CDI Week Q&A preview: Provider engagement & education

As part of the sixteenth annual Clinical Documentation Integrity Week, ACDIS conducted a series of interviews with CDI professionals on a variety of emerging industry topics. Alma Yap, MS, BSN, RN, CCDS, CDIP, CCS, AHIMA-Approved ICD-10-CM/PCS Trainer, an assistant CDI lead at the University Medical Center in Southern Nevada, answered these questions. Yap is a member of the ACDIS Furthering Education Committee and California ACDIS local chapter. For questions about the committee or the Q&A, contact ACDIS Editor Jess Fluegel (jess.fluegel@hcpro.com).

Q: According to the 2026 CDI Week Industry Survey results, 50.35% of respondents reported their medical staff are “somewhat” engaged (meaning they understand CDI concepts but inconsistently put them into practice or do so incorrectly), a notable decrease from the 57.12% who reported the same in 2025. This seems to indicate a positive trend, however, given that 42.70% reported their medical staff is “very” engaged in CDI this year (meaning they understand the importance of CDI and actively participate in documentation integrity efforts), a large jump up from 32.16% in 2025. What is the engagement like at your organization? Do you have any thoughts on why this jump may have occurred? What advice do you have to help CDI professionals move the needle from having “somewhat” to “very” engaged medical staff?

A: Provider engagement varies by specialty and organization. Although many providers understand CDI concepts, consistently applying them can be challenging when documentation responsibilities compete with clinical and administrative demands. Greater engagement reflects growing recognition that documentation affects not only reimbursement but also quality outcomes such as reported severity of illness, risk-adjusted mortality metrics, and publicly reported performance. To help providers move from “somewhat engaged” to “very engaged,” CDI teams should emphasize clinical relevance, present specialty-specific data, partner with physician advisors and service-line leaders, and demonstrate how complete and accurate documentation supports patient care and accurately reflects clinical complexity.

Q: When asked how frequently they conduct physician education sessions, 33.52% of respondents reported monthly, in line with 2025, while almost 14% said they do so quarterly, a small increase from last year (11.56%). How often does your CDI program conduct such sessions, and what successes and/or challenges have you seen? What advice would you give CDI professionals on how to educate outside of formal sessions as well?

A: In my experience, most CDI programs combine scheduled education, such as formal presentations and meetings, with informal guidance tailored to provider and specialty needs. Whether teams work remotely, in a hybrid setting, or on-site, learning can be integrated into the daily workflow through concurrent reviews, secure messaging, timely responses to provider questions, and one-on-one discussions conducted in person, by phone, or on virtual platforms such as Microsoft Teams. Targeted strategies, such as briefcase-based clinical scenarios, specialty-specific microlearning, and concise job aids, often have a greater impact than lengthy presentations. AHIMA and ACDIS also provide selected free resources that can supplement these educational efforts.

Q: According to the survey results, the number of respondents that have either a part-time or full-time physician advisor stayed steady year-over-year (71.63% in 2026 compared to 71.22% in 2025), as did those with a physician champion (46.03% in 2026 compared to 45.21% in 2025). Of respondents with a physician advisor or champion, 56.74% did report sharing them with another department. Does your CDI program have a physician advisor or champion, and if so, in what capacity do they assist your CDI efforts? What benefits and/or challenges have you noticed in working with (or without) a physician advisor or champion?

A: Physician advisors are invaluable because they translate documentation expectations into clinically relevant language and help build provider trust. They provide clinical insight, assist with complex or disputed queries, educate physician peers, support escalation pathways, and promote documentation that accurately reflects patient care while supporting quality reporting, coding, and compliance. A common challenge is limited protected time, particularly when physician advisors serve multiple departments. Clearly defined responsibilities and a formal allocation of time for CDI activities are essential to an effective physician advisor program.

Q: When asked how they measure the effectiveness of their CDI provider education program, the most common measurement selected was improvement in CDI metrics (76.5%), followed by feedback from providers (51.88%), and reduction in documentation errors (35.61%). How does your organization measure its CDI provider education? What advice do you have to help CDI programs better track their success in this area?

A: CDI programs should evaluate the effectiveness of provider education using multiple outcomes rather than attendance alone. Relevant measures include query response and agreement rates, fewer recurring query topics, more accurate reporting of severity of illness (SOI) and risk of mortality (ROM), stronger clinical validation practices, fewer preventable denials, provider feedback, and documentation quality audit results. Programs should monitor these indicators over time and compare results by service line to identify where targeted education and additional support are needed.

