This blog is not about ICD-10 or what it entails.
This blog is not about current state and future state or fate of HealthCare in US. Nor do I explicitly or implicitly mention my opinions thereof.
This is my opinion based on factual evidence about why I consider ICD-10 the engine that will transform HealthCare in US (definitely atleast US and maybe more).
Neither new nor untried, the World Health Organization’s (WHO)1 International Classification of Diseases, 10th Revision (ICD-10) code set is the international standard for disease reporting, surveillance, and mortality. It has been in use by WHO member states since 1994 for classification of clinical, epidemiological,and statistical analysis and quality reporting, and is the basis for national mortality and morbidity statistics. When the United States transitions from ICD-9 to ICD-10, it will be one of the last major countries in the world to adopt ICD-10.
As I stated above, I will refrain from giving my opinions about why US HealthCare is facing such a daunting task with the adoption and driving the transformation using ICD-10.
Significantly more complex than ICD-9, the ICD-10 classification system dramatically expands the number of codes to be used. Whereas ICD-9 has about 17,000 codes, ICD-10 has more than 150,000 codes. ICD-10 includes support for more precise medical concepts and specificity. It also includes codes for newer information types, such as genomics and biomedical informatics. Because ICD codes are essential to care delivery and business processes, migration projects will affect nearly all operational systems and procedures ranging from bedside (clinical documentation and decision support), to finance (billing, claims processing, and revenue cycle management), to administration (analysis and reporting). The transition will require investments in training, changes to legacy systems, and testing with partners, vendors, and payers. In addition, the migration to ICD-10 will necessitate either a crosswalk between ICD-9 and the new ICD-10 codes in order to ensure system compatibility during the transition timeframe, or a reimplementation of all the business rules using the new ICD-10 coding system. Regardless, it will be a laborious process, because often organizations will have to go back to the original intent of the rule and rethink how it should be configured in the new coding system.
In a very recent Healthcare Informatics Research survey, 367 hospital-based healthcare professionals shared their organizations’ migration strategies. These include key drivers for the project, budgetary allocations, leadership, and challenges, as well as anticipated benefits and opportunities. All hospitals represented in this online survey plan to migrate to ICD-10, but migration plans differ in rationale and expectations.
Key ICD-10 Migration Strategies
Among the organizations that have not begun work on their
The ICD-10 Migration Team
More than half (57%) of hospitals surveyed are relying on the
Health information management (HIM) professionals in medical
When asked to evaluate the importance of key ICD-10 migration milestones, most survey respondents ranked all key project milestones as “very important” to “extremely important” on a scale from 1, “not at all important,” to 10, “extremely important.” Recognizing the breadth and pervasiveness of the changes, more than half (55%) of those surveyed rated education and training on ICD-10 as “extremely important.”
Meeting ICD-10 Migration Challenges
Consistent with the overwhelming majority of survey respondents who rate education, awareness, and training as “very important” to “extremely important” to ICD-10 migration projects, survey respondents rate staff training as the migration’s biggest challenge,
with costs, specifically those related to remediation, a close second. Survey respondents rate support from executive management as one of their least important ICD-10 migration challenges, which may speak to hospital executives’ understanding of ICD-10 and the general support they have given ICD-10 project teams.
For the most part, the need to migrate to ICD-10 is understood throughout healthcare organizations. More than half (55%) of staff members understand the value and benefits. But among those surveyed, more than a quarter (27%) report that their staffs perceive
ICD-10 as a major issue and resent the mandate to change. This is understandable, as ICD-10 will result in extensive changes for clinical documentation, billing, and workflow in most hospitals, and staff may first perceive the migration as simply “more work.” But staff perceptions of ICD-10 and resistance to change are tied to level of awareness about the value that can be derived from moving to ICD-10 coding. For organizations that have not
begun migration work, or that are in the early stage of ICD-10 awareness and education, respondents are more likely to say that most of the staff perceives the migration as a major issue and resents the mandate to change. Organizations that are further along in the process, having progressed at least to the planning stage, find that levels of staff resistance decline. At later stages, once most staff members have received education, awareness, and/or training, they are better able to understand the need for change and the benefits of ICD-10.
Financial Concerns Related to ICD-10 Migration
1 World Health Organization, Geneva, Switzerland, http://www.who.it
About Healthcare Informatics Research
Like Healthcare Informatics magazine, Healthcare Informatics Research provides expert insight and analysis on topics of major importance to the healthcare information technology (HIT) community. By conducting research with information technology professionals at care provider organizations of all types and sizes, and the companies that serve them, Healthcare Informatics Research provides objective, primary source information that serves as the basis for research reports, white papers, webinars, and presentations. Members of the Healthcare Informatics Research Panel are recruited from the reader base of Healthcare Informatics magazine to share their observations, opinions, and experiences.
To better understand progress and plans, along with challenges and opportunities faced by hospitals as they migrate from ICD-9 to ICD-10, Healthcare Informatics Research, in cooperation with other F500 company(ies), conducted an online survey. Drawn from 3,441 eligible members of the Healthcare Informatics Research Panel, a total of 504 healthcare providers completed the online survey. Of this group, 367 were hospital-based care providers. The survey respondents represent a diverse group of healthcare executives and managers employed at a broad range of hospital types, sizes, and care delivery locations. All are in the process of planning for or migrating to ICD-10.