorsement comes from the data. Black Book Market Research shows 90% of hospitals that implement CDI solutions increase revenue by at least $1.5 million, making a strong case for the technology’s value.

For organizations hoping to transition away from spreadsheets and realize the benefits of CDI software, there are four crucial steps:

1. Implement appropriate training measures

A new CDI program can be resource-intensive, and experienced clinical documentation specialists are hard to come by. That means an organization will need to implement training protocols to make the CDI initiative a success. Coach CDI staff in not just how to use the CDI tool, but also the benefits it can offer their workflows. Look to the American Health Information Management Association and the Association of Clinical Documentation Integrity Specialists for a wealth of training resources.

2. Earn buy-in and engagement from providers

The success of a CDI implementation is largely dependent on the education and engagement of the providers filling out documentation. Stress to physicians that the quality of documentation is a reflection of the quality of care, and have these individuals work one-on-one with clinical documentation specialists to improve their documentation and reduce workloads for those reviewing and correcting coding.

3. Rely on innovative technologies

In an unstructured form, healthcare data contains countless insights, but it takes valuable time to parse through the information and uncover them. CDI tools that utilize AI and natural language processing can correctly discern how components such as diagnosis codes, prescriptions, and body parts relate to one another, and the tools can even be taught to understand a provider’s own shorthand or abbreviations.

4. Define metrics and track performance

Technology is only useful when it accomplishes specific and measurable goals, and in healthcare, those goals should center on improvements in efficiency, quality of care, and the financial standing of hospitals. Establish KPIs to track the success of the CDI program, with metrics such as time necessary to code patient data, the productivity of individual coders, and the rate of claim denials.

Implementing a CDI takes a substantial investment of time and money, but it reaps dividends in the long run. To say hello to the “improvement” in CDI, it’s time to say goodbye to the spreadsheet.

Chetan Parikh is the chief executive officer of EZDI, which provides clinical data mining and analytics tools to healthcare providers. A certified Six Sigma Black Belt and serial entrepreneur, he is also a co-founder of Mediscribes.

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