Updated on: September 23, 2013

Leading Physicians to ICD-10: First, Rebuild Compromised Trust

By Elizabeth Stewart, RHIA, CCS, CRCA, and Cindy Seel, MSA, RHIA
Original story posted on: May 30, 2013

Trust, as defined by Merriam-Webster, is “the assured reliance on the character, ability, strength or truth of someone or something, and one in which confidence is placed.” It is among the most basic of all human connections, and it’s a necessary element for organizational effectiveness. With regard to ICD-10, some may ask, “What does trust have to do with it?” The answer is: Everything.

A deeper level of trust between physicians and health information management (HIM) professionals is mandatory for hospitals and physician groups to transition to ICD-10 successfully. Physicians should trust their HIM staffs to lead them into a new world of coding and billing requirements. HIM professionals must rely on their physicians for more granular words, phrases and terminology in documentation. Now is the time for the development of trust between physicians and HIM professionals to allow both to mature and advance.

Here are six ways HIM professionals can rebuild compromised trust with their physicians, as described in a 2013 publication, “The Leader’s Role in Building and Maintaining Trust.” [i]

  • Articulate your vision and values so others know what to expect.
  • Focus on shared goals and take time to discover what is important to physicians.
  • Establish and maintain integrity; make knowledge-based decisions.
  • Be open and honest to avoid hidden agendas and eliminate ICD-10 surprises.
  • Take a caring approach with physicians and express genuine concern.
  • Engage physicians specialty-by-specialty so everyone feels part of the team.

Author Steven Covey stated that the quickest way to rebuild trust is by “doing what you say you will do — talk straight and deliver results.” Make certain to appreciate inquiry, shared vision and systemic thinking: three strategies that invoke a deeper level of trust. HIM leaders can employ each of these strategies to strengthen bonds with physicians. Once trust is rebuilt, maintain it. With trust repaired, here are seven steps to get physicians on board with ICD-10:

Step 1: Provide physicians with a general overview of the ICD-10 plan. Focus on implementation, training and communication.

Step 2: Conduct specialty-specific education in small bites, and remember that physicians are not coders and coders are not physicians! Respect and understand your audience.

Step 3: Identify the best training methods by being creative, knowing your clinicians, and selling your training.

Step 4: Assess documentation and identify key needs while consistently reducing the number of physician queries.

Step 5: Introduce the new terminology of ICD-10-PCS root operations and offer physician-led education sessions for your coders now.

Step 6: Explain the good, the bad and the reality of GEMs to your physician groups. Many in healthcare falsely believe that GEMs are the go-to answer for mastering ICD-10.

Step 7: Remember that physician office staff can be a missing piece of the ICD-10 puzzle. Provide them with external training and other services.

The time for ICD-10 urgency is getting close, as we are at the crossroads of ICD-10 preparedness. Physician participation and cooperation is imperative. Utilize deliberate, strategically guided actions to build trust with this group, and then methodically introduce them to ICD-10. That’s the key!

About the Authors:

Elizabeth Stewart is the corporate director of HIM for HRS. Her areas of expertise include coding, HIM, patient access, patient financial services, compliance and HIPAA privacy and security. In addition to her role at HRS, she continues to serve as the executive director of the South Carolina Health Information Management Association.

Cindy Seel is responsible for the development and presentation of ICD-10 instructional materials for clients. Such clients include large academic health systems, pediatric hospitals, general acute-care hospitals, physician groups, and clinical coders from a variety of settings. Before joining HRS, she most recently was the program director and lead faculty member of the Health Information Technology Program of Southwestern Michigan College in Dowagiac, Mich. Previous positions also include practice manager, vice president, quality enhancement, and director of medical records. Seel holds a Master’s degree of science of administration from the University of Notre Dame in South Bend, Ind. and is in the last months of completing her doctorate in community college leadership through Ferris State University in Big Rapids, Mich.

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[i] Barnes, Y., DeCamilis, S., Hert, F., Holoman, L., Hoxie, T., Klein, K., Wanick, D. What Does Trust

Have to Do with It? The Leader’s Role in Building and Maintaining Trust, 2013, Big Rapids, Mich., Ferris State University.

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.