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Clinical Documentation Improvement 2021
Who Excels with Both Technology and Relationships?
Author
Daniel Zeitner
Author
Jennifer Hickenlooper
Some significant changes have occurred in the clinical documentation improvement (CDI) market in the last couple of years, including vendor acquisitions and technology developments. This report examines how these and other factors have impacted the customer experience, seeking to uncover which vendors provide strong technology as well as the relationships and guidance healthcare organizations need to be successful.
A Note about Dolbey: Historically known for their speech recognition technology, Dolbey has seen early success with implementations of their new Fusion CDI solution. While customer feedback is currently too limited to share, early customers highlight the flexible configuration and high level of automation.
Iodine’s Full Solution Gaining Momentum; Energy Remains High for 3M 360 Encompass CDI
Historically used primarily for prioritization, Iodine—who often works with larger organizations—now offers full CDI capabilities in the AwareCDI solution, which is gaining traction. Interviewed AwareCDI users say new features—such as AI, NLP, broad reporting, and the ability to prioritize potentially problematic charts—have helped them achieve desired outcomes, including improved workflow efficiency and visibility. Relationships are also a strength, described by customers as collaborative and proactive. Also frequently used by larger organizations, 3M 360 Encompass CDI sees high consideration due to strong technology—e.g., APR-DRG methodology, reporting, quality indicators (such as PSIs), worklist prioritization, and EMR integration—and to 3M’s broad platform of other HIM and clinical solutions (e.g., for CAC, CAPD, HCCs). Optum is frequently considered; their clients speak highly of the product’s ease of use and ability to drive financial outcomes.
ChartWise Generates Positive Outcomes, Mostly for Midsize/Small Organizations
CDI solutions that fit within workflows and are easy to use help organizations prioritize chart review and achieve desired outcomes. Customers of 2021 Best in KLAS winner ChartWise feel their solution is easy to use and works as promoted. Respondents are mostly midsize or small organizations, and they report that the cloud solution has excellent reporting and enables outcomes such as improved physician query rates. Customers specifically highlight ChartWise’s frequent, smooth updates, and a couple report optimism about additional updates scheduled for 2021. A few customers note that their version has fewer bells and whistles (e.g., less developed NLP technology) than some competing products.
3M 360 Encompass CDI Delivers Strong Technology; Other Aspects of the Customer Experience Less Positive
As noted above, 3M customers value the strength and breadth of 3M’s technology. Some other aspects of the customer experience are less positive for users of 3M’s 360 Encompass CDI. Service and support continue to be a challenge (see chart to the right). Customers report issues getting technical help with upgrades and say 3M is not proactive in helping clients understand new releases or in providing the training needed to fully adopt the software. A couple of respondents have seen improvement with 3M’s new account management model. Exacerbating the service frustrations, over 50% of interviewed customers feel nickel-and-dimed for things like service, system fixes, and upgrades. A couple of 3M’s MModal CDI Collaborate customers (acquired in 2019) have felt an increase in nickel-and-diming over the last year and report an overall drop in satisfaction following the acquisition.
Strong Training from Nuance Leads to Good Outcomes; Lack of Expected Functionality Causing Some to Look Elsewhere
Nuance customers say the vendor’s implementations and strong front-end training result in good provider adoption and ease of use, enabling organizations to quickly achieve outcomes. Several satisfied clients also praise Nuance for their analytics package and proactive service. Nuance has a higher-than-average customer turnover rate, caused at least partly by poor EMR integration and lack of expected functionality. Customers say Nuance has been slow to roll out more advanced CDI functionality for both Clintegrity and the newer CDE One, which a few clients say is missing expected functionality (including improved AI functionality). Some Nuance customers also report nickel-and-diming, both with licensing for employees and when expanding contracts to new or acquired facilities.
Optum Customers Generally Satisfied, Looking for More Proactive Direction
Customers of Optum, one of the largest players in the CDI market, are generally satisfied with the technology (e.g., integration with coding) and highlight the product’s overall quality. They report mixed feedback about service and support. Many customers feel Optum’s support is excellent and describe the vendor as a partner who wants to help them grow and improve. Other customers have seen a decrease in support and proactive guidance following a recent reorganization at Optum. Additionally, customers note that Optum does not always follow through on development promises, especially around outpatient functionality. Customers of Iodine or ChartWise view their vendor/client relationships as strengths, and both vendors are praised for good communication during issue resolution.
ChartWise & Iodine Stand Out for High-Quality Training
A positive implementation and training experience can lead to better provider adoption, higher ease of use, and faster outcomes. ChartWise customers are impressed with the vendor’s speed in getting the system up and running, and the system’s consistent upgrades are seen as a positive. Most interviewed customers say the webinar training that ChartWise often employs during implementations and upgrades is sufficient to learn the system. Iodine also receives high implementation and training ratings, with customers saying that Iodine’s ongoing training helps them use the software to its full potential.
About This Report
Each year, KLAS interviews thousands of healthcare professionals about the IT products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared in reports like this one and online in real time so that other providers and IT professionals can benefit from their peers’ experiences. The questions from the standard evaluation are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.
The data in this report was collected over the last 12 months; the number of unique responding organizations for each vendor is given in the chart below.
What Does “Limited Data” Mean?
Some products are used in only a small number of facilities, some vendors are resistant to providing client lists, and some respondents choose not to answer particular questions. Thus a vendor’s sample size may vary from question to question and may not reach KLAS’ required threshold of 15 unique respondents. When a vendor’s sample size for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.
Overall scores are measured on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale.
Product Designations Used in This Report
- Component [C]: Products that serve only a subset of the market or include most but not all components that typically comprise a complete system. While Iodine now offers a full suite of CDI capabilities through AwareCDI, the vendor is marked as “component” in this report because the majority of interviewed customers use Concurrent, a component product that does not offer full CDI functionality.
Designer
Jess Wallace-Simpson
Project Manager
Natalie Jamison
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2025 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.