CDI External Auditing

donna.kentdonna.kent
in CDI Talk Archive
Please share opinions regarding companies doing CDI audits. Consultant groups okay, but I'd like to know about groups that are not just trying to sell a product and feel the need to teach advanced CDS starting from ground zero.

Comments

  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited May 2016
    Perhaps you could clarify what you are looking for -- "teach advanced CDS starting from ground zero"

    I think you may be asking for at least 2 different things --
    developing a competent CDS
    vs teaching & mentoring a competent CDS to reach levels of expertise & advanced practice.
    (Additionally, are you coming from the individual CDS perspective vs a CDI program perspective?)

    Also, please further define what you intend by "CDI audits". Are you looking for a random selection of cases &/or queries reviewed with feedback? Lecture styled presentations that focus on both clinical and coding knowledge? One on one real time mentoring and professional development? Program level evaluation & guided development?

    Are you an individual CDS? or a leader of a CDI team?

    There are a variety of companies (a couple I've had direct experience with) that offer all of the above services, but no one company that necessarily offers everything, especially if you do not want a company that is selling a 'product'. I think what you may have intended was a company focused on the agreed upon outcomes & not so much on delivering elements, tools or product and any shortfall in the learning & development is of less importance.

    Don

  • donna.kentdonna.kent
    edited May 2016
    As usual Don, your answer is full of wonderful detailed data elements.
    Helps me think through my own query. We have a CDI team that has been
    up and functioning since fall 2009. Our productivity shows a huge leap
    in improvement, charts reviewed, queries placed, high percentage agree
    rate and significant decrease in no responses. At the same time our CFO
    feels the CMI is not getting as high as it might be. While I agree, I
    also know without question that restrictions we face such as paper based
    queries and extensive travel time between access to our data storage
    CDIS & grouper and the place where we actually review the hybrid record
    impedes our our workflow tremendously. Senior leadership does not yet
    have a real appreciation for that.

    Their solution is to have a group come in to audit our process as well
    as accuracy. I'm not opposed to the audit for process at all. In fact,
    it would probably help. However, it would not be appropriate to have a
    group come in to teach the CDSs the need for a query on urosepsis vs.
    sepsis or specificity regarding heart failure, etc. That is what one
    group suggested at their recent demo. Their product seems to be a
    package deal. So I am looking for others that can actually help improve
    a fairly well functioning CDI program.

    Donna Kent, RN, BSN, CCDS
    Manager, Clinical Documentation Integrity Program
    Clinical Quality and Accreditation
    Torrance Memorial Medical Center
    ph.:310 784-6884 fax:310 784-6899
    donna.kent@tmmc.com

  • Unknown
    edited May 2016
    Have you heard of The Advisory Board Company? Not sure if they are "selling a product", but I listened to a webinar presented by this company which I found very helpful. They specifically spoke to reinvigorating existing programs that may have plateaued.
    Has anyone else worked with them?

    -Jane

  • mdomineseymdominesey
    edited May 2016
    Many hospitals already have established relationships with the Advisory Board. They indeed are selling their consultancy services for CDI in addition to the other services they sell.

    I listened to likely the same one you did and found it to be very helpful. I am meeting with them this week for a discussion about what they can do for my hospital. They are responsive to emails and phone calls if you would like to set up a similar phone meeting.

    Ark



    Mark N. Dominesey, RN, BSN, MBA, CCDS, CDIP
    Sr. Clinical Documentation Improvement Specialist
    Sibley Memorial Hospital

    Information Technology
    5255 Loughboro Rd NW
    Washington DC, 20016-2695

    W: 202.660.6782
    F: 202.537.4477


    http://www.sibley.org


  • Unknown
    edited May 2016
    Mark,
    Is there a fee for this service?

    Jane Hoyt, BSN,BA,RN
    Manager, Clinical Documentation Integrity
    Health Information Management
    Unit 8, Mailcode 1801
    Denver Health and Hospital Authority
    303.436.4112
    Jane.hoyt@dhha.org
    Think with Ink:)


  • mdomineseymdominesey
    edited May 2016
    You oughta check with your billing people, or accounts people to see if you already have a relationship with the Advisory Board. If your hospital does, then you can get a login where you are able to search their content to see what is available to you. There is no charge that I am aware of to have a chat like I am doing this week in order that they may be able to create a proposal for you. I can send your contact details on, if you would like.

    I am not shilling for them, but my last hospital had a relationship with them which gave me all kinds of goodies to help with my own CDI education/training and my current hospital has a relationship that is not as comprehensive, but I am considering a subscription for their CDI stuff.

    Mark


    Mark N. Dominesey, RN, BSN, MBA, CCDS, CDIP
    Sr. Clinical Documentation Improvement Specialist
    Sibley Memorial Hospital

    Information Technology
    5255 Loughboro Rd NW
    Washington DC, 20016-2695

    W: 202.660.6782
    F: 202.537.4477


    http://www.sibley.org


  • sharon.colesharon.cole
    edited May 2016
    I saw an earlier email about "The Advisory Board Company". But this sounds like you are now talking about an advisory board. Is this advisory board for AHIMA or ACDIS or??? Thanks, Sharon

  • mdomineseymdominesey
    edited May 2016
    The Advisory Board Company is colloquially referred to in the hospital industry as the "Advisory Board". I know of no other "Advisory Board".