Q: Do you provide formal education to your providers, and if so, how (i.e., one-on-one, group presentations by service line, informal coaching, tip sheets, newsletters, etc.)? How is education content decided (i.e., based on hospital standards, individual provider needs, etc.)? How have your provider education/engagement models changed over the last few years?

A: Effective CDI programs use a range of educational methods, including individual coaching, service-line presentations, department meetings, grand rounds, documentation tip sheets, newsletters, real-time feedback, and orientation for new physicians. Content should be guided by organizational priorities, documentation trends, denial data, quality metrics, regulatory changes, and specialty-specific needs rather than relying primarily on broad coding updates. Compared with traditional approaches, CDI education is increasingly data-informed, personalized, and integrated into clinical practice.

Q: The majority of respondents (57.30%) reported a 91%-100% physician query response rate, which was also the most common goal response rate for CDI departments (58.97%). What do you think these departments are doing to achieve or reach above their goals? Do you have any advice on query wording, policies, collaboration, etc., to help CDI professionals and providers achieve a higher response rate?

A: High-performing CDI programs use queries that are concise, compliant, and supported by relevant clinical indicators. They conduct timely concurrent reviews, maintain active physician advisor involvement, build provider trust, share performance data transparently, and use ongoing education to address recurring documentation gaps and reduce avoidable queries. Response rates may improve when physicians understand the value of complete and accurate documentation and view compliant queries as tools for clarifying and strengthening the medical record rather than as administrative burdens.

Q: When asked if their organization tracks physician query agree rate, 41.03% of respondents reported a 91%-100% agree rate and 23.23% reported an 81%-90% agree rate. Also, 41.72% said the goal query agree rate of their department was a 91%-100% agree rate, an increase from the 38.5% in 2025 who said the same. Does your department have a query agree rate goal, and if so, how was it decided on? What efforts has your CDI program made, if any, to achieve a higher physician query agree rate?

A: I believe the primary goal of the CDI query process is to obtain clinically meaningful clarification that supports an accurate, complete, and clinically valid medical/health record while preserving the provider’s independent clinical judgment. Strong agreement rates may result from relevant and sourced clinical indicators, clear and nonleading query construction, consistent CDI education, peer review of complex queries, collaboration with physician advisors, and focused provider education. However, agreement rates should be evaluated alongside query compliance, response rates, documentation outcomes, and disagreement trends rather than treated as the sole measure of success. Programs should regularly review these findings to identify opportunities to improve query construction, CDI education, provider education, and related workflows.

Q: Provider engagement will always be a relevant CDI topic, but how have you seen the conversation evolve in recent years? What external factors do you anticipate influencing how providers are engaged with and educated in the future? Any other thoughts you have on the future of the industry in this area are welcome!

A: Besides reimbursement, provider engagement is becoming essential to quality, patient safety, and organizational performance. CDI is evolving through greater integration into clinical workflows, value-based care, analytics, health equity initiatives, and stronger collaboration among providers, CDI, coding, quality, case management, and utilization review. In recent years, I have seen the conversation about provider engagement move beyond reimbursement to a broader focus on documentation integrity and its connection to patient safety, quality outcomes, risk adjustment, medical necessity, research, and publicly reported performance. CDI is also becoming more integrated into clinical workflows, requiring closer collaboration among providers, CDI, coding, quality, case management, utilization review, and physician advisors.

External factors likely to shape future engagement include the expansion of value-based care, increased scrutiny of clinical validation and denials, greater reliance on risk-adjusted data, regulatory and coding changes, health equity initiatives, and the growing use of artificial intelligence and automated documentation tools. Provider education will need to be concise, specialty-specific, supported by meaningful data, and incorporated into daily workflows. Technology may help identify documentation gaps earlier, but it will require strong governance, validation, transparency, and human oversight.

Accurate documentation will remain essential for reflecting patient complexity, measuring outcomes, supporting research, and reporting performance. CDI specialists with strong clinical acumen, data literacy, effective communication skills, and the ability to build trusted professional relationships will be best positioned to make a meaningful impact. The future of provider engagement will depend less on query volume and more on providing timely, credible, and clinically relevant guidance.