Crozer-Keystone Health System ICD-10 preparation leaders discuss their physician education strategy.
When physicians who haven't received ICD-10 training hear the upcoming conversion mentioned, you can see fear in their faces, says Joanna Lucas, ICD-10 committee chair and senior administrative director of health information management/care management at Crozer-Keystone Health System in Springfield, Pa.
"They get this sort of deer-in-the-headlights look," she says.
However, she says Crozer-Keystone — a five-hospital, nonprofit health system located in Southeastern Pennsylvania — has found a way to ease that fear and keep physicians from freezing in the path of the oncoming ICD-10 transition: thorough and customized education.
"They realize they don't have to be coders," Ms. Lucas says. "They just have to document with specificity. That really takes the fear of it away."
A small group of people who have specific ICD-10 training have met with physicians one-on-one and in groups to explain the new system and to give physicians a sense of calm and clarity surrounding the transition. Here are five best practices they identified for physician education in preparation for ICD-10.
1. Make information easily accessible online. Although in-person meetings are a significant part of Crozer-Keystone's approach, the system has also devoted a section of its website to ICD-10. It includes links to educational resources such as the American Medical Association's ICD-10 Center. It also has a section devoted to clinical documentation improvement tips.
"We provide information for providers including tips of the month, which inform them of the documentation concepts that will be required in ICD-10 pertaining to particular diagnoses," Eileen Garrity, manager of Crozer-Keystone's CDI program, says of the website.
2. Schedule short meetings with small groups. Concerning in-person educational meetings, Ms. Garrity says it's crucial to be considerate of the physicians' time. At Crozer-Keystone, they schedule ICD-10 training meetings to run for 30 minutes, although physicians can opt to stay longer. "The half-hour scheduling is huge because it shows a respect for their time," Ms. Garrity says.
Additionally, she and others involved in the training efforts find it's best to address no more than three physicians at a time, although residents and fellows are usually trained in larger groups.
"With the time constraint, three is an appropriate number," she says. "They have ample time to ask questions."
3. Tailor educational meetings to each physician group. Addressing physicians in small groups also allows Crozer-Keystone to customize the meeting materials for particular physicians. The ICD-10 trainers address the top 10 diagnoses for the physicians in the meeting depending on their specialty, says Marlowe Schaeffer-Polk, D.O., JD, physician adviser for two hospitals within the Pennsylvania-based system: Delaware County Memorial Hospital in Drexel Hill and Taylor Hospital in Ridley Park.
"I think that's been tremendously helpful," Dr. Schaeffer-Polk says. "It's a very well-directed approach toward each particular specialty and subspecialty."
4. Show the impact of correct documentation. Another important aspect of training involves presenting hypothetical, real-life situations, such as a patient showing up to the emergency room with a certain condition and showing physicians how their reimbursement for the case would differ if they didn't make any changes to their documentation in line with ICD-10.
Dr. Schaeffer-Polk says this helps physicians understand how taking the time to mention which side of the body an injury was on or the root cause of the condition can make a big difference in payment. However, she emphasizes the system is not in any way teaching physicians to "upcode," or indicate a higher-intensity service than appropriate. "If it's well-documented, you will receive the appropriate reimbursement," she says.
5. Don't worry about educating too much, too early. Overall, Ms. Garrity advises jumping in without hesitation when it comes to training physicians for ICD-10. "There's a lot of information out there now where they say you shouldn't educate too early," she says. "It's very important to get them used to it now, so on Oct. 1 it's not like we're flipping a switch. The more education they receive the more comfortable they'll be with it."
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