The Evolution of CDI to Advanced Practice with Mel Tully
Episode 3
Mel Tully is the Vice President of Clinical Education and Services at Nuance. She has been on the front lines of Clinical Documentation Improvement (CDI) since the early days. She shares her wealth of knowledge and expertise in developing meaningful education and what excellence and integrity look like in the field today.
Episode summary
3:01 “When I began this journey, the objective for CDI at that time was revenue improvement or revenue preservation. So the way we practiced was really asking physicians to document more accurately so that the hospital received the reimbursement that they deserved… and in the meantime, we were improving that patient’s clinical story.”
As she grew in her knowledge of CDI, she saw opportunities for providing better care for patients, which has been at the center of the evolution of CDI to advanced practice CDI.
Mel shares that most of Nuance’s clients have some sort of CDI program in place, with the efforts geared toward compliance and accurate accounting of resources for financial purposes. Nuance then looks for how to take that CDI to an advanced level so that hospitals and facilities can move from simply compliance and financial benefit to capturing an accurate clinical story. This next layer reflects the severity of illness which is crucial to patient safety and studies.
8:24 “Data is king now, you can’t do anything without a real robust data analytics of your documentation and your outcomes to be able to push that even further up the hierarchy of safe care and improving outcomes for patients.”
Mel highlights how small hospitals are closing because documentation of resources and patient stories are not accurate, which impacts their bottom line. This causes hardship for patients as they have to travel farther for care. This is where CDI can really make a difference in communities.
For a hospital or facility to run a high-quality CDI program, it requires resources and investment both internally and externally. Partnering with a CDI expert like Nuance can help make this happen, but hiring the right people internally is also key.
1. Look for professionals with strong clinical acumen who also have a deep understanding of CDI. This helps bridge the gap between physicians and technology.
2. CDI professionals should have strong leadership skills and the ability to communicate clearly and comfortably with hospital staff.
Mel shares how her role at Nuance allows her to work closely with the Association of Clinical Documentation Improvement Specialists (ACDIS), the American Health Information Management Association (AHIMA), and lawyers to make sure that Nuance and their clients are compliant with best practices and protecting patient privacy from a legal perspective.
She also mentors and does consulting for clients which gives her insight into what hospitals and facilities need from Nuance to make advanced practice CDI happen.
Mel shares a story from early in her career when CDI’s main purpose was focused on helping hospitals receive accurate reimbursement and improve revenue. Despite this, she quickly saw that by improving their documentation for this purpose, they were also able to help the hospital hire a much-needed specialist, which in turn helped patients.
22:24 “Can we expand that excellence very effectively and successfully into the outpatient arena, into the surgical centers, into the oncology specialties, stand-alone hospitals, is it always going to span to our large academic facilities? That excellence should permeate no matter who the client is or what the facility is.”
Best-in-class CDI is about building on the facility’s current infrastructure and supporting the current staff with the resources and education they need. When this happens, accuracy, outcomes, and patient care are impacted.