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ICD-10 readiness not there in SearchHealthIT and CHIME survey

Health information managers and a CMIO who looked at a SearchHealthIT-CHIME survey of more than 300 healthcare groups said the biggest surprise is the lack of ICD-10 readiness.

Healthcare information and technology specialists who looked at a survey on the impact of the ICD-10 delay found it interesting how many healthcare organizations still aren't ready for the new coding system six months after Congress postponed its introduction until late 2015.

A key finding of the summer 2014 SearchHealthIT survey of more than 300 healthcare organizations -- conducted with the College of Healthcare Management Executives (CHIME) -- was that only 10.7% of the respondents said they were fully ready for ICD-10, though a total of 71.8% reported they were in various states of ICD-10 readiness.

Surprise that some not ready for ICD-10

Now with the Oct. 1 rollout date set by the Centers for Medicaid and Medicare (CMS) approaching in a little more than a year, providers should be prepared by now because of all the extra time, said Dan Martich, M.D., chief medical information officer at the University of Pittsburgh Medical Center (UPMC).

"Ten percent? Give me a break," Martich said. "We're ready. We were ready a couple of months ago. Frankly, I'd be embarrassed if I were one of these other organizations."

Also, unlike 39.9% of the respondents, Martich said his sprawling healthcare system, which includes 22 hospitals throughout Pennsylvania, hasn't incurred many, if any, extra costs because of the delay. Neither has UPMC been able to put the time to significant use the six months to install or upgrade other IT systems, he said, compared to 44.7% who said they did.

"I don't think everyone's breathing a huge sigh of relief because we had more time," Martich said.

Double coding

Virginia Martin, manager of data quality at SwedishAmerican Health System in Rockford, Ill., said the survey results didn't surprise her at all, but that she's used the extra time for more education and training of her coding staff. Coders have done double coding in both ICD-9 and ICD-10, "just for practice," she said. There has also been more time for testing, something more than 32% of those who took part in the survey have either begun or completed.

So the delay has been beneficial in that sense, Martin conceded, though she said she opposed the delay in April, when Congress forced CMS to wait until October.

Like many health information managers, Martin characterized herself as a big supporter of the more up-to-date and comprehensive coding protocol, saying it will lead to more accuracy and completeness in diagnosis, treatment and billing and will bring the United States up to par with countries in Europe and elsewhere that already use ICD-10.

Advantages of ICD-10

"It's just so much more detailed and allows you to drill down further into what's going on and so you can see the severity of the patient's illness," she said. "You just get a better picture of the patient and how sick the person is."

While Martin said she originally feared that ICD-10 would be delayed again after the April holdup, "I can't say that anymore."

Similarly, a total of 48.1% of the surveyed participants said they did not think there will be further delay, though a majority either agreed moderately or strongly that another delay is coming.

Hope for no more delays

"I hope they don't delay it again," Martin said. "We're so behind. It's ridiculous."

Meanwhile, for Jody Smith, Ph.D, a professor in the Department of Health Informatics and information Management at St. Louis University and a former hospital health information manager, the survey's depiction of a healthcare IT universe in which most organizations have proceeded with dual coding systems is in line with what is happening in most settings.

However, "people have underestimated how long they've had to maintain a dual system," she said.

This issue stands out most sharply in the case of long-term rehab patients, for example, who are set to be inpatients for three to six months and whose care plans won't accept ICD-9 when they are released.

Another problem with the delay, Smith said, is that coders already trained in ICD-10 earlier this year have to be, or still need to be, retrained because they haven't been using and becoming familiar with the new system.

"There's just a lot of productivity slowdown," she said.

Smith also said she does not expect another delay, nor would another be useful.

"An additional delay would just muddy the waters," she said. "If you're going to do it, do it."

Let us know what you think about the story; email Shaun Sutner, news and features writer or contact @SSutner on Twitter.

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