As the ICD-10 Clock Ticks Down, Providers Face a Lengthy Road Ahead

The majority of healthcare IT leaders acknowledge their organizations have a long way to go when it comes to implementing the ICD-10 medical coding set, according to a recent research report from the Orem, Utah-based KLAS. The report, “ICD-10: Preparing For October, 2013,” reveals that only nine percent of the 163 providers surveyed said their organization was more than halfway through their ICD-10 preparations. Most said they were still in the early stages of preparing the move to the more modern code set.According to KLAS senior research manager Graham Triggs, the delay in preparation from these providers has come as a result of more pressing regulatory deadlines such as meaningful use Stage 1 and HIPAA 5010. Mike Smith, KLAS’ general manager, says there’s also a lack of understanding from many providers on the extensiveness of the ICD-10 implementation.“Sometimes you don’t know what you don’t know,” Smith says. “Some of these organizations don’t understand the scope and how far-reaching this could be for organizations. The reality is ICD-10 is going to touch a lot of systems and areas. You have to look at it from a technical perspective. You have to look at it from a training and education perspective. There’s a lot of testing that has to occur. You have to work with payers. All of this has to be coordinated.”Of course, the consequence for those who aren’t ready will be hefty. The price for an organization that does not have ICD-10 implemented by the October 2013 deadline is a loss of Medicaid, Medicare and other government reimbursement funds.Path Well-Traveled Many of the healthcare providers surveyed by KLAS, which Triggs said represented an array of C-suite executives and health information management (HIM), were optimistic that they’d complete the ICD-10 implementation by the deadline even though they had made little progress on it. However, those who have had a little more experience in implementing ICD-10 aren’t as optimistic that it can happen in two years.“They know what the road is and what steps they will have to take,” Smith says. There are a lot of moving parts, including vendors and areas outside of an organization’s control, which have to be put in place.For those who are beginning the process, Triggs says forming a steering committee is essential and something each of the progressive organizations had done. This type of committee is meant to bring all members of the organization affected by ICD-10 together and allow them to understand the implications of the change. One suggestion he has for those who are just beginning the process is to reverse engineer everything.“Go to October 2013 and work backwards to know the milestones that you will need to hit before then,” says Triggs. “Developing a roadmap of the objectives you need to reach and when to reach them based on size and complexity is extremely important.”

Mike SmithConcernsIn what was somewhat of a surprise to Triggs, numerous providers hadn’t yet set an ICD-10 implementation budget. This, he said, is something that should be done at the beginning of the process along with forming a steering committee.The confusion surrounding money is paramount, according to Triggs. While many C-suite executives understood the financial implications, others surveyed weren’t as sure. “Some of these steering committees may have not been formed yet because they didn’t understand what the budget was going to entail,” he says. “It was a little surprising that more didn’t have a firm dollar amount. There were some that actually told us they didn’t think it was going to cost anything.”The surveyed healthcare providers had bigger concerns than cost. Of those surveyed, more than 50 percent said their biggest concern with the medical coding switch was training among their physicians and nurses. Approximately 44 percent of respondents said their biggest concern was nurse/physician readiness.Software purchasing for ICD-10 has yet to play a significant cost role for most organizations’ budget. Two-thirds (64 percent) said ICD-10 would have little to no impact on its software purchasing decisions. Only 12 percent of the respondents said they would replace their current health information systems (HIS) because of ICD-10.And while most providers recognized the importance of computer-assisted coding (CAC) technology, only four percent of the respondents indicated they were going to buy that kind of software. However, Triggs says that will go up over time as more acute care communities recognize its importance in regards to ICD-10 implementation.

Graham TriggsThird-Party HelpWith a short time to the deadline, third-party consulting firms will play an integral part in the implementation process for most providers. All told, 65 percent of those surveyed said they were planning on using a third-party consulting firm. More than half, 52 percent, said they were already engaged with a firm. Of those who were using outside help, 70 percent said it was for strategy and gap-analysis.“A lot of these firms see opportunity out there and are looking to assist providers,” Triggs says. “I think it [third-party consulting] will have a pretty significant impact. There’s a unique scenario we’re seeing unfold before us, hospitals are being stretched so many directions, they might find themselves without enough resources to focus on these types of initiatives.”Those who are thinking about using an outside source, Triggs says, should find one sooner rather than later. He foresees resources becoming scarce as more organizations rush to meet the deadline. As with everything concerning ICD-10 these days, time is of the essence.