Journal excerpt: Developing an outpatient CDI tracking tool

Unlike the inpatient CDI world, there aren’t many outpatient tracking tools premade and available through vendors, so newly minted programs are often left to develop and rollout homegrown solutions. Developing an outpatient CDI tracking tool can be a long, arduous, and sometimes overwhelming process, however. While there are several options, many programs opt for Excel-based tools because they are easily customizable and affordable.

“We decided on Excel for our tracking tool,” says Caley Wilson, BSN, RN, ambulatory CDI nurse at University of Vermont Medical Center in Burlington. “We have Epic for our EHR, and at the time, there wasn’t really any solution in Epic for what we were doing. We worked with our ACO [accountable care organization] to determine our HCC capture rate, too, for a baseline.”

Like Wilson, Jennifer Boles, CPC, CRC, system manager of ambulatory CDI at Baptist Health in Louisville, Kentucky, also advocates leveraging the information available through other groups and departments at your organization.

“When I started in this position, I went and shadowed the inpatient team to see how they do their queries and to find out what’s worked and what hasn’t worked with their system. Learn from their mistakes and don’t make the same ones when you’re developing your own tool,” she says. “Ask them what reports they use and ask if they’ll share them with you.”

Though the inpatient CDI team may have more sophisticated tools and a different focus, outpatient CDI leaders should still evaluate the inpatient processes and see how (or if) they translate to the outpatient setting.

“Because we knew our focus was going to be HCCs, that was mainly what I put in that first spreadsheet,” says Karen Frosch, CCS, CCDS, CRC, CPHQ, CDI program manager at Christiana Care System. “I asked myself what I used for metrics on the inpatient side and what that translated to on the outpatient side. It really helped us with proving our return on investment.”

Editor’s note: This article is an excerpt from an article in the March/April 2019 edition of the CDI Journal. To read ACDIS’ position paper on outpatient CDI query compliance, click here.