January 26, 2012
A programmatic approach to the ICD-10 transition
We’re only about a month into 2012 and there’s no doubt
this is going to be a busy year from a regulatory perspective. Our Cerner
family will continue to make great progress toward attesting to Meaningful
Use. The first performance period for the hospital
value-based purchasing program will conclude, and the pay-for-performance
era will formally begin here in the United States. Hospitals will become
financially accountable to 30-day readmissions. A handful of you will be well
on your accountable
care organization journey. While these initiatives all have a direct impact
on health care organizations, we cannot overlook another initiative likely to
have the broadest impact on health IT since Y2K.
On October 1, 2013, our entire health care industry will be transitioning
to ICD-10. I’m sure you’ve heard that date before. The transition is
something we’ve known about for some time. While we are still 21 months away,
the runway looks short and, with the other programs I mentioned earlier still
on the plate, there’s sure to be some anxiety around the shift. This is especially
true if you’re not well under way in performing thorough assessments to understand
how this change will impact your organization. It’s not a question of if; it’s
a question of how much.
As complex as ICD-10 is, there’s no way I can address all
the ins and outs of the transition in one post. Instead, we’ve decided to create
a series of posts dedicated to our approach to a successful ICD-10 transition.
True Programmatic Approach
The
impact of ICD-10 will be realized across several functional areas, the obvious
ones being coding and the payer, but ICD-9 codes live in many places inside
clinical systems. And don’t forget about
the patients. Without a proactive strategy to educate patients on what they
should expect in terms of statements and timeliness of claims processing, there
could be patient satisfaction consequences.
So,
while it is highly likely that there will be independent plans within each
functional area, it is important to have an overarching point of accountability
to ensure the program as a whole stays on schedule and in sync. In the image
above, the vertical represents key elements of a programmatic approach. While plans
will vary based on the size of your organization, we strongly recommend committing
a director-level resource as the program manager, making the transition their
primary responsibility with PMO support. This person will be responsible for
driving the initiatives and resources in each functional area, as well as reporting
progress and risks to an executive steering governance structure. This person
could be someone on staff who can be redirected or could be resourced out. It
is important to make this decision as early as possible because the truly
skilled and experienced resources will not be on the market long. There is
simply going to be a shortage, given every organization in the country is
working toward the same timeline.
Over
the next few months, other posts from my colleagues will touch on best
practices for assessing your organization’s readiness to transition to ICD-10,
the importance of a learning plan to drive adoption of new coding practices,
the transition through the eyes of a coder and tips and tricks to ensure
clinical documentation integrity.
While
ICD-10 will be a major change for health care providers here in the U.S.,
careful planning and flawless execution will help avoid most of the major
headaches.
Roy Foster leads a team that consults health care provider organizations in developing strategies that position their organizations to proactively respond to the current and future health care economy. This includes education and comprehensive strategies for surviving and thriving post American Recovery and Reinvestment Act of 2009 and Patient Protection and Affordable Care Act of 2010.
Foster joined Cerner in 2001 as a Solution Delivery Consultant responsible for installing electronic medical record systems. During his career, Foster has implemented EHR’s at over 70 organizations and 200 facilities that range from small community hospitals to large IDN organizations. Prior to his current position, Foster lead the growth and development of Cerner’s clinical quality consulting practice. Clinicians in that practice worked with health care provider organizations advancing the use of the EHR to proactively manage clinical quality metrics by embedding core measure awareness and capture into the clinical workflows and by utilizing clinical quality dashboards. Foster earned a Bachelor’s of Arts degree with a major in biology and an emphasis on chemistry from Ottawa University. While attending college Foster worked in the laboratory at the VA Medical Center in Leavenworth, KS.