June 1, 2011

ICD-10 Survey Shows Urgent Need for Physician Education and Medical Staff Buy-In


J.A. Thomas & Associates has announced top-line results from an ICD-10 survey sent to its U.S. hospital client base.

The ICD-10 Final Rule sets out a specific date, Oct. 1, 2013, by which all entities impacted by HIPAA must convert to and begin using new ICD-10 code sets.  ICD-10 conversion means major changes in coding rules, terminology and structure and an eight-fold increase in the number of codes.

Providers face both the prospect of productivity losses, and possibly, nonpayment since providers are evaluated – and paid – based on reported patient data and the care they receive.

To address this daunting challenge, J. A. Thomas & Associates developed and issued a survey to its client base in April 2011 to assess the following:

- Are hospitals and staff getting prepared for ICD-10 and to what extent?
- Where are the gaps in ICD-10 readiness?
- What do hospitals need most to close these gaps?

Hospital staff, spanning the C-suite, physicians, nurses, clinical documentation specialists, HIM, coders and IT, submitted 378 responses for this survey.

Key Findings

- When asked if they are currently taking steps towards ICD-10 transition, 78.6 percent say ‘yes,’ while almost a quarter say ‘no.’

- The grand majority, 71 percent, has formed an ICD-10 Task Force, although only half have invested in staff training.

- Getting buy-in from physicians and then training physicians is clearly the greatest challenge faced by survey respondents (74.3 percent).

- The majority (71.3 percent) say that they are going to use a mixture of in-house and external training programs for ICD-10 training.

- For those who indicated that they are currently not taking steps towards ICD-10, half indicate that other priorities are in the way and 20 percent say that it is not a priority now. 

- Clearly, investing in education and training is most beneficial to those surveyed (71.8 percent), with more than half pointing out that they need help facilitating medical staff acceptance and endorsement of ICD-10 conversion.

Physician Buy-In Lagging

“A significant discovery, perhaps not too surprising to some, is that physicians are finding it hard to see the benefit of ICD-10 to their practice and/or patient care,” said Paul Weygandt, MD, JD, VP of Physician Services for J. A. Thomas & Associates.  “Without physician cooperation and understanding, other changes in workflow or systems to accommodate ICD-10 ultimately will fail.  We not only need to make a compelling argument as to the importance of I-10, but we must also build the necessary infrastructure to assist physicians in accurately documenting in a much more complex system.”

Hospital and health systems should make physician training and awareness a priority, sooner rather than later.   Clinical team involvement and endorsement will improve
ICD-10 success and boost overall staff morale, particularly with HIM, coders and CDS’s who need to work in concert with clinical teams to make this transition a success.

Training Must Extend Beyond the Coder

According to Mel Tully, MSN, CCDS, Senior VP of Clinical Services and Education, “Training efforts, to-date, have fallen squarely on coders.  Now, we need to see hospitals push this training to physicians and clinical documentation specialists.  Effective clinical documentation and coding accuracy happens when coders work in concert with the clinical team.”

Physicians, CDS’s and other members of the clinical team should have a training roadmap in place that ensures they understand the scope and depth of the ICD-10 transition and how this will impact their current clinical documentation process and program.

Read 109 times Updated on March 16, 2016
Mark Spivey

Mark Spivey is a national correspondent for ICDmonitor.com who has been writing on numerous topics facing the nation’s healthcare system (and federal oversight of it) for five years.