Recent comments concerning the possible delay of ICD-10 have pushed the transition further into the spotlight, with supporters praising CMS Administrator Marilyn Tavenner for her willingness to take another look at the timeline and opponents claiming it will only make things worse.

No matter the stance, though, both sides can agree the conversion will eventually require providers to prepare in advance for productivity issues, vendor conundrums and other hurdles. 

Kerry Stark, senior director of Revenue Cycle Management Services at VHA Inc., suggests five tips for the implementation of ICD-10. 

1. Providers should conduct a “three-prong” ICD-10 opportunities assessment and develop a roadmap for implementation. And the assessment should include operations, finance and technology, said Stark. “All three areas are going to be dramatically affected,” he said. “The potential impact of ICD-10 to healthcare providers includes multiple system upgrades and testing cycles, increased human capital needs, and significant training.” Not to mention, Stark addedd, increased claim denials, delayed payment, lost or reduced reimbursement and impacts to cash flow, and, finally, more complex financial reporting. “Technology may prove to be the larges piece of this pie, however, as the move to ICD-10 will require significant upgrades and change’s to a provider’s IT vendors, payors, and other business partners.” Lastly, Stark warned the process can be very time consuming and frustrating, since providers will have to rely on vendor partners to provide them with timely and accurate information regarding the status of their system upgrade, activity, and timeline.

2. Hospitals will need to upgrade multiple information technology systems to support the conversion from ICD-9 to ICD-10. For a provider’s IT department, said Stark, planning and testing is needed to ensure they’re ready to meet the transition deadline on Oct. 1, 2013. “Hospitals need to start with a clean, up-to-date inventory listing of all systems being used throughout their organization,” he said. Stark added, based on what he’s seen, most hospitals don’t have an inventory that provides a “true reflection” of all the IT systems that have been purchased and are utilized throughout their health system. “Many of the IT inventory lists hospitals have currently don’t include all of the bolt-on applications, which have been purchased within individual departments, current interfaces in their entirety, and registry listings,” he said. “They also may refer to applications by outdated vendor names, as there have been many acquisitions and changes in the healthcare IT industry.” This means, continued Stark, that an organization will need to do research on the front end to ensure they have a “good handle” on all the systems that will need to be addressed regarding the ICD-10 conversion. 

[See also: ICD-10 deadline do-over?.]

3. Don’t underestimate the role of the vendor in the transition. Keep in mind, said Stark, the timelines really do depend on the vendors. “This is the scary part for providers [since] they’re at the mercy of their vendor partners to provide them with timely, truthful information [regarding] their progress,” he said. This could include daily or weekly interaction with a substantial number of vendors and even a tracking process for determining which vendors are providing the proper information regarding the process, which are missing set timelines, and which aren’t taking the appropriate steps to provide enough testing time for providers. “Decisions will have to be made by providers whether or not to trust certain vendors who aren’t meeting their commitments, or to move to another vendor who has shown they will be ready for the conversion,” he said. “We’re hearing rumors of vendors who are deciding to sunset certain applications, as it would not be financially feasible to go through the work effort to update the application. This information is vital to providers to have [since] they will need to make other arrangements.”

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