HIMSS: ICD-10 poses costly challenges
NEW ORLEANS—According to the Workgroup for Electronic Data Exchange (WEDI), ICD-10 is expected to be the most costly government-mandated change ever to hit the healthcare industry, Mike Hourigan, RN, senior practice manager at Cerner, told an audience March 4 at the Healthcare Information and Management Systems Society (HIMSS) annual conference.
After counting a few tentative hands in response to the question are you ready for ICD-10, Hourigan elucidated some of the challenges of the transition.
One case study of an ICD-10 implementation at Humber River Regional Hospital, a three-site, 605-bed healthcare system in Toronto, suggested that coding productivity dropped 50 percent in the year after transition to ICD-10. Although productivity rebounded, it remained 15 to 20 percent less than baseline one year after the transition.
Hourigan offered a bevy of reasons for the productivity drop. ICD-10 entails a new code set and coding rules, and coders’ knowledge of the requisite anatomy and physiology is lacking. An exacerbating issue is insufficient documentation by physicians and a shortage of qualified coders. Another blow to productivity is an increase in physician queries by coders, which not only cuts coders’ productivity but also is estimated to result in a 3 to 5 percent decrease in physicians’ productivity.
ICD-10 requires improvements in documentation and coding, said Hourigan, who outlined four Cerner tools to help providers navigate the transition to ICD-10. These are:
- Diagnosis assistant, a wizard tool for physicians that helps guide users to the correct codes;
- Document quality review, an inference engine that uses natural language processing technology to identify information that is likely to be queried back to the physician;
- Care management, a chart review tool that searches for ways to bring more accurate information into the chart; and
- Computer-assisted coding.
Hourigan suggested providers also begin planning for scheduling for future appointments after October 2014, educate physician offices about those changes and conduct multi-layered testing and training.