HIMSS: Failing to prepare for ICD-10? Plan to fail
As the deadline to transition to ICD-10 creeps up on providers, healthcare liaisons urged that planning will be the bolt that keeps the entire process together and leads to a hospital’s success. This concept was presented Aug. 10 at The HIMSS Virtual Briefing: Critical Factors of the ICD-10 Conversion.

“Bear down and plan well,” urged John Dingle, senior health systems engineering analyst at the Mayo Clinic. “If you haven’t already started planning, you need to clearly understand the regulations and what you are being asked to do.”

Dingle outlined five tasks that will be imperative during the ICD-10 conversion planning process:
  • Identify a project sponsor who will champion the entire project through;
  • Identify small and medium enterprises within your organization to brainstorm the next steps;
  • Develop a high-level timeline and then plan backwards—starting at Oct. 1, 2013 and move backwards to today;
  • Create a sense of urgency: “Even if you start today, you are already late,” said Dingle; and
  • Ignore all rumors that the implementation dates will change.

Dingle said that there are five important stages organizations will go through to make their way toward ICD-10: initiation, planning, execution, monitoring and control and closure. “Make sure you have all your bases covered,” he said. While the ICD-10 transition will be “learn as you go,” he said that organizations must be flexible in terms of project frameworks. “You will need to break the process down so it’s manageable and understood by all.”

As far as the initiation phase goes, Dingle suggested organizations will need to identify team leaders, stakeholders (both internal and external), steering groups, a communication team and a risk management team.

For planning, he said it will be imperative that organizations perform a system gap analysis to identify all the systems that will be affected by the coding transition. Additionally, hospitals should understand which staff will need to be trained and develop a resource plan. “Resources will be tight so you will need to understand at what point you may need to add additional resources to feed your plan,” said Dingle.

Jon Melling, BSc, president of HIMSS Arizona and practice consultant at Top Tier Consulting, said that performing a system impact assessment will also be important. Hospitals must consider which clinical systems and data warehouses will be affected by the new codes. “However, it won’t be sufficient to simply identify systems; we must also understand the relationships between the systems, how data flow, how data are sent and where data are sent to.”

Hospitals will need to ask their vendors: What is covered by contracts?
  • What are you doing to address ICD-10?
  • What are your plans and your timeline?
  • How will systems work with both ICD-9 and ICD-10 codes?
  • What does the implementation process include?
  • Is there a cost associated with training and support?
  • Will we need additional infrastructure and software?

“As soon as you get the impact assessment, the sooner you can start working on the work that’s required,” said Melling.

As crucial as the planning stages are, it will also be imperative for hospitals to perform a business gap analysis, said Rhonda Taller, MHA, Siemens Healthcare regulatory product manager.

“This is the first new coding system in the past 30 years,” Taller said. “It is going to require a whole lot of change.”

Developing a planning checklist can help thwart the potential drop in productivity that hospitals may experience as they transition to ICD-10. The drop in productivity will depend on a variety of factors, including coding backlog, claims backlog and reduced cash flow. The planning checklist can help to monitor readiness and help implement a training and education plan.

Lastly, hospital administrators should review reimbursement and how it will be impacted by the new code sets. “Look at a plan to mitigate decreases in productivity and quality,” concluded Taller.

“The will to win is important, but the will to prepare is vital,” summed Dingle, quoting football great Joe Paterno. If hospitals fail to plan for ICD-10 they must also prepare to fail.