ICD-10 'storm' posing dilemmas for health information management strategies

KLAS report indicates new strategies being sought; AHIMA suggests ways forward

Health providers are reassessing their health information management (HIM) strategies as the big switchover to ICD-10 couples with new challenges related to health reform, staffing and EHRs, according to a report from KLAS.

The study, titled  "HIM Services 2012: Helping to Weather the Storm," finds that the changes augured by ICD-10 and other regulations are posing challenges to many providers' HIM plans.

"The monumental shift to ICD-10 has providers worried about keeping up with regulatory requirements, obtaining and retaining the right staff and handling the fluctuation in volumes and productivity that they predict will occur," said Graham Triggs, research director at KLAS. "As volumes increase, with 10,000 baby boomers turning 65 every day for the next 18 years, the need for adequate, qualified and trained staff becomes clear."

“The biggest challenge that we are facing in the HIM department is the healthcare reform and decreasing revenue streams from government payers and how that impacts our ability to staff well enough to meet our functions,” said one HIM director interviewed for the report.

To address staffing and other HIM challenges, some providers are looking to third-party assistance to outsource transcription, coding, scanning or release of information, the report finds. Providers looking to alleviate ICD-10 coding concerns are also considering computer-assisted coding (CAC) and clinical documentation improvement technology.

The KLAS report takes a close look at the turnaround times, report quality, account management and administrative tools of medical transcription service organization (MTSO) firms. It finds that providers have identified clear distinctions as they examine what firms offer in expertise and tools and their track records of client satisfaction.

Precyse and TransTech top the satisfaction rankings, in the study, but more comprehensive offerings by larger firms Nuance and M*Modal continue to dominate market share.

Other fully rated MTSO firms include Accentus, Acusis, Nuance (Transcend), and Superior Global. Early data and component firms include Amphion, FutureNet, Keystrokes, MedScribe, M*Modal, NEMT, PJ&A, StenTel, and Transdyne. Findings about Alpha Systems for scanning services and about Healthport and MRO Corp for release of information are also discussed in the report.

The KLAS report comes just as the new issue of The Winter 2013 issue of Perspectives in Health Information Management, the American Health Information Management Association's (AHIMA) online research journal, is published.

Among the stories in Perspectives is one titled "Leading by Design", which spotlights was HIM professionals can chart the way forward through these challenges.

As the industry shifts and technology evolves, new roles are emerging for HIM professionals, and old roles are being rethought and redesigned.