Serenity CDI: Value of CDI and ACDIS

By E.S. Damalie, MD, FACHE, FHFMA, RHIA, CCDS, CDIP, CCS

Clinical documentation improvement (CDI) is an essential piece of hospital operations today, taking the healthcare industry by storm while assuming varied dimensions and perspectives. CDI efforts, however, may be understood differently by different organizations—some organizations exhibiting no clue whatsoever as to CDI programs’ overarching importance. Nevertheless, the dynamism of the healthcare environment today has only solidified the relevance of CDI.

Increasingly, many individuals with varied backgrounds have chosen the CDI professional path, and I happen to be one of them. The journey for these individuals may not always be smooth—there are always challenges in any profession—but those working in the field typically become buoyed by a sense of fulfilment when the job is done very well.

I first found myself in this profession purely by accident. There was a very pleasant individual who came and asked questions during my usual clinical rounds; questions that were silly and redundant to me and other physicians at the time, but nonetheless we were courteous to this individual and answered her questions. I had no idea what her job title was nor do I remember her name. Then came the opportunity to temporarily step into a documentation improvement role. At the time, I saw this role as very much in tandem with clinical care. The deeper I got into this role, the more it reminded me of the individual who I thought was ‘bothering” me during my clinical rounds.

Over the years, I have grown to appreciate and champion CDI’s relevance. The initial phases of understanding CDI concepts can be a challenge, especially if a new staff person does not get the right guidance. Such challenges deepen if the individual fails to apply himself/herself and has no curiosity of mind regarding the greater importance of the job at hand.

After many years on the sidelines, working as a CDI specialist, then progressively rising through the CDI managerial ladder, attending ACDIS conferences and purchasing ACDIS books and services,  I decided to “join the game” by answering the call to become a member of the recently created ACDIS Practice Guidelines Committee. The rest, as they say, is history.

The whole concept of clinical documentation can be traced to Hippocrates who, around 430 B.C., placed much emphasis on the systematic observation and recording of clinical findings. And here we are in 2017, with CDI professionals assuming significant importance especially in the current healthcare environment.

For organizations to excel at CDI, they need all the resources they can get. As this profession’s proverbial home, ACDIS has blazed a trail for us to follow, providing much needed resources and support to professionals in this field. I have fond memories of some of the early conferences where I could almost count the number of participants to its current state with a seemingly endless ocean of attendees. The CDI community has indeed grown and so has its contribution and relevance to today’s hospital operations.

As we celebrate a decade of ACDIS’ tremendous impact, I want to add my voice to the role ACDIS has played in shaping the professional direction of many a CDI practitioner. As I personally sit back and take stock of the nearly 100 CDI professionals that I have helped train and mentor over the years, I know my efforts would have been impossible without the resources and support provided by ACDIS.

ACDIS has been that one-stop-shop, invaluable to the CDI professional in general and to me personally. As we move through the months ahead, into the seemingly uncertain healthcare environment before us, one can only anticipate that CDI professionals and ACDIS will remain a pivotal part in addressing today’s clinical operations in the healthcare terrain we find ourselves.

Editor’s note: Damalie, a physician and CDI specialist by training, has worked to establish CDI programs across the country and served as a consultant for multiple organizations. Damalie is currently a fellow of both the America College of Healthcare Executives and Healthcare Financial Management Association,.  a member of ACDIS CDI Practice Guidelines Committee, and the chairman of the Certification Committee for the Southern California Chapter of HFMA. He is currently affiliated with Serenity CDI+ Solutions, which offers CDI, appeals and denials management, coding and auditing, HIM optimization, and other revenue cycle management services. The opinions expressed do not necessarily reflect those of ACDIS or its advisory board. Contact Damalie at serenityCDIplus@gmail.com.