Q&A: Physician advisor collaboration with CDI

Editor’s Note: As part of the fifth annual Clinical Documentation Improvement Week, ACDIS has conducted a series of interviews with CDI professionals on a variety of emerging industry topics. Thomas W. Huth, MD, MBA, FACP, Vice President of Medical Affairs at Reid Hospital & Health Care Services in Richmond, Indiana, answered the following questions regarding physician advisor’s role in CDI. With more than 20 years of clinical practice experience and a Master of Business Administration degree, Huth has served in a variety of medical staff, organized medicine, and community leadership roles. Contact him at Thomas.Huth@reidhospital.org.

Q: Can you describe your role as a physician advisor to CDI?

A: I give expert guidance to the CDI specialists when they have questions about what to query, and how to do it, and how to approach the doctors in an effective manner.

Q: Can you describe the engagement and collaboration of your medical staff in CDI?

A: We work to establish a cultural expectation of engagement and collaboration of the medical staff with the CDI specialists. We provide constant feedback to the doctors and to the medical staff leaders about performance. We also ask the medical staff leaders to send the message to the individual doctors about the importance of CDI to the quality of care for patients and the objective performance of the organization on severity adjusted metrics.

Q: What has been your most successful approach for obtaining physician buy-in?

A: We have had good success by providing physician-specific feedback on the impact of complete and thorough documentation to measures of quality and efficiency. When doctors are shown their own data they usually become much more engaged in the process.

Q: Does your medical executive committee have an escalation policy or other policy requiring physicians to respond to queries/CDI clarifications in a set timeframe? Can you describe its effectiveness?

A: We have an analytics team which gathers in-depth data on physician response rates and we provide that to doctors on a weekly basis. Consequently, our response rates have improved to above 90% in most weeks. There is a comparable rate of agreement with the CDI specialist’s assessment. We don’t emphasize agreement rates to the doctors and we don’t report the rates to them individually. Instead, we use agreement rates as a measure of the quality and appropriateness of the CDI specialists’ queries.

Q: What are your biggest challenges with getting physician buy-in?

A: Keeping doctors engaged in improving the processes and quality of documentation since they have a lot of other priorities.

Q: What do you think the role of the CDI physician advisor is/should be in terms of program advancement and analysis?

A:  It’s very important to have a physician advisor with advanced training in CDI available to the CDI team. The advisor should be an effective liaison to, and teacher of, the medical staff. The physician advisor can provide many useful insights into the data and help plan improvement projects.