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ICD-10's appearance at my doctor's visit

As a health IT journalist, it’s always interesting when you experience what you write about in real life. In my case, this happened when I went to the doctor yesterday.

I was sitting in the examination room as the nurse practitioner asked me questions and then clicked around on the computer updating my medical record. At this particular moment, she had been clicking around for a while, clearly trying to find something but having some trouble, and not talking to me. Then all-of-sudden she said under her breath, “I hate this new coding system.”

My ears perked up. We at SearchHealthIT had just done extensive coverage of ICD-10. We interviewed doctors, talked to CIOs, quizzed analysts and wrote articles with tips on how healthcare organizations can make sure they’re prepared for the new coding set. We even monitored Twitter on October 1, the day ICD-10 was implemented, to see how people were fairing.

So when the nurse uttered her words, I had to ask her about it.

I explained I was a health IT journalist and she began to tell me how new technology requirements like ICD-10 are taking her away from interacting with patients, and she feared it would get to the point where she’d be fiddling around with the computer so much she wouldn’t even get the chance to touch the patient and examine them, never mind have a conversation with them.

This is a sentiment I’ve come across quite a few times in my own reporting on ICD-10. This nurse is not alone.

She explained how difficult it is to find the appropriate ICD-10 code for the right ailment. For example, if someone is experiencing arm pain, she said she can’t just search arm pain and find it, she has to go through a series of steps to specify which arm and whether the pain is internal or external. She told me she’d much rather write a detailed note then click through and make sure everything was appropriately checked off.

As for me, the patient, I definitely noticed her preoccupation with the computer and I must admit, I do wish there had been more time to really have a conversation with her.

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Apart from the obvious effects of the new coding system in terms of technical glitches and for some, denials, there is a widespread consensus on it being times consuming and demanding, which has greatly resulted into little or no time for even a decent conversation with the patients.
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