August 14, 2012

An ICD-10 Training and Education Planning Primer Part I

By Annie Boynton, BS, RHIT, CPC, CCS, CPC-H, CCS-P, CPC-P, CPC-I, CPhT

EDITOR’S NOTE
This is the first in a two-part series addressing ICD-10 training and education matters for providers.

Training is often one the last considerations in major implementation plans, and ICD-10 is no different. By now you probably are aware of CMS-0040-P, the April 9 HHS-issued proposed rule that proposed a delay to Oct. 1, 2014.

While we know the implementation date likely will change to this new deadline, we must keep moving forward. Hundreds of millions of dollars are at stake, and the gift of additional time offers great value in terms of better handling the change process associated with ICD-10 – and in particular, planning for education and training.

Perhaps the greatest benefit in this area is that with the proposed delay, the industry will have an additional fiscal year with which to spread out training costs. Now is the time for strategic thinking and planning regarding ICD-10 training and education. It is critical that organizations begin education planning early and do not underestimate the size and scope of ICD-10 educational requirements.  Without careful, thoughtful strategic planning, ICD-10 training easily could be one of the larger expenditures in any overall ICD-10 implementation budget.

Organization leaders must think strategically in order to maximize training value and minimize costs. Centralizing training, spreading costs over multiple fiscal years, and establishing train-the-trainer programs all can help save precious resources and as the industry moves forward along the ICD-10 implementation path.

Centralizing training refers to adopting project management principles: creating a formal governance structure complete with an education and training committee, for example, is a solid start. This allows a straightforward, bi-directional approach with regard to decision-making and information dissemination. An ICD-10 education and training committee can assist with the development of:

  • Training/education plans – (What’s our overall vision?)
  • Training needs assessments – (Who needs training?)
  • Budgetary estimates – (How much will it cost?)
  • Timing of training delivery – (When will we deliver training?)
  • Resource selection – (Who will provide training?)
  • Outcome measurements/assessments – (Was training successful?)

Again, the guiding vision for training should be set forth in the training plan, which should address the overall objective – in essence determining what will be accomplished during training. The plan will help address methods to be used to accomplish the objectives, plus whether internal or external resources should be selected. The training plan also will identify target audiences, or the intended recipients of training activities. The plan also should involve instructional design methods, or what styles of education will be used.

Whenever training is conducted, it is important to keep in mind that not everyone learns in the same manner – there are visual learners, audio learners, kinesthetic learners and adult learners, all of whom tend to have different educational needs than kids. It is also important that the training plan include timing of delivery, which is especially important in light of the proposed delay. Finally, the training plan should include the vision for outcome measurement, which often is represented by some form of test, quiz or other mechanism of follow-through that can demonstrate whether training accomplished its objectives (and also whether individuals may need additional or supplemental training).

The scope of ICD-10 education can be vast. With guidance from project governance, the education and planning committee can help narrow the scope, and this is another reason why it is important to consider including some type of formal project management concepts within the overall implementation plan (as well in as the training and education planning activities). There are many topics that could be considered for an ICD-10 training plan, including:

 


 

  • Implementation overview
  • GEMs mapping
  • 5010 & meaningful use
  • General regulatory overview
  • Compliance applications/decisions
  • Support applications
  • Clinical documentation improvement  (CDI)
  • Support application training
    • Any application/tool purchased specifically for ICD-10 Implementation
      • Existing application training
  • Business process-specific training
    • Ex.: ABN form, payer policy changes, etc.
    • General code set overview
  • Detailed code set instruction
    • ICD-10-CM
    • ICD-10-PCS
  • Supporting knowledge
    • A&P
    • Pathophysiology
    • Surgical procedural methodology (ICD-10-PCS)

All of these topics could add value for role- or user-based training, which, again, requires careful planning so organizations can make the most of their precious training dollars. For example, this may warrant introducing documentation improvement now so as to spread out costs.  It also may be prudent to begin introducing coding concepts now and saving in-depth code set training until we are closer to the implementation deadline – again spreading out costs over multiple budget years.

With such a wide variety of topics and needs regarding ICD-10 education, it is important that any training and education committee have a solid grasp of the job roles that will require training. ICD-10 is forcing the healthcare industry to value and invest in people like never before. To that end, ICD-10 education will be needed for more than just physicians or coders. Additional staff who may require training include revenue cycle staff, administrative staff and customer service staff – and let’s not forget patients! At some point a patient may have questions or concerns about ICD-10, and the prudent training committee will be prepared to accommodate basic education, perhaps through a one-page flyer that can cover the main bullet points regarding ICD-10 implementation and potential for reimbursement delays.

Devising a training and education plan for ICD-10 implementation can be a daunting task if left to the last minute. Consider beginning the process now and phasing in topics, instructional design methodologies and mediums during the next two years.

The effort will make the actual implementation in 2014 much easier to swallow.

About the Author

Annie Boynton has worked in the health information management field for more than 10 years in provider, payer and educational capacities. Currently she is the director of 5010/ICD-10 communication, adoption and training at UnitedHealth Group. Annie is a member of the American Academy of Professional Coders National Advisory Board, representing the Northeast region, and was a developing member of the AAPC’s ICD-10 Implementation Training Curriculum.

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