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Getting ahead of the ICD-10 curve

Large organizations like Sutter are hoping to avoid trouble and take advantage of opportunities by going live well in advance of the ICD-10 deadline

Tom Sullivan, Editor-in-Chief, Healthcare IT News

With an eye toward spotting opportunities and avoiding calamity, some large healthcare companies are moving toward going live with ICD-10 early.

One of those companies is Sutter Health. The organization announced during a session at the AHIMA convention this week its intention to go live with ICD-10 on May 31, 2014.

[See also: Avoiding the ICD-10 claims backlog]

“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,” said Danielle Reno, ICD-10 program director for the health system.

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Many large health systems are likely to follow Sutter’s lead, said 3M Health Information Services vice president JaeLynn Williams said in an interview with Healthcare Finance News’ sister publication, Government Health IT, at the conference.

Many of the healthcare organizations that 3M works with are plotting similar avenues to ICD-10, even if they’re not stating it publicly, Williams said. What’s more, Williams estimated that 2 percent of healthcare organizations started doing so during the month of October, a full year out. Others will start with three or six months before the 2014 deadline.

Some of these providers, such as Lucile Packard Children’s Hospital in Palo Alto, Calif. 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.

The road to ICD-10 success of these organizations is paved with planning and testing.

One of O’Dell’s milestones was reaching 1,000 natively-coded cases that were coded in both ICD-9 and ICD-10 to see if there was any shift in the DRGs.

Sutter, with its 5,200 doctors, turned to physician engagement. “We focused on a tri-fold approach to physician education,” Reno said.

The first was awareness – many months of simply getting key staff and management on board and understanding the timelines and the financial impact to budgets.

To advance understanding, Sutter made available in July a series of 30 to 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 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.

Peer-to-peer training was the third piece. 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.”

Education and training are just some of the key pieces organizations need to do to get ready to go live with ICD-10, said Christine Armstrong, principal of Deloitte’s ICD-10 practice. She urged conferences attendees to pay attention to key performance indicators, payer collaboration, cross-mapping solutions, vendor readiness, systems remediation, as well as the sort of dual coding Sutter and Lucile Packard have undertaken. 

“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.”

This story is based on a report published by Government Health IT.