RNs performed DRG validation reviews primarily from providers’ EMRs. Reviews were a page-to-page comparison (often averaging 500+ pages per case) within slow systems with cumbersome navigation. Once RNs located decision information, they created screenshots and saved them to an internal shared drive. After using these EMR screen shots to determine whether to downgrade each DRG, reviewers opened a letter template in Microsoft Word, populated it with the case’s relevant feedback, and emailed it directly to the provider. The final step was updating their workflow system. After navigating one of multiple EMRs plus accessing a shared drive, Microsoft Word, and email, the final step was updating their workflow system.