Salt Lake City is an interesting place; I’m glad I went to the American Health Information Managers Association (AHIMA) 83rd Convention and Exhibit. The architecture was stunning as advertised, and granted our staffers were only there three days, but rumors that it’s an unbearably strait-laced place were unfounded — the city center, at least seemed cast in an earthy-crunchy Vermont sort of mold.
Inside the Salt Palace Convention Center, though, things were anything but laid-back. Some general perceptions and interesting nuggets from the cutting-room floor that either didn’t or haven’t yet made it in SearchHealthIT.com stories:
- HIM leaders are treating the ICD-10 transition in October 2013 as a potential catastrophe. It seems like a technically do-able switch on the technology side, but the organizational changes needed — updating all the policies and procedures that involve ICD-9 codes, getting senior leadership to take it seriously even though it’s still 23 months away, educating busy physicians on new documentation strategies, working out a game plan with payers — seems like an insurmountable challenge to these folks
- One very credible source with whom I discussed the particulars of ICD-10 said that software vendors are so far behind that they don’t even know how far behind they are. His assessment is based on the fact that many vendors rely on third parties to develop ICD-related content in their applications, and don’t monitor their partners’ progress. Furthermore, because for some time after the swtichover, there will be claims with both ICD-9 and ICD-10 codes wending their way through the system, application vendors need to map ICD-9 forward to ICD-10, and backward from ICD-10 to ICD-9 to be able to quickly sort out problems with wrongly coded claims. Easier said than done, he said, since no one’s written a definitive map that crosswalks in either direction…which could result in months of chaos around the ICD-10 transition date
- Speaking of which, that source and others say that the ICD-10 transition could lead to financial instability for hospitals, as accounts receivables will extend out months longer than they usually do while health care providers wait for payers and their coding staffs to resolve issues. Explain to senior hospital leadership that ICD-10 preparation will have to include hiring more accounting staff to reel in those unpaid claims; that might get their attention for getting your shop’s ICD-10 ducks in a row now — still, a hidden cost of ICD-10 implementation will be collecting accounts receivables, as few HIM managers and vendors I talked to believe that payers will be 100% ready for the change. They fully expect technical glitches on the payer side to result in denial of payment, even in some cases of correctly submitted claims
- All this being said, what kind of brass did the World Health Organization’s ICD czar T. Bedirhan Üstün, M.D. demonstrate in his keynote exhorting attendees to make the ICD-11 transition as soon as they could possibly do it after its 2015 release? Wow. HIM managers, in general, weretoo polite to wing hunks of listeria-sodden cantaloupe from neighboring Colorado at the good doctor, but judging from the looks on their faces, a few were considering it
I give Üstün credit for his hardcore stance, from which he never wavered, even when given a chance in the post-keynote presser with us usual journalist suspects. One reporter for another health IT-related site asked me later on, could I believe he went with ICD-11 for a keynote in this particular place?
“I don’t care what he said,” I responded. “Like Jim Rome says, he had a hot take and stuck to it. That, to me makes the story interesting. Thank goodness I’m not responsible for implementing it.” Which was a sardonic way of saying to the HIM managers afoot: You’ve got a tough job. We sympathize. Keep twisting the arm of IT staff — and reading our site — because help is out there to get you through a very complicated period of transition for the health care back office.