{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:20:46Z","timestamp":1788175246839,"version":"build-2803163510"},"reference-count":51,"publisher":"Walter de Gruyter GmbH","issue":"3","funder":[{"DOI":"10.13039\/100000936","name":"Gordon & Betty Moore Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000936","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100027162","name":"Society to Improve Diagnosis in Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100027162","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_dx-2025-0088_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Omissions in clinical documentation hinder diagnosis by obscuring important information and delaying communication among clinicians. Additionally, carefully implemented incentives can improve health care processes such as clinical documentation. Therefore, we created a pilot using $20,000 in compensation incentives to improve free text documentation for six common outpatient diagnoses (cerebrovascular accidents, chronic kidney disease, congestive heart failure, deep vein thrombosis and pulmonary embolism, chronic obstructive pulmonary disease, and smoking) in an urban health system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2025-0088_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For each diagnosis, we asked clinicians to document 2\u20133\u00a0pre-specified clinically significant, evidence-based details that influence diagnosis or management. We compared baseline documentation (Aug 15th\u2013Sep 25th, 2022) with an incentivized period (Sep 26th\u2013Dec 16th, 2022) using an unadjusted signed rank test and an adjusted generalized linear mixed model. All 32 eligible physicians and advanced practice providers participated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2025-0088_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 693 baseline and 1,494 intervention opportunities when a diagnosis was assessed, documentation that included all clinically significant details improved from mean 32.2\u202f% (SD 20.7) to mean 47.1\u202f% (SD 23.6; p=0.01) and in our adjusted analysis from 35.6 to 48.2\u202f% (p&lt;0.001). Seven participants\u2019 documentation improved by\u00a0\u22651.6 diagnoses per\u00a0week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2025-0088_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In conclusion, compensation incentives improved free text documentation of clinically significant information to improve the diagnostic process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/dx-2025-0088","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T14:58:16Z","timestamp":1772636296000},"page":"419-429","source":"Crossref","is-referenced-by-count":0,"title":["Pilot demonstration for physician compensation incentives to improve diagnostic specificity in clinical documentation"],"prefix":"10.1515","volume":"13","author":[{"given":"David S.","family":"Burstein","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of General Internal Medicine , Rush University Medical Center , Chicago , IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Medicine , University of Illinois Chicago , Chicago , IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhiroop","family":"Ganguly","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , Olive View\u00a0\u2013\u00a0UCLA Medical Center , Los Angeles , CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Hanak","sequence":"additional","affiliation":[{"name":"Department of Family and Preventive Medicine , Rush University Medical Center , Chicago , IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura J.","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of General Internal Medicine , Rush University Medical Center , Chicago , IL , USA"},{"name":"Department of Family and Preventive Medicine , Rush University Medical Center , Chicago , IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Keshavarzian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology , Rush University Medical Center , Chicago , IL , USA"},{"name":"Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center , Chicago , IL , USA"},{"name":"Department of Anatomy and Cell Biology , Rush University Medical Center , Chicago , IL , USA"},{"name":"Department of Physiology , Rush University Medical Center , Chicago , IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"2026083110583459780_j_dx-2025-0088_ref_001","doi-asserted-by":"crossref","unstructured":"Clynch, N, Kellett, J. 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