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Jul 30 2012   7:00AM GMT

Executive Guide to Achieving ICD-10: The Enterprise Approach



Posted by: Jenny Laurello
ICD-10, ICD-10 migration, ICD-10 migration planning, ICD-10 planning

Guest post by: James Truesdale, MS, PMP®, ITIL®, Partner, The Kiran Consortium Group, LLC

There are many inherent risks that your organization will face as a result of making the transition from ICD-9 to ICD-10.  However, to mitigate these risks, it is important that your health care organization take an enterprise approach due to the far reach of ICD-10.  Chief among those risks are:

  • Competing initiatives – For many organizations, the number of proposed initiatives exceeds organizational capacity to resource all requested initiatives across the enterprise.
  • Financial disruption / Revenue cycle – One question that arises often is whether there will be revenue neutrality as a result of ICD-10 efforts.
  • Budget Allocation (short term and long term) – The potential budget required at your health care organization is dependent on a variety of issues. It is for this reason that there is no conclusive estimate to fund all required efforts related to ICD-10 compliance.
  • Operations – There will be an impact at both the functional and departmental levels of your organization.
  • Productivity – Reports to date, both retrospective and prospective, suggest that for a medium to large acute-care facility, an initial productivity decrease in the neighborhood of 50% is to be expected.
  • Resources, both internal and external (access and quantity) – A variety of resources will be required to achieve ICD-10 compliance:

                                 §  Internal Staff (e.g. allocation or reallocation of current staff, corporate staff, etc.)
                                 §  New Information Systems and Technology (e.g. Computer-Assisted Coding (CAC).
                                 §  External Technology (e.g. proprietary or cloud-based solution, etc.)
                                 §  External Staff (e.g. targeted, select service)

  • Skills – There is a significant shift in the level of skills that will be required by various health care professionals throughout the various phases of the projects related to achieving ICD-10 compliance.
  • Partners’ ability to meet their respective Compliance requirements and timeline (i.e. payers, vendors, etc.) – The potential exists that one or several business partners may or may not be able to achieve ICD-10 compliance by October 1, 2014 pending Final Ruling.
  •  Information Management – Data is a corporate asset of every health care organization.   ICD-10 data is found in reports that span the health care enterprise.

In order to take an enterprise approach to addressing these issues, here are eight recommended steps to begin your enterprise approach to compliance efforts:

  • 1. Educate First – As with every significant industry shift, the transition of ICD-9 to ICD-10 will require education at all levels of an organization. Why is education important? It assists to build understanding as to how each discipline will be directly or indirectly impacted.
  • 2. GovernGovernance and governing the processes are critical to ICD-10 as a result of its enterprise-wide impact. A steering committee and appropriate tasks Force should convene early.
  • 3. Communicate – Given the duration and complexity of the transition to ICD-10, communication is essential. It helps to set expectations, share progress, inform and educate all health care professionals and raises awareness as to each person’s role, tasks and responsibilities.
  • 4. Plan – The tactical plan that supports your ICD-10 initiative should be in place. The scope of your ICD-10 initiative will inform the number of tasks, activities, designated resources and elapsed time required to complete each supporting project.
  • 5. Allocate Resources – To support this initiative, the accurate allocation of resources – time, people, skills, funds, level of required effort among others. – to support all tasks and activities.
  • 6. Assess – An assessment of your health care organization provides a snapshot of the current operational state and identifies any gaps that exist to prevent achieving ICD-10 compliance.
  • 7. Measure – With so many required efforts across your enterprise, consistent measurement of progress is crucial to managing expectations, efforts and resources as well as mitigating risk.
  • 8. Contingency planning – With so many “touch points” within your organization, contingency planning is a critical component in preparing to mitigate against the various risks associated with ICD-10 deployment.

About the Blogger:

James is a Partner with The Kiran Consortium Group, LLC (TKCG) responsible for Health Care Compliance initiatives.  Mr. Truesdale has 20 plus years of combined information technology, project and program management experience and is former Director with Director with Ernst & Young’s (CGE&Y) Telecom, Media & Network (TMN) practice.  He has experience with Federal mandate compliance in the Health IT space with emphasis on business processes, technology assessment, regulation, planning, remediation & compliance. TKCG is a private, global, professional services firm. Please visit www.kiran-consortium.com.

Bibliography:

Blog adapted from The Kiran Consortium Group’s Executive Guide For Advancing ICD-10 Efforts presented by Lucy Mancini-Newell and Willie Williams during TELNET 2744 session held on March 22, 2012 for the Georgia Hospital Association.

Mearsian, Lucas. New medical coding system taxes hospital IT resources, ComputerWorld, June 13, 2011. http://www.computerworld.com/s/article/9217549/New_medical_coding_system_taxes_hospital_IT_resources?taxonomyId=11

Morrissey, John. Your ICD-10 To-Do List, Hospitals & Health Networks, September, 2011, pp..24-28.

Rodak, Sabrina. What You Should be Doing to Prepare for ICD-10: 3 Strategies, Becker’s Hospital Review, May 10, 2011.  http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/what-you-should-be-doing-to-prepare-for-icd-10-3-strategies.html

Truesdale, James. (Speaker) “DCH ICD-10 Project Overview”, Medical Care Advisory Committee (MCAC) Meeting, Atlanta, GA, May 2011. http://web.dhr.state.ga.us/ph/MCAC05182011

Truesdale, James. (Speaker), “5010 and ICD-10 Overview”, Georgia Medicaid Fair, Macon, Georgia, November 2011.

Truesdale, James, (Speaker) “ICD-10 Coding”, MAG Law and the Physician Seminar, Medical Association of Georgia, Atlanta, Georgia, December 2011

Truesdale, James (Webcast), “Transitioning to ICD-10 Codes”, Health IT Exchange, March 2012.

Truesdale, James (Panelist), “ICD-10, T-24 Months: Is Backward Planning an Answer?” Georgia Healthcare Trade Faire & Regional Conference, Atlanta, GA, 2011.

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