To gauge vendor's ICD-10 readiness, turn to its partners

When hospitals ask vendors if they are ready for ICD-10, they need to know if the vendors' partners are ready. After all, each software application has its own ICD-10 challenges.

Many hospital software application vendors aren't coding-savvy, so they rely on third parties to provide ICD-10 modules. That's according to Kelly Jorgensen, vice president of business development at VitalWare. His company developed VitalView, software that gives hospital IT leaders a dashboard view of their vendors' ICD-10 readiness.

This need comes as the health care industry faces a tough road in implementing ICD-10 by Oct. 1, 2013, as discussed at last month's American Health Information Managers Association's AHIMA 83rd Convention and Exhibit. This article, the second in a series, explores the challenges that providers face as they race to meet the ICD-10 deadline.

VitalWare teamed up with the Health Information and Management Systems Society (HIMSS) to push software vendors to reveal standardized ICD-10 readiness data, verified through testing. Together they hope their efforts can give hospital CIOs a more transparent, accurate idea of their overall ICD-10 readiness by providing an "apples to apples" comparison of vendor progress.

What is the likely outcome for organizations that pursue such efforts? Hospitals with large, well-established EHR vendors might feel a false sense of security.

Standards for ICD-10 readiness can avoid "mind-boggling failure"

"It's not whether [the EHR vendor is] ready, it's whether [it] and [its] partners are ready -- and that's one of the biggest misconceptions," Jorgensen said. "The full complexity of ICD-10 is not well known. It's not just a number change, it's not just a field-value change, it's a new language. And how they digest that language, how they put it forward, how they interact with applications is still a huge unknown."

In surveying the market, Jorgensen said that each hospital system, whether it's an EHR application, charge-capture system, lab or radiology information system, has its own separate ICD-10 implementation issues. For instance, one large EHR vendor had planned to deal with the ICD-10 transition by simply putting both ICD-9 and ICD-10 code databases in its EHR templates and letting physicians -- or the IT staff -- update all the templates themselves.

That approach is "mind-boggling failure," Jorgensen said. Doctors don't know ICD-10 or the documentation it will require.

For the physician or for an application to really understand ICD-10…it's not a text search or term search. It's a whole different vocabulary that you've got to understand.

Kelly Jorgensen, vice president of business development, VitalWare

Furthermore, he said, there are numerous imperfections in the Center for Medicare and Medicaid Services' ICD-9 to ICD-10 General Equivalence Maps (GEMs), which physicians might be using because it's the authoritative reference right now. For example, if a physician codes a template for an ankle sprain in ICD-9 and uses GEMs to get ICD-10 code equivalents, he will miss more than 100 codes, Jorgensen said.

"For the physician or for an application to really understand ICD-10 and build the intuitiveness to get to that level [of understanding] of ankle sprains that they need to, it's not a text search or term search. It's a whole different vocabulary that you've got to understand," Jorgensen said. "There's some sophistication that most organizations don't get yet. So, for a doctor or an office to have to go and change their [EHR] templates, that's just crazy."

Standardizing the definition of ICD-10 readiness, he believes, will help hospitals and vendors alike. Hospitals will be able to gauge how much work they have ahead of them before implementing ICD-10, and vendors will be able to see how their internal preparations stack up to the competition.

Hospitals must remember that gauging ICD-10 readiness is the responsibility of the provider. Put another way, vendors may not freely offer up the information.

For now, hospitals can start determining vendors' readiness by asking when the ICD-10 compliant beta versions of their products are due and building a calendar of delivery dates to see an overall schedule of when the products on their particular network will come together.

If they feel like prodding further, Jorgensen concluded, providers could ask to see each vendor's roadmap for ICD-10 implementation to get more granular information.

Let us know what you think about the story; email Don Fluckinger, Features Writer.

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