Getting CDI Buy-In from Physicians

If there was only one major insight to be had in two day’s worth of presentations at AHIMA’s CDI Summit in Alexandria, VA last week, it was a new appreciation for the mind of the modern physician and the tools being developed to navigate it.

During Thursday’s summit sessions, attendees learned strategies for working with physicians from their own kind—clinical documentation improvement (CDI) specialists and health information management (HIM) professionals. On Friday, however, that advice came straight from a physician in the opening session “ICD-10 and Physician Engagement Query Weary Docs? How to Engage Physicians to Respond to Queries,” delivered by P. Roger DeVersa, MD, FHM, MBA, RN, CPE, CCS, CDIP, revenue integrity, Erlanger Health System.

Having spent several years as a registered nurse and as a physician, Dr. DeVersa admitted straight away that prior to earning his CDIP credential he was a “curmudgeon” when it came to responding to queries from coders and CDI staff.

He explained that physicians are reluctant to respond to queries due to competing demands and because they’ve relegated queries to “low priority” status. Or, they perceive queries as a way the hospital is just trying to make more money. Both of these views can change if CDI and HIM staff take the time to educate physicians properly on the significance of a query.

To get a doctor’s attention, CDI and HIM staff would do well to their CDI educational efforts if they keep them brief, clear, and concise.

“Nobody’s going to listen to a lecture. Develop a sales pitch or five minute elevator speech,” Dr. DeVersa said.

That sales pitch, about why CDI is important, should include two topics that every physician cares about—their expected mortality rates and defending the length of stay averages for their patients.

In the same vein, if you tell a physician you’re keeping a report card tracking factors like expected mortality, length of stay, and query response rates it will get their competitive juices flowing. They appreciate knowing where they stand and whether they’re outperforming their colleagues.

For some physicians, setting the right tone for a conversation, body language, and projecting a strong sense of professionalism will go a long way in gaining their cooperation.

“Depending on where you are with a physician, sometimes it helps to let them win a few battles. Just like you can’t fight a three-year-old every single day, you can’t fight [physicians] them when you’re trying to engage them. Choose your battles. Choose your strategy and deploy it consistently,” Dr. DeVersa advises.

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