System-Wide Clinical Documentation Improvement

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A non-profit, community-directed Wisconsin health system partnered with Prism to review its clinical documentation improvement (CDI) program. The system, which includes eight hospitals, outpatient clinics, post-acute care and high-quality affiliated physicians, identified opportunities to more accurately reflect the severity of illness and risk of mortality and increase compliant payer reimbursement for the inpatient population.


Working with Prism’s CDI experts, the system refreshed the existing CDI program by focusing on CDI team education, program infrastructure and transition. Initiatives included:

  • Hiring and training new CDI associates
  • Providing physician education to support the query process
  • Implementing tools to drive standardized workflows
  • Developing an HIM/CDI dashboard to provide monthly program metrics for Quality and Utilization Management Committee updates
  • Creating policies and procedures as well as an ongoing CDI education plan to support program transition and long-term sustainability

The system’s CDI program has boosted the bottom line through additional compliant reimbursement and improved the organization’s quality profiles.

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