Disruption in the Clinical Documentation Improvement Market - Cover

Disruption in the Clinical Documentation Improvement Market

Clinical documentation improvement (CDI) has been changing drastically through acquisitions and technology developments. Things like prioritization that were nascent a couple of years ago have seen quite a maturation in recent years. While larger vendors have chugged along with new advancements, some vendors with historically smaller market share have started to disrupt the market in big ways by offering better services and more training.

Time will tell how this resurgence of other vendors into the market will affect the old guard, so we at KLAS have prepared the Clinical Documentation Improvement 2021 report to dive into all the recent developments and interesting details.

Vendors Seeing Steady Improvement

Overall, the clinical documentation improvement market has been seeing steady improvement. 3M has kept up their large market share, and they are not dropping the ball. Their product is working exactly as intended, and a lot of customers are satisfied by the fact that all of their pieces work well together. Meanwhile, vendors like Nuance have stood out for strong financial outcomes and lower error rates, though their multiple products have created issues for some clients. However, they are creating flexible options and good interfaces while also fitting prioritization into the workflow. ChartWise has grown beyond the ambulatory space in recent years and has added on to larger health systems, while Iodine Software has continued to thrive in larger health systems. Both of these vendors have made big splashes recently through their strong service and partnerships, which customers really appreciate.

CDI Training a Critical Factor

The biggest disruption from these vendors probably comes from their training, which has been described as excellent.

Training on clinical decision improvement  is critical. If the people that are interacting with the tools are not properly trained on the system or workflows and don’t know how to make changes, do updates, pull out codes, or read those codes properly, major workflow traffic jams are made that go all the way down the line. The best thing for that issue is to have a really robust training program, and both ChartWise and Iodine Software have been showing off their new training and implementation practices, which have led to better outcomes. This has made quite the difference in comparison to other vendors’ training programs and has shown a marked improvement, as can be seen below:

Clinical documentation improvement score and trending

In terms of the training from the larger vendors, customers have felt that training programs get scaled to the bigger health systems while the smaller and mid-sized systems don’t have an ideal, standardized way of getting the training out there. That is one of the contributing factors in how that stronger focus from the vendors with less market share has made such an impact. Some of these vendors did on-site visits before COVID-19 and now do virtual visits in order to talk to the teams before the groundwork goes down for an implementation. As a result, people know what to expect and what to do, and that helps these vendors stand out.

Some Issues Facing Vendors

One thing to consider about these smaller market share vendors is that there are bound to be some deficiencies in what is offered just by the nature of having that smaller market share. For example, KLAS has seen certain vendors not have things like the APR-DRG coding, which is something that leaders have in spades and have even established a lot of the protocol for. For many customers facing this issue, it is like buying a Honda that needs a Chevrolet engine in order to run. The car may be just fine or even exceptional, but that issue would make it solely dependent on other functions that other vendors offer.

Inversely, the more well-known vendors have been experiencing a lot of complaints over nickel-and-diming. Issues with charging for things unnecessarily have fostered some concern among customers over what the future will look like, and this has resulted in a drop in satisfaction. Mergers, like the ones with 3M and MModal or Change Healthcare and Optum, have created more nickel-and-diming worries as well as service concerns.

The Call for Transparency

As things continue to change in the CDI market, one call has gone up for more transparency into vendors’ road maps in order to promote further communication and sharing. This is a concern of providers across the board, not just CDI providers. People like to know what is coming before it becomes important, whether that be for a rule change, a regulatory issue, or some modification to the tool. We are optimistic that vendors will continue to work to help providers achieve the best outcomes. To keep up with these changes and whatever else the future may bring, be sure to check out KLAS’ Clinical Documentation Improvement 2021 report.

Photo credit: Andrey Popov, Adobe Stock