Sepsis-2.5: Resolving Conflicts Between Payers and Providers.

Competing definitions of sepsis have significant clinical implications and impact both medical coding and hospital payment. Although clinicians may prefer Sepsis-2, payer use of Sepsis-3 to validate clinical diagnoses may result in denial of payment or requests to recoup previously paid funds from healthcare providers. The Sepsis-2.

The Natural History of CDI Programs: A Metric-Based Model.

The success or failure of a clinical documentation integrity (CDI) program is often evaluated using a designated set of metrics. However, these metrics change over time, and an understanding of these changes is critical to properly judge the efficacy of the CDI effort. The authors propose a model of the natural history of a CDI program based on commonly used CDI metrics.

The Expanding Role of Clinical Documentation Improvement Programs in Research and Analytics.

The future of clinical documentation improvement (CDI) will require expanding the reach of CDI programs into new areas of expertise because the traditional realms of CDI work are increasingly becoming automated. CDI-based research and analytics can serve as a means for demonstrating continued value to an institution. We present four studies as examples of these efforts.

A preliminary comparison of levalbuterol and albuterol in prehospital care.

Nebulized levalbuterol has been documented as more efficacious than albuterol in enhancing airflow in Emergency Department (ED) patients with bronchospasm. This work attempts to determine if nebulized levalbuterol yields similar improvements in peak flow measurements as those produced by albuterol in the Emergency Medical Services (EMS) arena. All adult EMS patients given a nebulized beta-agonist from January to June 2000 were included in this prospective, before-and-after, open-label study.

Effect of levalbuterol on prehospital patient parameters.

This study was performed to determine if levalbuterol improves dyspnea as assessed by prehospital clinical parameters. All EMS patients >or=16 years old given nebulized levalbuterol over 6 months were included in this prospective, open-label work. Data collected included demographics, initial pulse rate (P), respiratory rate (R), patient report of respiratory distress (S), and peak expiratory flow (PF).