Venturing into outpatient CDI – a growing trend

May 31st, 2016 / By Ann Chenoweth, MBA, RHIA, FAHIMA

We see it everywhere: AHIMA and ACDIS are offering education programs to help their members embark on the outpatient CDI journey. Consulting firms and technology companies are launching new services and solutions to support expansion of CDI programs to outpatient and physician settings. And healthcare executives are investing in resources to ensure documentation across the care continuum is accurate, complete and tells the patient’s full story.

What is driving this trend? 

As we all know, the healthcare industry is experiencing a dramatic shift toward the use of risk-based agreements and population health management.  The acceleration of value-based models such as bundled payment is requiring cross-continuum relationships to deliver more coordinated care, improve patient outcomes and monitor organizational performance.  There is an increasing awareness that accurate data and information is a critical foundation for reform 

According to a recent ACDIS survey, “Expansion of clinical documentation improvement to outpatient and physician services: A growing trend,” which was conducted in partnership with 3M Health Information Systems and released last week, over 10 percent of the 500 health systems surveyed indicate they will be implementing CDI in the outpatient and/or physician practice setting over the next 12 months.  This is a notable increase over the single digit growth we have seen in previous years. 

Perhaps the most compelling survey results are the anticipated objectives of re­spondents’ outpatient CDI programs. 60 percent say they will focus on improving documentation accuracy, while 51 percent say they will focus on obtaining documentation to support the proper level of care (i.e. inpatient, outpatient or observation).  Almost one quarter of the respondents cited the need to strengthen documentation to support revenue improvement associated with Hierarchical Condition Categories (HCCs).

Lisa Lanier, 3M Con­sulting Services senior manager, is not surprised by the survey results. She notes, “Health systems are now looking for information to help them identify opportunities and get started in outpatient record reviews. Outpatient CDI, though different and challenging, is the next logical step for a CDI program.”

As an HIM professional, I am excited to see the industry embrace the need to improve the quality of documentation and coding outside of the acute care inpatient setting.  The need for documentation quality does not begin when the patient is admitted.  Physicians who document well in outpatient settings and in their practices help establish a baseline for patient severity and medical necessity.  By telling the patients story – regardless of care setting – we can enhance care coordination, enhance patient care and improve the health of the populations we serve.

Ann Chenoweth is Director of Industry Relations for 3M Health Information Systems.