    Mark



    Mark N. Dominesey, RN, BSN, MBA, CCDS, CDIP
    Sr. Clinical Documentation Improvement Specialist
    Sibley Memorial Hospital

    Information Technology
    5255 Loughboro Rd NW
    Washington DC, 20016-2695

    W: 202.660.6782
    F: 202.537.4477


    http://www.sibley.org


  • Unknown
    edited May 2016
    Yes, I have worked for more than one organization that used the Advisory Board services. My experience with this company has been very positive.

    Anne

  • donna.kentdonna.kent
    edited May 2016
    Thanks Mark. I now have a login with them as of last week.

    Donna Kent, RN, BSN, CCDS
    Manager, Clinical Documentation Integrity Program
    Clinical Quality and Accreditation
    Torrance Memorial Medical Center
    ph.:310 784-6884 fax:310 784-6899
    donna.kent@tmmc.com

  • Unknown
    edited May 2016
    Thanks for your guidance Mark. I now have a login also :)

    -Jane


  • Unknown
    edited May 2016
    Jane:

    May I ask the name of the webinar you listened to about reinvigorating
    existing programs?

    Linda

  • cfowlercfowler
    edited May 2016
    Donna
    I am not sure if I have already shared this with you or not but.....I had the same scenario as it related to productivity. (paper based queries, multiple programs etc) My solution was ChartWise.
    I too work for the CFO so I understand your pain of the CMI.... despite best efforts to explain the importance of CDI from every other angle.... the CMI still lingers in the shadows. :)
    However, I was able to see a significant increase in my CMI with CW... in my opinion because I was able to spend more quality time with the MDs and in the Chart versus the manual labor I was experiencing before.
    ChartWise is a software solution not a consultant company. The software manages my CDI program from chart review, query generation, query tracking, and about any report metric you could think of... all customizable to what I need.
    When I started the process with ChartWise, I was very clear from the beginning that I was not looking for a consultant and/or management company. They made it and continue to make it clear that they are not either. It has been a very wise investment on our part.
    http://www.chartwisemed.com/

    Good Luck with your processes!
    c

    Carla D. Fowler, RN MBA
    Director,Case Management/CDI
    Colquitt Regional Medical Center
    229-891-9363

  • Unknown
    edited May 2016
    It was presented by The Advisory Board Company. The name of the presentation was "Creating Top-Tier CDI Capabilities". For more information contact
    stillerz@advisory.com

    -Jane

    .
  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited May 2016
    Donna,

    Though we've already talked directly, I thought others might find some additional comments helpful.

    As I mentioned, there are a variety of different sources & it really depends on what you are looking for.
    From what you describe, sounds like you are looking for a bump up to a higher level of expertise along with suggestions that focus on improving process and looking at the value in changing certain physical elements.

    As we all know, one of the largest factors in the success and effectiveness of a CDI program is physician engagement -- I'd be reflecting deeply on how I felt that status was for my program, and then seriously looking for services that will support improvements in that area if I felt it necessary.

    Most consultants should be able to provide the type of process & insight for some of the issues you've briefly mentioned. The sticky point sounds like the growth, learning & mentoring to jump up to a higher level of expertise, and I am not certain that ability is nearly as common.

    Several things I'll point to (and as a caveat, I am the author of these, so take with a grain of salt):
    ACDIS On line Poll:
    How long do you think it takes to achieve an "expert" level of proficiency as a CDS?
    http://www.hcpro.com/acdis/view_readerpoll_results.cfm?quiz_id=2258
    ACDIS Blog:
    Thoughts on evaluating vendors/consultants
    http://blogs.hcpro.com/acdis/2012/01/thoughts-on-evaluating-vendorsconsultants/
    CDI specialist orientation (more CDI Talk inspiration)
    http://blogs.hcpro.com/acdis/2012/02/cdi-specialist-orientation-more-cdi-talk-inspiration/

    I've had direct experience with 2 CDI consultants.

    JA Thomas worked with my organization to start our CDI program. We have not been actively involved with them for several years now. They did an outstanding job of education and training to start our new program, and had good ongoing support. (please NOTE: I don't have an understanding of their current services) However, I understand they provide a monthly educational webinar (difficult to find an educational source anywhere) on various topics. They have also improved & expanded their physician services focus, doing quite a bit toward ICD-10 & have several thought provoking initiatives which they refer to as advanced practice. My impression is that they have more of a comprehensive total package, though in the past they've been very open to 'customizing' of desired services. One of our sister hospitals has been active with JATA for about 7 years and remain very satisfied.

    The second consultant is Dr Garry Huff for the past 3-4 years. His work with us has been been excellent, with more of a focus on physician relationships, developing expertise and knowledge for both CDI & coding staff, with a strong emphasis on the clinical understanding, insight & application to CDI roles. His services are valuable to us in providing perspective & expertise in a variety of ways, including compliance considerations. He provides a high level of expertise & knowledge with a challenging blend of deep clinical understanding that is applied in very complex cases with the underlying context of appropriate and most correct coding. Finally, we find significant value from an educational point of view. He very much customizes his services to the clients' needs and choices.

    There are several other consultants that I've not worked with, but have had the opportunity to meet and appreciate through the national conference exhibits & talks as well as through other ACDIS venues. Though I don't feel I can directly recommend, I'd certainly want to investigate their services. Dr James Kennedy (FTI Consulting), Dr Gold (DCBA) & Huron Consulting (Gerri Birg & Fran Jurcak).

    I am sure there are other consultants that provide very good services, but I don't have enough of an impression to feel comfortable mentioning -- perhaps others would be willing to toss out some names they like?

    I'd be happy to discuss individually further.

    Don

    Donald A. Butler, RN, BSN
    Manager, Clinical Documentation
    Vidant Medical Center, Greenville NC
    DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )


Sign In or Register to comment.