May 8, 2015

ICD10 – Why Resiliency is a must for Project Managers

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Dictionary.com defines resiliency as “the power or ability to return to the original form, position, etc., after being bent, compressed, or stretched; elasticity.”

Many of us surely have seen the movie “Apollo 13.” The movie is about the seventh manned mission to the moon. The mission was aborted after an oxygen tank exploded – and working in uncharted territory, the mission managers’ resources and energy back home in Houston were stretched. They were able to develop an alternate mission (based on the circumstances), and failure was not an option. Ultimately, they were able to bring the crew safely back to earth.

How does this translate to ICD-10, with less than six months to go before the compliance date? The entire ICD-10 project team has job descriptions (clinical documentation improvement, assessment, financial review, etc.), but the project manager has a job description that includes a specific set of important tasks (scope, schedule, costs, etc.).) Sufficed to say, he or she will be compressed (satisfying the medical staff, IT staff, and vendors) and stretched (working 70-plus hours per week) – and this is the uncharted territory no one has yet been through, at least in the U.S. Here’s a few questions to consider:

  • Project Plan Are all the deliverables defined (clinical documentation assessment, effective sample size of the clinical documentation records to gauge the readiness, etc.)?
  • What tasks are incomplete? How do you gauge the completeness of each task (providing training to coders/auditors versus providing training and observing the effectiveness of the coders/auditors, for example)?
  • What are the costs to date? By subtasks?
  • How long has it taken to complete the work already accomplished? For example, training for physicians – What if the physician(s) are not available?
  • Based on the provider’s schedule, when will the tasks/subtasks be completed?
  • When will the project be completed? What will be the costs at completion?

Vendor Management

  • What if a payer is not ready to accept the ICD-10 claims?
  • Do you know how much revenue is derived from each payor? If so, what is the fallback scenario if the payor will not be ready to accept ICD-10 claims?

Human/Internal Organization

  • How is progress measured in your organization? By CEO? CFO? Providers?
  • Do stakeholders still think that the ICD-10 compliance date will be delayed?
  • Are your internal systems (and auxiliary systems) compliant? If not, what happens when the vendor does not upload software patches or remediation software on time?

Financial

  • Is the cost out of control?
  • If the go-live date is again delayed, what happens?

Testing

  • Are the testing resources sufficient?
  • Do the test cases cover the entire workflow?

These are examples of cases in which the project manager will be bent and stretched:

1. Do not let analysis paralysis affect your project.

As a project manager, you need to set a firm date – when to start a task and when to end the task, plus when to stop collecting more information. For example, say that after repeated calls, a payer is still not responsive about its readiness. Once a hypothesis is set (and calls/contacts with the payer are made) then it should be placed on the follow-up list so that it does not remain an open-ended question.

2. Recognize the team’s contribution.

Rare is a project that does not hit any rough spots. Most projects hit them while meeting the completion date. It is critical to have weekly meetings, recognizing what went right and what went wrong, and to debrief regularly and make a list of alternatives. Involving the team in all aspects is critical.

And then there is the project plan:

The project manager needs to ensure that the project management system is established by defining the project objective, assigning deliverables internally versus externally,  scheduling testing, budgeting every subtask, and devising accurate estimations.

The project managers draw up the plans and then need to stick to the plan. With all of these intangibles and uncharted territories, the plan should be monitored and checked regularly. The plan needs to be a constant work in progress and every modification or update should be delegated to members of the team.

These tasks are difficult for the project manager(s) because they are striving to accomplish their goals while working through uncharted territories. And when the CFO is pressured to report on the cost(s), it won’t be long before the project manager will feel the heat as well.

About the Author

Paresh K. Shah is president of MindLeaf Technologies, Inc. in Bedford, Mass. He is a member of the HIMSS ICD10 Task Force and co-chair of the HIMSS Playbook.

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Paresh K. Shah

Paresh K. Shah is president of MindLeaf Technologies, Inc., and a member of HIMSS –ICD-10 Taskforce as well as the co-chair for HIMSS Playbook.

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