Here we are, our last episode of Off the Record this year.

I hope you’ve had a great 2025.

Just my voice today.

I’m ending with a solocast, a reading/summary of a paper about the biggest news story of the year: The explosive growth and proliferation of artificial intelligence, or AI.

You might recall my poll from a couple weeks ago; you all confirmed it.

Where do people fit with this tech? None of us really know, but I offer my opinion here.

Outpatient CDI is still in its pioneer-”ish” stage. Why do I say that? Per the most recent ACDIS survey data, only 31% of respondents indicated their organization had a dedicated OP CDI program.

Progress, but not enough, and still a minority.

So when you find an “OG” who has been working in risk adjustment for well over a decade, you need to pay attention. Odds are they’ve got some lessons to share and wisdom to confer. That certainly describes Amy Campbell, Director of Outpatient CDI for LifePoint Health.

Listen in as we discuss:

• “Building the airplane as we were flying...” Her start and early days in OP CDI.

• A “day in the life of” her role as OP CDI Director today for a large and growing healthcare organization

• Dashboard for success and most impactful/important KPIs

• Manual chart reviews (yes, they do this—no assistive tech). What does a pre-visit review look like/how is it conducted, and what common clarifications and dx opportunities are her team finding?

• Rapid fire round: Biggest OP CDI pet peeve (a doozy), RN vs. HIM staffing decisions, and the hardest part of managing people

• Interesting career stops, from critical care nurse and neurological intensive care nurse, to consulting, to content reviewer for Lippincott.

• Being a mother of an adult child with autism

No matter how great your CDI program is—its spectacular workflow, outstanding chart review team, on-point KPIs, shiny new AI tools—nothing works if you don’t have engaged physicians.

It still all comes down to provider engagement. Without a physician staff who is bought in and willing to participate and document with specificity in the health record, all these efforts are for naught.

But with great engagement, great things are possible.

So where are we today with the big daddy of all CDI topics? Joining me on this episode of #OTR are two physicians with considerable experience and plenty of war stories. Trey LaCharite, Medical Director for CDI and Coding and Clinical Associate Professor for University of Tennessee Medical Center, and Vaughn Matacale, director of the physician advisor group for ECU Health in North Carolina, open up for a frank, no-holds barred discussion on the following topics:

• What is overrated when it comes to provider engagement--and what is underrated?

• The best high-tech solution each recommends, and a great low-tech solution that stands the test of time.

• An ultimate success story winning over a difficult provider or service line.

• Notable failures others can learn from.

• RUSH reunion tour in 2026—yay or nay? Spoiler alert: Of course the answer is yes...

• And other fun stuff you really shouldn't miss...

Fans of Off the Record may recall my recent episode with Chris Petrilli, Director of Revenue Cycle of Operations at NYU Langone, who joined me to discuss his experience delivering a TEDx Talk on artificial intelligence.

Chris was well prepared and delivered a great lecture, which you should definitely check out on YouTube. And on the podcast he sang the praises of a coach brought in to prep him and other NYU Langone staff for the big day on the big stage.

My wheels started to spin, I reached out... and landed that coach for OTR.

Susanna Baddiel is an actress, director, voice over artist and TEDx Speaker Coach. She works in both the UK and the US and is a founder member of Actors Shakespeare Company where she continues to act, direct and coach. She has more than 17 years of experience teaching public speaking, personal impact, presentation skills, leadership development, and executive coaching.

It was my honor to host her in a bit of an offbeat show than the usual mid-revenue cycle topics. But I picked up a few pointers about public speaking that helped me, and I think you will too.

This special episode kicks off November, a month in which I’ll be taking a deep delve into provider engagement. Odds are if you’re trying to engage providers you’ll have to present or educate, and Susanna offers some great advice and practical tips and takeaways.

On this show we cover:

• Her background as an actress in Britain, transition into coaching, and eventually working with niche clients in science and medicine

• Working with the team at NYU and Chris Petrilli—preparing them, building them up, and getting them ready for the big day.

• Why preparation is everything in public speaking, as is gratitude for the opportunity

• Balancing authenticity vs. general principles of good presentation

• The differences between in-person and presenting on camera. Susanna offers some GREAT suggestions for being better on Zoom.

• Books and other resources Susanna recommends

Erin Kreider gives me hope for the future of the CDI profession. That’s a pretty positive first impression for someone I recently met. Why do I say this?

Erin is a newly-minted clinician who returned to medical school after nursing and CDI to become a nurse practitioner (NP), and now sees patients once a week. Her “welcome mat” on LinkedIn lists her core passions, which include clinical honesty and ethical integrity in the final code set, advocating for patients’ rights and best interests, and education and thought leadership.

Today the majority of her work is with a technology company, Ambience, where she is helping build out ambient listening technology that assists with documentation and coding.

Prior to that she had lengthy stop at Kettering where she was a CDI professional and a case manager.

How’s that for achievement—and purpose?

