CDI Week Q&A preview: Provider engagement & education

As part of the sixteenth annual Clinical Documentation Integrity Week, ACDIS conducted a series of interviews with CDI professionals on a variety of emerging industry topics. Natalie Negro, MPH, BSN, RN, CCDS, FACHE, corporate CDI manager at Penn Medicine/The Hospital of the University of Pennsylvania, answered these questions. Negro is a member of the ACDIS Furthering Education Committee. For questions about the committee or the Q&A, contact ACDIS Editor Jess Fluegel (jess.fluegel@hcpro.com).

Q: According to the 2026 CDI Week Industry Survey results, 50.35% of respondents reported their medical staff are “somewhat” engaged (meaning they understand CDI concepts but inconsistently put them into practice or do so incorrectly), a notable decrease from the 57.12% who reported the same in 2025. This seems to indicate a positive trend, however, given that 42.70% reported their medical staff is “very” engaged in CDI this year (meaning they understand the importance of CDI and actively participate in documentation integrity efforts), a large jump up from 32.16% in 2025. What is the engagement like at your organization? Do you have any thoughts on why this jump may have occurred? What advice do you have to help CDI professionals move the needle from having “somewhat” to “very” engaged medical staff?

A: Provider engagement has evolved substantially compared to when I started in CDI over a decade ago. CDI has become much more embedded in the overarching goals of our institution and in the care teams, and our exposure to and relationships with providers have enhanced as a result. Leadership has made complete and accurate documentation a priority, and engagement really does trickle down.

Overall, I believe the change in engagement expressed in the survey is a result of a greater understanding of how CDI programs can help the quality of patient care, communication across the care continuum, and health system sustainability. My advice would be to align CDI goals with system goals and communicate that alignment in a way which resonates with your providers.

Q: When asked how frequently they conduct physician education sessions, 33.52% of respondents reported monthly, in line with 2025, while almost 14% said they do so quarterly, a small increase from last year (11.56%). How often does your CDI program conduct such sessions, and what successes and/or challenges have you seen? What advice would you give CDI professionals on how to educate outside of formal sessions as well?

A: We take a combination of approaches when it comes to provider education. Our more formalized education includes annual resident didactic sessions, targeted service line sessions, online modules, and tip sheets. Ad hoc education sessions for individual providers and groups are also provided based on trends and requests.

One challenge we have adapted to is migrating the majority of education sessions from in-person to virtual settings. We have adapted to different platforms and worked to accommodate a variety of provider schedules. Our motto is that, if we are invited to a room (virtually or otherwise), we will be there!

Less formal education sessions can encourage mutual learning and perspective-sharing. Having some data handy can be helpful to get the conversation started, but we’ve found that two-sided, open communication sessions can yield even more effective engagement than lecture-style education alone.

Q: According to the survey results, the number of respondents that have either a part-time or full-time physician advisor stayed steady year-over-year (71.63% in 2026 compared to 71.22% in 2025), as did those with a physician champion (46.03% in 2026 compared to 45.21% in 2025). Of respondents with a physician advisor or champion, 56.74% did report sharing them with another department. Does your CDI program have a physician advisor or champion, and if so, in what capacity do they assist your CDI efforts? What benefits and/or challenges have you noticed in working with (or without) a physician advisor or champion?

A: This is a very exciting time for us, as we have welcomed our very own CDI-dedicated physician advisor just this past April! We are still developing and exploring the possibilities of the role, but we’ve already started to experience positive impacts and outcomes. Our physician advisor has assisted us with evaluation of potential query opportunities and interpretation of clinical indicators, helped with development of clinical definitions, and been a valuable voice in provider engagement and query response discussions.

Q: When asked how they measure the effectiveness of their CDI provider education program, the most common measurement selected was improvement in CDI metrics (76.5%), followed by feedback from providers (51.88%), and reduction in documentation errors (35.61%). How does your organization measure its CDI provider education? What advice do you have to help CDI programs better track their success in this area?

A: CDI metrics, such as query rate and volume, can certainly play a role in how CDI programs measure provider education efforts, but context should always be considered. For example, staffing changes, CDI program scope, and even fluctuations in the patient population served can impact many of the traditional CDI metrics. Overall, agree rate may be one of the most useful metrics in evaluating the efficacy of provider education, as it can give insight about the alignment between CDI and provider understanding.  

Q: Do you provide formal education to your providers, and if so, how (i.e., one-on-one, group presentations by service line, informal coaching, tip sheets, newsletters, etc.)? How is education content decided (i.e., based on hospital standards, individual provider needs, etc.)? How have your provider education/engagement models changed over the last few years?

A: We do provide formal education sessions in a variety of settings, such as our annual resident lecture-style presentations, online modules, tip sheets, and service line-focused education sessions. The content of the sessions is tailored to the goals expressed by the primary stakeholders and the audience. Although many of our educational strategies have remained consistent, we do continue to explore ways in which we can adapt our presentations and communications to better meet the needs of our providers and keep pace with evolving documentation best practice standards.

Q: The majority of respondents (57.30%) reported a 91%-100% physician query response rate, which was also the most common goal response rate for CDI departments (58.97%). What do you think these departments are doing to achieve or reach above their goals? Do you have any advice on query wording, policies, collaboration, etc., to help CDI professionals and providers achieve a higher response rate?

A: Various factors have influenced query response rates over the years. One aspect is almost certainly the evolution of query technology. The process of answering queries via electronic querying processes has led to an easier and much more streamlined workflow for CDI specialists and providers when compared to the paper query days. Another major aspect positively impacting response rates is perhaps the culture shift that comes with recognizing that CDI work drives more than just reimbursement. With the furthering integration of CDI outcomes into organizational and clinical priorities, CDI specialists have become more widely accepted as partners to the members of the care teams working towards the same goal of high-quality care.  

Q: When asked if their organization tracks physician query agree rate, 41.03% of respondents reported a 91%-100% agree rate and 23.23% reported an 81%-90% agree rate. Also, 41.72% said the goal query agree rate of their department was a 91%-100% agree rate, an increase from the 38.5% in 2025 who said the same. Does your department have a query agree rate goal, and if so, how was it decided on? What efforts has your CDI program made, if any, to achieve a higher physician query agree rate?

A: We do have an agree rate goal which was based on an industry standard. Agree rate is a potential measure of physician and CDI alignment. Strategies to evaluate and help improve agree rate may involve CDI query audits, targeted CDI education based on the audit findings, and identification of target areas for improvement in provider education.

Q: Provider engagement will always be a relevant CDI topic, but how have you seen the conversation evolve in recent years? What external factors do you anticipate influencing how providers are engaged with and educated in the future?

A: Provider engagement will continue to develop as the role of CDI specialists evolves and expands. Over the past decade, CDI scope has moved beyond the traditional DRG level impact to encompass many other aspects in the quality, regulatory, and performance measurement realms. One area I expect to impact CDI and provider engagement in particular is technology. Our tools have developed at a rapid pace on both the provider documentation side and on the CDI side; we will need to become even more collaborative with our providers and other departments in order to align and optimize practices in the technology’s design and governance.

There may be an opportunity for CDI professionals and providers to be even more embedded in the process of reviewing and preventing denials, as well as in negotiations with payers. There is certainly a lot of innovation and change behind us and even more to come. I speculate that no matter where the road leads next, provider engagement will be a critical part of continued success for CDI departments everywhere.