Updated on: September 23, 2013

Educational Strategy for ICD-10: The Right Mix of Options is Just What the Doctor Ordered

By Cassi Birnbaum, MS, RHIA, FAHIMA, CPHQ
Original story posted on: January 18, 2013

As we work with healthcare clients of all sizes, types and geographical areas, we are coming to understand that one size does not fit all when it comes to the bill associated with the educational strategy for your transition to ICD-10. For example, when your organization performed its original assessment and gap analysis, perhaps a Web-based approach leveraging your organization's learning management system (LMS) appeared to be the path of least resistance. After further study, however, many organizations have concluded that their educational plans are sorely lacking a focused approach, or perhaps they appear to be too deep for some audiences and too abbreviated for others. Some organizations have taken the approach of folding their plans into their annual mandatory education (AME) requirement, mandating deeper content study acquired through professional organizations. Although many providers have invested in a multi-pronged approach of Web-based education, sending their coding staff to the American Health Information Management Association’s (AHIMA's) ICD-10 Academy to prepare staff in hope they will find the time to develop custom educational programs, other organizations are sitting on the sidelines until the transitional date gets closer.

Whatever approach you have taken – perhaps based in part on a limited budget, geographic distribution of your workforce, preferences of your medical staff, or your typical educational approach – the most successful strategies involve the aggregation of roles based on depth and the need for customized content. Learner pathways with a clearly defined curriculum make the most sense, with a deliberate emphasis on coding, CDI, medical staff and those who heavily rely on secondary clinical data (quality and outcomes reporting, research, decision support, etc.).  Despite the uniqueness and complexity of your organization, try not to make this process overly convoluted. Reuse content for your baseline training, introducing minor tweaks to reduce the level of difficulty of the development effort. Also, seek advice from a stakeholder group representing key constituencies in your organization rather than a few squeaky wheels who have preferences that may not play well to the masses.

Also, consider serving up the content in a multitude of formats to take into consideration geographical challenges and providers who may have a home elsewhere (allow a reciprocity relationship with other hospitals in your service area, also). And consider partnering with your local community colleges or universities if they offer classes that your coding team can take advantage of for their foundation training and core ICD-10 content.

Regardless of the approach you employ, appoint someone to be in charge of ICD-10 education. Resource allocation will vary depending on the size of your organizational footprint. All courses offered should have associated evaluations and post-tests tied to CEUs. To ensure that your workforce is trained properly, you need to mandate the training and ensure that it is tracked via a performance-based set of metrics, either through your LMS system or a third-party system. The optimal education roadmap features a front-end assessment used to identify gaps in coder knowledge, along with a customized pathway through which staff can access information and demonstrate competency. This ensures that physicians are not sifting through detailed content that is not relevant to what they need to know in order to improve the integrity of their documentation. It also should provide the detail necessary to facilitate quality coding, and should ensure that patient access and revenue cycle staff know what changes will be relevant to their workflows and back-end processes.

However you go about this task, make it fun, relevant, useful, relatable and well-designed. Don't drag out the content to meet a preconceived set of criteria and duration, and offer choices to account for learning preferences and logistical requirements. Consider the unique challenges of your non-employed medical staff as well: don't force them into a cookie-cutter scenario that doesn't fit their busy practices. Finally, explain the "why behind the what" in order to ensure they understand why this matters and what will change post-Oct. 1, 2014.

The time is now to plot your educational roadmap, and don't get lost in your quest to ensure that your workforce has acquired the knowledge to operate successfully in an ICD-10 world.

About the Author

Cassi Birnbaum, MS, RHIA, FAHIMA, CPHQ, is vice president of health information management for Peak Health Solutions, specializing in providing remote coding, auditing, data collection and analysis, clinical documentation improvement, ICD-10 transition, and HIM resource planning services nationwide. For the last 15 years, Birnbaum was the director of health information and privacy officer at Rady Children’s Hospital in San Diego, Calif.

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Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.