by Brian Murphy

According to the 2021 CDI Week Industry Overview Survey, only 20.6% of organizations have a standalone outpatient CDI program. That number is far too low… but I get it. Outpatient/ambulatory CDI is a different beast than inpatient, and therefore intimidating to get into. Hospitals are still in a trial-and-error mode, searching for the best review cadence, diagnoses and documentation to target, and key performance indicators (KPIs) with which to track their progress. Tools and support are lacking, as compared to the mature CDI technology we have in the inpatient setting.

There’s also been several high-profile audits of Medicare Advantage companies and other entities submitting diagnoses for the purposes of risk adjustment. I’ve been covering this regular stream of reports from the Office of Inspector General on the ACDIS Podcast. More than ever, compliance is critical.

Given the opportunities, and vulnerabilities, we know that outpatient is an area CDI departments should be in. The biggest unanswered questions for most are, how do I start, and, how can I demonstrate impact?