December 11, 2012

Assessing ICD-10 Readiness: Understanding Assessments and Looking for a Better Way

By

EDITOR’S NOTE: This is the last installment of a two-part series about ICD-10 readiness.

In Part 1 of “Assessing ICD-10 Readiness,” I talked about the different perceptions in the industry regarding the varying degrees of readiness among providers. In part, this is because of the inherent issues involved with self-assessments.

No matter how well you structure a survey or attempt to measure readiness, you run the risk of getting some false positives. That means that ultimately you will have some people reporting something that does not correlate with reality. For example, with ICD-10 some may report their readiness as being further along than it actually is. Does that mean that responders are misleading you intentionally through their answers? Not necessarily. It could happen for other reasons, too:

  • Different stakeholders have different work to do: Not all healthcare providers will have to complete the type of work that payers do for ICD-10, and vice versa. Your questions may be geared to your organization, and thus they would not provide a true picture of readiness for another organization.
  • You don’t know what you don’t know until you don’t know it: Perhaps some survey responders don’t know the entire scope of the work they face, so they think they are further along than they are.

No matter the reason, this distortion of the readiness picture could lead to problems during implementation.

So, how do you resolve these issues? There is no magic bullet, but there are strategies that we as an industry can employ to help ease the confusion.

1)   Aligning assessments

Using a single assessment for each uniform group of entities would help. If, for example, there was one assessment for large hospitals, one for multi-state payers, one for vendors, etc., and the questions were consistent across the industry, this would help put everyone on the same page. It also would align the language of the ICD-10 transition, giving everyone a clear picture of what’s important about the transition and eliminating unnecessary duplicitous work.

To accomplish this however, you need to understand the entire body of work that needs to be done in order to prepare for ICD-10. That’s a challenge that we’ve been facing for quite a while, and reaching agreement across all parties is difficult.

2)   Understanding your survey audience

You also have to understand the people on the other end of your survey. There’s nothing more frustrating for a survey respondent than having to answer a bunch of questions that have little or nothing to do with their daily business. Sometimes working with a stakeholder representative can help make your survey questions clear, concise and understandable to your audience.

3)   Peer group comparison

Reporting individual results of questions about ICD-10 readiness can be helpful to an individual entity, but understanding where an organization is in comparison to its peers is even more valuable. Assessments should have some element of group reporting or peer group comparison built into them. This gives users (and the industry in general) a better view of where they are in comparison to others facing the same sets of challenges and work.

From the beginning we’ve said that the greatest challenge of ICD-10 is the unknown. By performing accurate and thorough assessments, we can help eliminate many unknowns and bring the industry to a better place.

About the Author

Dennis Winkler is the Technical Program Director of Program Management and ICD-10 for Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan. He is responsible for ICD-10 program direction and is the IT business partner for Medicare Advantage. Dennis graduated with distinction from the University of Michigan's Ross School of Business. He spent his first 11 years of his career with Anderson Consulting (now Accenture); specializing in large, complex system development projects. Winkler joined BCBSM in 1998 and since has been responsible for leading major enterprise programs including HIPAA 4010 implementation, Social Security Number elimination and the National Provider Identifier initiative, among others. He has spoken at several national summits and seminars about ICD-10 since BCBSM began its ICD-10implementation.

To comment on this article please go to