While many in the industry are nervous about complying with ICD-10 by the mandated deadline next October, Sutter Health is planning to flip that switch months ahead of time.
“Our go-live date will be May 31, 2014,” said Danielle Reno, ICD-10 program director for the health system during a session here at the AHIMA Convention. “We won’t be submitting claims to payers in ICD-10 but we will turn it on and physicians will be able to use it.”
Since Sutter has some 5,200 doctors, its road to ICD-10 was paved via physician engagement.
“We focused on a tri-fold approach to physician education,” Reno said.
The first was awareness, simply getting key staff and management on board and understanding the timelines and the financial impact to budgets. “This took many, many, many, months.” To advance understanding, Sutter made available in July a series of 30-60 minute online educational videos focusing on clinical documentation improvement, relying on some employees as change agents for ICD-10 across 27 specialties.
The second thing was to also enlist physician champions. “We knew we couldn't do [ICD-10] alone,” Reno explained. So they armed physicians with many privileges to take ICD-10 back into their departments every month to communicate out to their teams, ultimately flowing to specialists. Those physician champions also communicate all Sutter’s EHR changes to their teams.
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Peer-to-peer training was the third piece. As Reno and her team learned that doctors didn't want someone coming in who didn’t necessarily understand their specialty to train them for ICD-10. So, three weeks ago Sutter started offering all day back-to-back sessions and has thus far had “great success,” Reno said. “Once people heard about it, they wanted to come.”
While Sutter is certainly on the leading edge, 3M Health Information Services vice president JaeLynn Williams said in an interview with Government Health IT at the conference that she expects many large health networks to proceed in a similar fashion.
Williams said that many of the healthcare organizations that 3M works with are plotting similar avenues to ICD-10, even if they’re not stating it publicly. What’s more, Williams estimated that 2 percent of healthcare organizations started doing so during this month of October, a full year out. Others will start with 3 or 6 months before the 2014 deadline.
Some of these providers, such as Lucile Packard Children’s Hospital in Palo Alto, are starting sooner to analyze the opportunities and spot potential problem areas, notably claims denials, as early as possible.
While he did not commit to an early go-live date, Chris O’Dell, revenue cycle manager at Lucile Packard, explained that it has been tracking key performance indicators and denial metrics across five areas: clinical operations, decision support, information systems, the non-HIM revenue cycle, and physician adoption and training.
One of O’Dell’s milestones was reaching 1,000 natively-coded cases that “we took and had coded in both ICD-9 and ICD-10 to see if there is any shift in the DRGs as we move to ICD-10.”
In addition to KPIs, and physician engagement, Christine Armstrong, principal of Deloitte’s ICD-10 practice, urged attendees to focus on training and education, payer collaboration, cross-mapping solutions, vendor readiness, systems remediation, as well as the sort of dual coding Sutter and Lucille Packard have undertaken in their own manner.
“The lessons learned show that if you can even do a little bit of dual coding, even within the education modules, that is beneficial,” Armstrong said. “Those timelines are moving and you don’t get to control them.”