Q&A: Projects for HIM students
Q: In partnership with technical schools and universities, we've been approached to assist with providing opportunities for health information management (HIM) students, specifically for their practicum. Do you have any advice for projects related to CDI for HIM students?
Response #1: Students from several HIM/coding programs in our state are scheduled with a few different leaders in the revenue cycle including the CDI department. When we were onsite, the CDI team would take students up to the units and review records to expose them to that environment. But that was prior to the pandemic. Now, they will be on a Teams meeting with someone on my team and get a high-level overview of CDI, and then see how we review medical records and query providers. If the students have additional questions (potentially structured questions from their respective programs), there will be time to address those as well.
Response #2: If the students have already been through their coding classes, a good project for them may be reviewing accounts that have to trigger a CDI review and auditing. They can audit a particular diagnosis, like patients with coronary artery disease, and see if they were prescribed aspirin or a statin. This can help them get used to looking at documentation within the EHR.
Response #3: I looked for needs within our department, which were mostly related to data and reporting, so I asked for students who were energized by that area of HIM, though it did require getting approval for access to our medical records.
For one project, we needed help sorting out discrepancies and non-standardized logging of the associated impact of queries within the software. Our CDI team had newly become a system and four individual hospital teams were moved to that system. Each team had different workflows and processes related to queries. There were many variations as to how each team member logged and interpreted information, and we needed to come up with the best overall practice so that we could design a policy/procedure around this and trust our impact data going forward. The student who took on the project looked at months' worth of CDI team data and sorted out all of the different approaches.
For another project, we needed to report top queries and metrics surrounding collaboration with the CDI team to individual providers and departments. The HIM student developed a report that compiled this data on a monthly and quarterly basis for us so that the information could be shared during provider education sessions.
Response #4: Project ideas should come from the CDI program and its needs. But at the least, you can expand the HIM students’ knowledge of the revenue cycle and make them more familiar with the process and departments within it. Currently, our CDI educators provide a 30-minute overview presentation, covering topics such as:
- Our mission statement and ACDIS
- Where CDI is within the revenue cycle
- Education background of a CDI reviewer and our organizational chart
- Types of hospitals and admissions we cover
- Role of a CDI reviewer
- Query basics
- Progression table examples of DRG movement
- How hospital revenue is calculated
- What metrics come from documentation and how CDI supports
- What departments CDI collaborates with
Our partners over in acute care coding say they go through a plethora of PowerPoints with HIM students explaining the different aspects of their portion of the revenue cycle and how they interrelate and collaborate with other departments (including CDI) during interactive video meetings. They also utilize HealthStream to let the student practice on simulated charts (coding incubator, arcade functions, etc.). They aim to give the student a taste of the real world, some career wisdom, hands-on experience in HealthStream, and reassurance that this career they’ve invested money and time in pursuing is really great and worth their efforts.
Editor’s note: This question was answered by members of the ACDIS CDI Leadership Council.