I was reading an article today about healthcare reform and the affordable care act, which linked an increase in CDI staff with the increased use of electronic health records. I began to reflect on the past 10+ years in the Clinical Documentation Integrity field.

We have gone from just looking for a single opportunity to move a DRG for financial enhancement to looking at the accuracy, compliance and integrity of the documentation produced by providers. We are gearing up for the transition from ICD-9 to ICD-10, which will provide for another shift in the work of CDI around more specificity and the codes to more accurately describe the diagnostic terms. The affordable care act has also shifted the paradigm of healthcare reimbursement to quality and outcomes-based. HCC, PSI, and HAC will continue to drive reform in healthcare that will hopefully produce the patient care that we all strive to obtain.