On this episode of HI Pitch, Tammy Combs, RN, MSN, CDIP, CCS, CCDS, director of CDI and clinical foundations at AHIMA, and Brian Murphy, director of ACDIS, discuss a new white paper that addresses rapid technology advancements impacting CDI.
CDI is critical to the usability of medical data and ongoing efforts to improve patient care. New technologies, such as artificial intelligence and natural language processing, can streamline CDI initiatives, reduce administrative burden on providers, and achieve high-quality documentation. But the use of these tools requires a more sophisticated approach to assessing and incorporating them into the documentation workflow, the paper’s authors say.
The technology tools suggest query opportunities to the CDI professional based on “triggers” that are identified during an automated scan of the health record, such as documentation, vital signs, lab results, radiology findings, or medications. It’s essential, the authors write, that CDI professionals continue to look for opportunities in the record that were not suggested by the technology. “This is especially true when the opportunities are more complex and require critical analysis by the CDI professional to determine the big picture of what is happening during the admission and the clarification needed to reflect the true cause and effect of some conditions,” the authors write. Listen to learn more.
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