Symposium spotlight: Wilk tackles top outpatient “problem;” offers solutions for handling the list

Editor’s note: Deanne Wilk, RN, BSN, CCDS, CDIP, CCS, will present “How to Handle the Problematic Problem List” on Day 1 of the ACDIS Symposium: Outpatient CDI, which takes place November 14-15 at the Hyatt Regency in Austin, Texas. Wilk is the manager of CDI at Penn State Health Hershey and a member of the ACDIS Advisory Board.

ACDIS Blog: In your opinion, why is the problem list so problematic? Has it always been a problem or is a more recent development?
Wilk: The problem list was very personal to the provider who used it in years past. With electronic records and meaningful use requirements, this brought multi-provider access and input with little ease of reconciling information in the record.

ACDIS Blog: In its current state, how is the problem list used? In an ideal world, how could it be used?
Wilk: Currently, the majority of the industry is using the problem list as a “catch all” for anything patient related. We need to get to an accurate, concise list of conditions that providers can easily access and update, that can be shared amongst providers and facilities. We need to quickly reflect the overall historical picture and ongoing care needs of the patient.

ACDIS Blog: Your presentation will touch on an analysis project and case study. Can you give us a preview of what that project entailed and found?
Wilk: What started as a project to capture HCCs quickly turned to the root cause of the lack of integrity in the problem list. It was a year-long effort that is still ongoing.

ACDIS Blog: How is Penn State Hershey tackling the problem list at the current moment?
Wilk: We are taking a combined approach from the organization and clinic provider standpoint and leveraging tools within our EHR.

ACDIS Blog: How do you suggest CDI professionals educate physicians on the problem of the problem list? What’s been your most successful approach?
Wilk: First, educate them about the purpose and intent of the problem list. Help them to understand that anyone who enters or interacts with it such as those working on both the inpatient and outpatient (physician practice) setting may be affecting what information gets communicated about their patient. Make educating physicians an organizational effort. Have CDI educate with the same message to each provider and/or service line for consistency. Query providers on the problem list conditions; both inpatient and outpatient. Ensure inpatient and outpatient CDI teams are on the same page and consistent in their messaging.

ACDIS Blog: Are you a cat or dog person? Why?
Wilk: I am both! Now, I’m a cat person but I’ve always owned dogs previously. Cats are a bit easier to be left alone a day or two and you don’t have to get dressed for them to use the bathroom. I do miss wet dog smell though! Was that TMI [too much information]?