In an attempt to understand how healthcare executives are
preparing for the transition from ICD-9 to ICD-10, we
conducted focus groups with Chief Information Officers
(CIOs) throughout the country. Our conversations were
enlightening: coder training and application upgrades
continue to dominate the mindshare. While coder
training and application readiness are critically important
in preparing for the transition, they are only the tip of
the ICD-10 iceberg. Consider what lies beneath; an
enormous undertaking requiring significant changes in the
specificity of documentation by the provider. Now imagine
the effort required to help providers document in this new
language, ICD-10, with this new level of specificity.
A lack of appreciation for the provider role and the
importance of clinical documentation will have a dire
financial impact on organizations. Leaders must
recognize the importance of clinical documentation now, and
align these efforts with other valuable initiatives in
their organization.
Planning for the ICD-10 transition is analogous to planning
for a big-bang EMR Go Live happening for everyone on the
same date: October 1, 2013. Successful adoption
of the new coding system requires a disciplined approach
that begins long before go live and does not abruptly end
on October 1, 2013. Leaders who appreciate the magnitude of
change and how it will impact key stakeholders will plan,
prioritize and communicate more effectively. Their
preparation and assessment of the stakeholders' needs
drives timely and relevant education and training by
role. This investment in people and process can begin
now! Improvements in clinical documentation and
coding accuracy provide tangible benefits today. The
discipline of measuring these outcomes becomes a habit and
serves the organization long after the transition to
ICD-10. Continuous improvement and optimization of
documentation and coding requires a long-term commitment to
education and measurement. Metrics can highlight
areas that require our attention and education/intervention
drives improvements in those areas.
Organizations who commit to the changes required for
improved clinical documentation are more likely to achieve
timely reimbursement for providers, improved public health
surveillance and improved measures of health services
quality. Don't underestimate what lies beneath the
ice; the transition to ICD-10 is an enormous effort that
will require a plan to address not just coders and
applications, but also providers!
