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Clinical documentation improvement (CDI), also known as "clinical documentation integrity", is the best practices, processes, technology, people, and joint effort between providers and billers that advocates the completeness, precision, and validity of provider documentation inherent to transaction code sets (e.g. ICD-10-CM, ICD-10-PCS, CPT, HCPCS) sanctioned by the Health Insurance ...
As more diagnostic tests have come online, the rate of “confirmed cases” — the key performance indicator (KPI) being monitored by decision-makers across the country — continues to accelerate.
The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks.
In practice, overseeing key performance indicators can prove expensive or difficult for organizations. Some indicators such as staff morale may be impossible to quantify. As such, dubious KPIs can be adopted that can be used as a rough guide rather than a precise benchmark. [16]
The Physician Quality Reporting System (PQRS), formerly known as the Physician Quality Reporting Initiative (PQRI), is a health care quality improvement incentive ...
Avedis Donabedian, a physician and health services researcher at the University of Michigan, developed the original model in 1966. [3] While there are other quality of care frameworks, including the World Health Organization (WHO)-Recommended Quality of Care Framework and the Bamako Initiative , the Donabedian model continues to be the dominant ...
where national standards and guidelines exist; where there is conclusive evidence about effective clinical practice (i.e. evidence-based medicine). areas where problems have been encountered in practice. what patients and public have recommended that be looked at. where there is a clear potential for improving service delivery.
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