The transition to ICD-10 is a leading concern for many healthcare executives and was a popular topic of discussion at the recent annual meeting of the Healthcare Financial Management Association, held in Orlando, Fla.
While the challenges will be considerable as hospitals prepare for the transition, most within the industry seem to agree that there will be eventual benefits of the change — though they make some time to appear.
"ICD-10 gives physicians and hospitals better information about patient populations for use in quality and outcomes programs to help improve patient health, while allowing them to be appropriately reimbursed for the care provided," says Chris Powell, president of Precyse. "So, while providers do have to make an investment in this, the payoff should be equally as significant for a health system over time."
Mark Morsch, vice president of technology Optum, agrees. He says the improved specificity allowed by ICD-10 will "allow conditions and procedures to be recorded and captured in greater detail that is not possible in ICD-9."
So while benefits do exist, the effort required on the part of health systems to prepare is great. Where should systems start?
The first step is completing an ICD-10 assessment to identify the systems and processes that must be updated. An assessment is used to guide the creation of an ICD-10 project plan. Most hospitals have completed assessments on their ICD-10 readiness, explains Mr. Morsch, and now the challenge becomes carrying out their project plan.
Mr. Morsch explains: "At this point because it is less than 18 months away, it's really the point where hospitals and physician groups need to be looking at implementing all the actions that are recommended in their ICD-10 assessments and then preparing in early 2014 to do the testing required to validate that all systems, all the people are really ICD-10 ready and validating that their payers can accept ICD-10 transactions."
While some organizations continue to push for a delay of ICD-10, all evidence from CMS suggests one is unlikely. "ICD-10 was pushed once, but the national coordinator for healthcare IT stated recently there would be no extension of the deadline," says Mr. Powell. "There is a clear picture emerging that healthcare organizations are not ready. Much hard work needs to be done in the form of clinical documentation improvement, training and development, process improvement and systems testing between now and October 2014. There is no time to procrastinate."
So how does a system ensure its ICD-10 is effectively carried out?
"You need to understand the full impact of ICD-10; it's not just an IT problem, it's not just a coding problem," says Mr. Morsch. "You need to have fairly aggressive and focused follow-up from leadership around the ICD-10 plans."
Both administrative and physician leadership should educate others on the benefits of the transition, or the why behind the change. "[Explain] how it's not just about coding and ICD-10, it is about improving clinical documentation and improving the overall clinical information inside a system," says Mr. Morsch.
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