Nuance’s clinically driven CDI program and a unique staffing model engage physicians and drive results
Baptist Health South Florida is a six-hospital system in
Miami and the Florida Keys with a large international
presence throughout the Caribbean. Its 15,000
employees and 2,200 physicians in virtually all
specialties serve over a million patients a year from
around the world.
Historically, Baptist completed chart reviews after patients had been discharged from the hospital. The retrospective requests to update clinical documentation met with physician resistance, with only a 20% response rate, and missed opportunities to improve quality and receive appropriate reimbursement.
Lorena Chicoye, MD
Corporate Medical Director
Administrators understood that this manual, retrospective process resulted
in critical data being missed. So Baptist Health, under the leadership
of Lorena Chicoye, MD, corporate medical director, engaged Nuance
to help change this practice. Baptist Health deployed Nuance’s Clinical
Documentation Improvement (CDI) program because of the emphasis on
physician engagement and proven results. Unique in its approach to clinical
documentation improvement, the Nuance process employs technology and
education designed to empower clinically trained CDI specialists to engage
in a dialogue with physicians about the quality of patient care and how best
to capture those details in their documentation—all while minimizing workflow
disruption through a concurrent review process that brings to light care and
quality documentation issues while patients are still in the hospital.
Within six months, Baptist Health saw measurable results. The average physician response rate to the CDI team’s concurrent clarifications increased from 10–20 percent to 95 percent. Even more compelling is the 80 percent agreement rate, indicative of physician compliance in capturing the quality details in patient documentation. In the four years since the Nuance CDI implementation, the more accurate severity-based CDI approach has generated a 13 percent average increase in Case Mix Index (CMI) across the system, translating to $45 million in appropriate reimbursement.