Memorial Hermann, Houston, Texas
Houston-based Memorial Hermann Health System had a problem: Its providers often were not documenting all the diagnoses managed in the acute care setting.
Coders and clinical documentation-improvement specialists spend several hours each week educating physicians on the implications of missing or nonspecific diagnosis. Over the last several years, the informatics division partnered with CDI specialists in the acute care venues to design and implement interruptive EHR alerts that prompt physicians to enter diagnoses when specific criteria are met.
Clinical documentation improvement queries The predominant method for capturing the missing or incomplete diagnoses in our organization is CDI queries that often are several days after the condition was managed; the CDI query process is not within the physicians workflow, and the newly entered diagnosis rarely gets propagated to future physician documentation, explained Dr. Nnaemeka Okafor, vice preside