Introduction

In our latest ClinIntell webinar, we spotlighted WVUMedicine’s transformational journey to improve malnutrition documentation using data-driven strategies and collaborative workflows.

The conversation, hosted by ClinIntell’s VPMA Terrance Govender, featured Dawn Diven, System Director of CDI at WVU Medicine, and Curt Rockhead, CDI Analyst.Together, they revealed how they tackled a complex, longstanding issue in clinical documentation—malnutrition—and achieved measurable, system-wide improvements.

With rising scrutiny on documentation accuracy, risk adjustment, and denial prevention, the WVU team’s approach offers a blueprint for success many organizations can learn from.

👉 Watch the full webinar to hear directly from Dawn and Curt

Key Takeaways

1. The Malnutrition "Itch" That Couldn't Be Ignored

Malnutrition is often seen as a revenue issue—or worse, overlooked. But as Dawn explained, WVU Medicine reached a point where denial rates were climbing, clinical documentation lacked consistency, and provider engagement was slipping. The issue wasn’t just financial—it was clinical, quality-related, and systemic.

"Malnutrition might not always be revenue impactful, but it is always a risk adjuster." – Dawn Diven

2. Moving from CDI 1.0 to CDI 2.0: The Power of Predictive Analytics

WVU's traditional benchmarking tools weren't providing actionable insights. The team tested one for over a year—with minimal results.That’s when they pivoted to ClinIntell’s predictive analytics.

The data revealed a 12% malnutrition prevalence across the system, yet documentation reflected only 5–6%.

"If we could fix this, everything else would fall into place—denials, revenue, quality. It was the root cause." – Dawn Diven

That insight reframed everything.

“This isn’t about missed queries—it’s about missed diagnoses. And that message resonates much more with clinical leadership.” –Terrance Govender

With this new lens, they weren’t chasing charts—they were addressing a clinical gap affecting outcomes, revenue, and risk adjustment.

3. Building a Coalition and Redesigning the Workflow

Instead of approaching malnutrition as a CDI issue alone,Dawn formed a 32-member coalition spanning physicians, RDs, coding, quality, and more.

They anchored on a shared definition using ASPEN criteria and developed a new workflow:

  • RDs fill out a standardized flow sheet.
  • Providers are notified and use a smart phrase in their note to integrate RD findings.
  • The smart phrase is editable and improves compliance with payer expectations.

This eliminated the need for duplicate RD note signatures—resolving a deficiency backlog valued at approximately $9 million in delayed claims accumulated over 3 years spanning 2021 through 2023.

4. Data Transparency = Physician Buy-in

Curt and the team knew that any process would only succeed if it worked on the ground. So, they built internal dashboards showing tracking:

  • RD-documented malnutrition cases
  • Physician smart phrase usage
  • Cases that didn’t make it onto claims

This allowed local leaders to own their progress and course-correct in real time.

“You can’t fix what you can’t see. Once physicians saw the numbers, they started asking how to help.” – Curt Rockhead

Query volume dropped. Capture rates went up. And physicians started using the smart phrases on their own—without nudges.

5. Results That Speak for Themselves

This isn’t a set-it-and-forget-it model. Ongoing review of data trends allows the team to:

  • Identify breakdowns in communication
  • Correct old documentation templates
  • Support underperforming facilities with targeted education

"You don’t know what you don’t know—until you start tracking it at the diagnosis level." – Dawn Diven

Within one pilot hospitalist group, the malnutrition documentation rate spiked almost immediately—without a rise in queries. Another facility saw an 11% improvement in O:E mortality rate. Across the system, malnutrition capture jumped from 48% to 61% in just one year.

More importantly, the change stuck. With continuous monitoring and open communication, facilities that embraced the process have stayed aligned with predictive targets—even as volume fluctuated.

“Change is hard. But once teams saw what was possible, they didn’t want to go back.” – Dawn Diven

Conclusion

WVU Medicine didn’t just improve documentation—they built a smarter, scalable way to identify and close critical clinical gaps. Their story is proof that when you lead with data from predictive analytics, engage your people, and keep patient care at the center, even entrenched challenges like malnutrition can be solved.

👉 Watch the full webinar to hear directly from Dawn and Curt
👉 Explore more CDI insights and case studies on our ClinIntell Resources and Blogs
👉 Want to replicate this success? Get in touch with our team to learn how

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ClinIntell

Redefining Severity Reporting

ClinIntell is the only data analytics firm in the industry that is able to assess documentation quality at the health system, hospital, specialty and physician levels over time. ClinIntell’s clinical condition analytics assists its clients in identifying gaps in the documentation of high severity diagnoses specific to their patient mix, ensuring the breadth and depth of severity reporting beyond the existing CDI approach. Accountability and an ownership mentality is promoted by the ability to share peer-to-peer documentation performance comparisons and physician-specific areas of improvement.
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