Once an informal process that received significant attention at just a few hospitals; Clinical Documentation Improvement (CDI) is now the backbone of an organizations financial viability. Essential for patient safety, proper and accurate reimbursement, quality ratings and more, a strong CDI program will ensure documentation integrity – a key factor in the ICD-10 transition. Organizations that seek to improve the efficiency and effectiveness of their CDI programs will find that the rewards are immense. The benefits received by Florida Hospital stands testimony to this fact.
Healthcare IT News reports that Florida Hospitals implemented the CDI program in 2014 and by May 2015 and completed an expansion across eight affiliated hospitals. Pre 2014, the observed-to-expected mortality rates for the hospital stood well above the national average. According to the hospital this was due to gaps and errors in clinical documentation. Within a year of implementing CDI, the mortality rates were reduced by a whopping 48% – a result of accurate documentation of the disease acuity of the patients at the hospital. Today, the hospital stands in the top quartile of the industry average.
Florida Hospital aimed towards improving their case mix index by eight basis points through the implementation of more accurate and complete clinical documentation of care delivered to its patients. By fall 2015, the hospital’s case mix index basis points, which are worth approximately $2.5 million a year for the hospital, had risen to 1.88 basis points from 1.59. This increase in the case mix index basis points translated to an increase of $72.5 million in appropriate reimbursement.
In a nutshell, Florida Hospital reduced mortality rates by 48%, improved its case mix index, achieved ICD-10 compliance and increased its reimbursement earnings by $72.5 million – all due to its CDI program. According to the hospital, increased integrity of its clinical documentation, better accuracy and physician engagement are the reasons for their clinical and financial improvement.
This documentation initiative was driven by educating and engaging 20% or 2,200 medical staff at the hospital. Physician response rates to CDI clarifications stood between 87 and 92 percent.
Florida Hospital plans to expand their CDI program, using the framework to provide a more efficient workflow for their clinicians and clinical documentation specialists. Integrated into Cerner’s Document Quality Review platform, computer assisted physician documentation technology will provide physicians with automated CDI clarifications.
According to the American Health Information Management Association (AHIMA), “Successful CDI programs facilitate the accurate representation of a patient’s clinical status that translates into coded data. Coded data is then translated into quality report cards, physician report cards, reimbursement, public health data and disease tracking and trending.”
Florida Hospital would agree with that.