How CDI Can Save Your Healthcare IT Clients Money

By Megan Williams, contributing writer

If you’re looking for a way to provide some very straight forward benefits to your clients’ revenue, clinical documentation improvement (CDI) is one of your best bets, and an example from a rural, Northern Arizona hospital could help change their minds about the potential CDI has for their facility.

Summit Healthcare Regional Medical Center implemented a CDI program, run by a team of nurses, that saved the facility $550K and the implementation and results are detailed at Health IT Analytics.

The Facility

Summit is an 89-bed facility that cares for about 90,000 patients, some of which come from Native American reservations. Changes in Medicare and RACs drew new attention to their need for understanding issues around their revenue cycle, so they started building a CDI program from the ground up. Registered nurse Mandy Rogers, a floor nurse, and her partner, an audit nurse who had also been in the position for 40 years, took on the project.

Rogers tells Health IT Analytics, “At the moment, we are half paper and half electronic, which is really frustrating. We have doctors that dictate reports to be transcribed. We have doctors that handwrite them in the charts still. So, we are all over the place. We do part of our review at our desks, and then we go to the floor with laptops and we review the rest of the charts that are hand written. It quickly became clear that we needed some kind of electronic way to do this, because the manual recordkeeping was awful. It took forever, and it was really hard to do. We are excited about the day when everything will be dictated and we won’t have to do that.”

Selecting A Vendor

Summit had a difficult time finding a vendor that was willing to take on a facility as small as they were, but ended up finding, and signing with one that gave them enough support and that would allow them to drive forward toward their improvement goals. Rogers says, “One of the things that we hit pretty hard at first was what changes to the documentation were going to change our DRGs [diagnosis-related group]. What was going to get us a major complicating condition (MCC)? We focused on those things and really just did the rudimentary queries about things like pneumonia. What kind is it? That changes your DRG this way or that way. So, we really just focused on that.”

Results

Summit is happy with the results. In the first year alone, the hospital case mix has increased by an average of 20 percent. MCC capture has increased by 37 percent and the complicating condition (CC) capture in turn is up by 22.8 percent. That all translates to a savings of $558,187 in those few months.

Their administration, of course, was quite pleased according to Rogers, “Our administration and our board have been really good about supporting our CDI work. We knew that we when you’re growing a CDI program, it’s incredibly important that you show how your efforts are working so that your executive leaders will continue to pay for the program. So we really needed a reporting mechanism to be able to do that. We showed those good results right off the bat, and they’ve been happy to continue putting money into it.”

Some highlights around Summit’s CDI work,

• It focused on ICD-10, a pain point for the facility
• It kept doctors’ needs in mind and focused on easing their frustrations
• Training and implementation prioritized strong communication

Read more on the details of the money-saving, Summit CDI implementation here.