We get into all this on this episode of Off the Record, covering:

• Erin's first day on the job as an NP and what becoming a clinician taught her about documentation/coding/the mid-revenue cycle that she didn’t know or fully appreciate prior.
• CDI in the ED: Missed opportunity to improve documentation for admitted patients and strengthen Medical Decision Making (MDM)
• Best practices for leveraging APPs: Support system for MD physician advisors, second level chart reviews, educators, and more—a topic she recently wrote about for ACDIS’ CDI Journal
• UR/UM synergies with CDI and coding
• CDI pet peeves: Queries for the sake of metrics, and perception of CDI as an easy retirement job for fatigued bedside nurses
• How ambient listening can help with documentation, provider burnout, and surface additional missed diagnoses/HCCs

Many healthcare organizations know they need an outpatient CDI program, but are tripped up by the most fundamental question: What is the expected return on investment after a considerable upfront investment of time, human capital, training, and technology?

Discover the tangible impact of outpatient CDI on revenue, risk capture, provider alignment, and compliance in this special session of Off the Record. Jason Jobes, Senior Vice President, Solutions, Norwood, and Carol Ann Hudson, AVP of Quality and Clinical Operations and Population Health for Lifepoint Health first presented this popular session at the ACDIS 2026 national conference and later for a select virtual audience, and I’m pleased to bring it to my listeners.

You’ll walk away with a big picture understanding of OP CDI and concrete, operational strategies for transforming your program. If you haven’t started yet, consider this your blueprint.

Note that “ROI” doesn’t only equate to revenue. Return on investment can also come in the form of denials resistant documentation, coding compliance, and improved patient care and value based care alignment through a greater emphasis on patient scheduling. All of which Lifepoint Health experienced.

• Note: Jason and Carol Ann refer to slides at points of this session; the audio can stand alone but if you prefer you can also download them on the Norwood website (free with registration): https://www.norwood.com/resource/the-roi-of-outpatient-cdi-slide-deck/

If you’ve been in the CDI space for any length of time you probably know the name Fran Jurcak.

After a memorable stint as an ER/trauma nurse, CDI and then consulting, Fran made an impact in ACDIS, serving on the CCDS certification committee and later the ACDIS advisory board. She authored and continues to author the CCDS Exam Study Guide.

But what makes Fran unique is that she’s never afraid to share her opinion—or make a big career move.

Fran made the successful leap from traditional consulting into technology. And in the same manner that marked the rest of her career climbed the ladder all the way up to her current role as Chief Clinical Strategist at Iodine.

So yeah, you might very well know Fran. But, what you might NOT know is she is winding down her career—she plans to retire from the industry in October.

This episode is a fantastic, wide-ranging conversation recapping her full career. Fran brings a seasoned perspective on technology and CDI few can match, so it seems only natural to debut this episode in conjunction with CDI Week. Listen in as we talk about:

• Career progression from bedside to CDI to consulting to tech. How did she make the jump—and then advance?
• What does a fully AI tech enabled CDI position look like?
• How does the modern CDI professional work in this setting? How much of their clinical knowledge do humans still apply vs. reviewing machine output?
• How much of a job displacer is advanced AI, but what can’t machines do, and who will survive the new reality? What mindset and skills do they need to have?
• The most important lesson Fran learned in her career.
• Her stint at CDI consulting OG JA Thomas: Their place in the industry, what she learned from them, pro and con.
• Her greatest career accomplishment, and where CDI needs to change
• Winding down and retirement plans (grandkids and cruising on the docket)

Cheryl Manchenton and I go back a long way—I once took a ride from a Las Vegas casino to the airport with her after an ACDIS conference well over a decade ago. And I’ve learned over the years she also happens to be as sharp—and as outspoken—as anyone I’ve ever met regarding the subject of healthcare quality, specifically measuring hospital quality with coded or abstracted data and how it all relates to the work of mid-revenue cycle professionals.

I think we even talked quality on the way to the airport.

So I was thrilled to get her on Off the Record to go deep on this topic, along with her Disney World obsession and other fun asides (Gandalf the Gray makes his way in to the conversation). This was a fabulous, wide-ranging talk on quality. Tune in and listen to:

• What Cheryl thinks about how we measure quality in healthcare, specifically through the use of coded data
• What quality-obsessed hospitals often get wrong about impacting outcomes with documentation and coding alone (with a deep dive into healthcare acquired infections, or HAIs).
• Borderline or unscrupulous practices done to artificially improve quality rankings
• What concrete steps would Cheryl take were she leading a small community hospital seeking to improve its observed/expected mortality ratio
• The recently-released 2026 OPPS proposed rule and the large number of hospitals potentially impacted by the new Safety Measures change (we both like this: presently a hospital can rank at the bottom for safety and still be 5 stars)
• The reality of “picking your poison” among many quality programs and getting aligned with what really matters to your organization
• Cheryl’s career north star, how she stays educated, and thoughts on her long career winding down
• Disney craze, grandkids, and best tips for navigating the theme parks