Tuesday, June 7, 2011

ICD10 Kickoff meeting

Although BIDMC has finished its 5010 work in anticipation of the January 1, 2012 deadline, we're just beginning our ICD10 project for an October 1, 2013 go live.

As I've written about previously, I believe that ICD10 implementation should be delayed until after Meaningful Use Stage 3 (2016) to enable widespread adoption of structured clinical documentation including vocabularies like SNOMED-CT which will provide the necessary detail for coders using ICD10.   Moving forward with ICD10 in the absence of enhanced electronic clinical documentation makes no sense.

That being said, we need to follow the October 2013 timeline, as that is the current requirement.

Our ICD10 Steering Committee includes a multi-stakeholder group from inpatient, ambulatory, finance, HIM, our physician's organization,  and IS.   ICD10 is not an IS project, but is an enterprise project involving all operational areas.

To ensure a common understanding about the scope of work ahead, I've prepared this presentation.

I've also circulated a sample project plan from the American Medical Association.

At our first meeting, we'll need to select a project manager and allocate the resources for the detailed work ahead including

*completing an inventory systems where ICD info is housed.
*checking with each of the software vendors so impacted to see if the current version of their software can support the extended characters and transitional issues
*determining the state of our software installs and plans for upgrades to compliant versions
*checking payer contracts for use of ICD10 codes
*creating test plans for pre-production cutover
*conducting training sessions for our coding staff on ICD10
*contacting payers on their timeframe for being compliant and arranging pre-production test plans
*checking web reporting systems such as State, Federal, or others on use of ICD10 codes

If ICD10 was delayed until 2016, our approach would be different.    We'd focus on getting widespread provider adoption of SNOMED-CT on the front end, then limit ICD10 implementation to back office functions, mapping clinically focused SNOMED-CT codes to administrative ICD10 codes for billing.  Let's hope wise folks at CMS realize the benefits of such an approach.

Until then, our project will march ahead.


Lynn Kosegi said...

Dear Dr. Halamka: Many experts in the HIM domain believe that physicians will need significant training for ICD-10 documentation. I would be interested to know your thoughts about this. Do you believe that physicians will need to be taught to document differently in order to provide the level of granularity to support ICD-10 (and SNOMED for that matter)? If so, at what point in the project plan would you recommend this begin?

Thank you,
Lynn Kosegi
Director, Health Information Services

Greg Wilson said...

On a related note, Dr. Halamka, your thoughts on IT solutions that help to improve upon the quality/comprehensiveness of physicians' clinical documentation at the point of authorship? Do you believe that proper documentation techniques can be achieved through training alone?

Kind regards,
Greg Wilson
Salar, Inc.

Zach Tumin said...

Greetings and good 4th of July to you! I noticed this on HITNews:"Docs face problems as they fall behind on HIPAA 5010/A majority of medical groups have not completed critical software upgrades for transition to HIPAA Version 5010 electronics standard, nor have they scheduled testing with health plans, according to follow-up research by the Medical Group Management Association (MGMA)." Does this mean fast movers like BIDMC should whoa up and make sure everyone's "good to go" - protecting their own investments to date - or should they keep moving forward and figure the "laggards" will get there/this pace is about what you'd expect? Very interested to learn your views on this. All the best, John.