Clinical Documentation Technology Complements Staff, Fills Gaps Amid Worker Shortages

Clinical documentation integrity (CDI) has a direct effect on patient care, and as documentation requirements become more complex, CDI departments are challenged by workforce shortages that are likely to persist.

Keeping CDI Teams Productive and Patient Data Accurate During the COVID-19 Pandemic

COVID-19 has caused unprecedented upheaval for hospitals across the globe. Hospitals in hotspots face overcapacity. Providers are risking their lives, and the lives of their family members, working round-the-clock to treat patients who need critical care.

Over the last month, we’ve been checking-in with our customers. We ask them how we can help – whether by creating a specific report, adding a COVID-19 template to their library, or simply giving moral support at this difficult time.

Our hospital colleagues have shared stories about ever-increasing COVID-19 admissions, decreasing overall admissions, providers who’ve been exposed and quarantined, employees furloughed, and more personally, the stress they feel every day.

We’ve taken to heart that each person has expressed gratitude for the ability to continue to do their jobs remotely using our technology. Here’s what we’ve learned from our hospital colleagues as it pertains to our business of supporting accurate patient documentation.

CDI will become even more critical for hospitals’ financial survival
Hospitals in hard hit areas have become overwhelmed with COVID-19 admissions that require complex and expensive care. To minimize the spread of the virus, all hospitals across the country have been forced to suspend high-margin elective surgeries and refocus resources on potentially rapid increases in critical care patients.

As a result, hospitals expect to lose significant revenue this year. They have responded with immediate cost-cutting measures, such as flexing and furloughing staff, halting IT projects, and even closing or filing for bankruptcy.

Clearly, hospitals have an immediate and paramount public health responsibility to document and report COVID-19 patient data as accurately and comprehensively as possible.

Across the board, our hospital colleagues say they need to lean on CDI review even more, otherwise their hospitals risk losing additional reimbursement.

One CDI professional commented, “Proper coding of COVID-19 will be important for hospitals to stay afloat financially – to get reimbursed for all of the services they are performing and to apply for funding from the government to keep them in business.”

Public health decisions are informed by hospital data – it must be accurate and comprehensive
Government and public health officials are analyzing hospital-reported patient data daily to inform life-saving decisions regarding flattening the curve, securing medical supplies, and determining when it’s safe to reopen schools and businesses.

The importance of ensuring accurately reported COVID-19 patient data cannot be overstated. A CDI professional explained, “CDI review and clarification of patient data plays a critical role in our ability to study and understand COVID-19 – how it spreads, the risk factors, associated deaths, and how we can avoid future outbreaks.”

Clearly, hospitals have an immediate and paramount public health responsibility to document and report COVID-19 patient data as accurately and comprehensively as possible. Our safety and the development of effective therapeutics and vaccines depend on it.

Given the right technology, CDI staff can work from home effectively
During routine times, CDI staff typically round with providers on the floors to ensure patient information is accurate in the chart. Last month, non-essential hospital staff were asked to begin working from home. CDI teams fall into the category of “non-essential” to in-person patient care.

One CDI manager remarked, “CDI teams often work on top of each other, sometimes with three members in a 10×10-foot room! Keeping your social six-foot-distance just doesn’t work.”

At hospitals across the country, CDI teams have setup at home. Some report having sufficient technology to do their jobs, while others are restricted and frustrated by basic IT issues – slow Internet, inability to connect to VPNs, and limited access to hardware provided by the hospital.

Giving providers faster, more convenient mobile solutions will be imperative as we redesign healthcare workflows with post-pandemic learnings.

For hospitals with cloud-based technologies such as Artifact, CDI productivity and engagement with physicians have continued without interruption. One CDI manager commented, “Our workflow hasn’t changed from home. Physicians are responding to our queries in Artifact. It’s business as usual for us, and we don’t know how we would have kept up without our mobile query platform during this time.”

Each hospital colleague we spoke with agreed that, while it’s helpful for CDI teams to be onsite for education, their jobs can be done from home. A physician asserted, “One of the lessons we will learn during this pandemic is that CDI teams can work efficiently remotely because of the technology now at their disposal.”

Mobile technology for providers is faster to use and less distracting to patient care
Prior to the COVID-19 outbreak, physician burnout had become a major focus of concern for hospitals. The pandemic has taken physician well-being challenges to a heightened and truly incomprehensible level.

A CDI manager described the atmosphere at her hospital saying, “With the onset of COVID-19, physicians are solely focused on patient care and it’s nearly impossible to get their attention. They are completely overwhelmed and not accessible to answer emails, phone calls or talk in person to someone about responding to a query. They are maximally stressed.”

During normal times, the most valuable asset to providers was having more time in their day. Administrative burden and cumbersome EMR workflows were often to blame for taking time away from patient care. With this pandemic, an already bad situation turned much worse overnight.

A Director of Emergency Management at a state medical center pointed out, “Right now everyone is asking physicians for all types of information. Crises like pandemics illuminate why mobile technology tools like Artifact are critical – it’s all about access and control over the flow of information.”

We can only hope COVID-19 teaches our healthcare system new lessons that bring safer, more efficient care for the next generation. Giving providers faster, more convenient mobile solutions will be imperative as we redesign healthcare workflows with post-pandemic learnings.