A look inside two health orgs actually making ICD-10 progress

By Bernie Monegain
10:17 AM
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Less than 10 percent of healthcare providers are more than halfway ready for ICD-10, according to a new report from research firm KLAS. Two that are well on their way to compliance, however, are Rady Children’s Hospital in San Diego and St. Louis, Mo.-based SSM Health Care, which is also rolling out an electronic health record system before the Oct. 1, 2013 deadline for ICD-10 conversion.

Albert Oriol, CIO at Rady; Cassi Birnbaum, Rady’s director of health information and privacy officer; and Carole McEwen, project manager, ICD-10 for SSM Health Care, had some tips Wednesday for a ballroom full of CIOs at the annual fall forum of the College of Health Information Management Executives (CHIME) in San Antonio, Texas.

[See also: Could ICD-10 be the next mortgage crisis? Yes, and here's why.]

At Rady, ICD-10 planning started two-and-a-half years ago.

“We have a head start because Cassi a few years ago began waving the ICD-10 flag and convinced me that ICD-10 was much more than a coding project,” said Oriol.

While Rady may be ahead of most on ICD-10 conversion – committees in place, coders and clinicians onboard – she acknowledges there is still plenty of anxiety to go around. She is always at the ready to point to the opportunities whenever doubt rears its ugly head.

“The bottom line is documentation," she told the audience. "We have the perfect storm of initiatives (meaningful use among them). We decided to wrap around those initiatives. There’s all these reasons we need to shore up our documentation.”

Key among those reasons, she said, is that better documentation leads to better decision-making.

At SSM, McEwen said, the ICD-10 team is developing classes for the coming year, and coders are already practicing ICD-10 on ICD-9 coding sets. SSM had 80 or so payer contracts to review, and the process is nearly complete with five left to peruse. The payer contract review is under way at Rady, too, with a workgroup designated for the task.

[Q&A: How meaningful use is clashing with ICD-10.]

Shared ownership of the ICD-10 project is the way to go, the panelists said.

At Rady, Birnbaum is driving, but she can count on buy-in and support from Oriol and also from the chief finance officer. As McEwen sees it, the involvement of the CIO is critical, He or she should be a key leader, a key enabler, she said. The same goes for the CFO. The initiative also needs help from both the clinical and revenue cycle leadership.

In Oriol’s view enlisting the right physician champions can help move the initiative ahead more smoothly. “They are able to talk to their peers about the why behind the why,” he said.

Organizations that have yet to launch an ICD-10 initiative should do it now, all three panelists recommend.

“Wait too long and that ramp-up time is going to be extremely difficult," McEwen warned. "There is stiff competition for staff and resources, especially integration resources," Birnbaum added, "but there are also some new tools, such as computer assisted coding that may help."

[Cover story: ICD-10's ten-year reign of fear.]

For those who might think they can put ICD-10 conversion on the back burner, Oriol advises against it. As someone who is “fairly comfortable with risks,” he said, he considered gambling that the government might push the deadline as it had in the past. It was tempting, he added, “because we had so much on our plate.”

“This risk was not one as an organization we were going to take,” Oriol concluded.

“The train is running at high speed,” he said. “Either you play a game of chicken or you take the wheel and drive it.”