February 26, 2014

My View from the Road: Same-o, Same-on

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EDITOR’S NOTE: The following is a transcribed version from Denny Flint’s segment on Talk-Ten-Tuesday, Feb. 25, 2014.

What’s the view from the road, Chuck? What’s the view from the road?

I’ll tell you the view from the road. It’s the same view as this time last month, and this time the month before that, and this time last year. I feel like Bill Murray in “Groundhog Day.” Every day I wake up and go to work and nothing, I mean nothing has changed. I’m tired of delivering the same tired old content that HAS absolutely NO IMPACT. (Convert your top codes, identify the new documentation elements, create some training tools, do some simple chart reviews, engage your payers and vendors.) No. Today, no “HOW TO” content.

Today, you get “WHY NOT?!” content. Today, you get a good old-fashioned hissy fit tantrum rant. Just like Peter Finch in “Network.” You remember that character? He had a complete meltdown and leaned out the window and yelled, “I’M MAD AS HECK and I’m not going to take it anymore!” That’s how I feel.

Last Friday, I spoke at… we’ll call it an unnamed state’s orthopedic conference, with about 150 physicians in the room. This past Saturday, I was in front of over 200 clinicians at a hospital-sponsored family health symposium. Three hundred and fifty doctors in two days, and when I asked the question, “How many of you have actively started work on your ICD-10 transition?”, only five hands were raised in those two days. Five out of 350!!! Same result as this time last year, and the year before that. I don’t know what I have to do to get people to understand what a massive undertaking this is.

I’m tired of hearing the same old excuses. Like… “I’m not worried. My EHR company is going to completely handle ICD-10 for me.” Your EHR company is going to handle your ICD-10 transition, huh? If you are listening to this podcast at HIMSS, please turn up your speakers so everyone can hear. “HEY EHR VENDORS… stop telling your customers you’re handling their EHR transition. Especially if you are one of the dozens I talked to at the trade shows. Because when I asked the hard questions about ICD-10 readiness, I was blown away by how NOT READY your EHR companies actually are. Oh, but when you ask them about ICD-10, they’ll tell you, “No worries. We’ll be good to go. We’ve got our customers’ backs.” But privately, they tell me, “Yeah… we’re buried in the Meaningful Use stage 2 objectives and haven’t even started ICD-10 stuff.”

I’ve yet to see an EHR vendor who is actively training our providers on documentation requirements. I’ve yet to see an EHR company talk to all the business partners doctors routinely work with to assess how you’re all going to work together under ICD-10. Labs, imaging groups, PT, OT, DME, referred-to and referred-from providers. Is your EHR company talking to them? Is your EHR company creating your budget? Assessing your day-to-day workflows surrounding pre-authorization, order entry, and compliance? Has your EHR company scheduled a meeting with your payers to discuss managed care contracts or new payment policies you need to know about in order to mitigate the estimated 20 percent loss of revenue and productivity?

Ask MEANINGFUL questions, like, when EXACTLY are you going to deploy so we can start training and testing? Will there be downtime as a result of the deployment? Will we lose current customization when you push through the upgrade? Will it run a dual track coding environment? When will you be ready to test? And here’s the big question… what’s the COST of the upgrade? Dr. Perry Jernigan from East Tennessee Medical Center in Kingsport just got an ICD-10 upgrade bill for $110,000 from his EHR Company.

Other reasons to be in denial… “There’s eight months to go. We have plenty of time.” Gee… CMS commissioned a study that says this is an 18-to-20-month process and you’re going to do it in seven months? Good luck. Other excuses I hear every day: “I can’t get my doctors engaged. But it’s okay, because the AMA just sent another letter to Congress and we think it’s not going to happen or they’ll give us another delay.” Good luck. Every single communique out of Washington, every single WEDI ICD-10 pilot program that completes, everything we hear including from the payers is that this… is… going… to… happen, and no amount of hopey-changey thing is going to derail the juggernaut. A Blue Cross board member told us privately the other night that they are prepared to deny every single ICD-9 claim that comes in the door on October 1. They are sick of waiting, and the doctors have had plenty of time to get on the bus. All your claims denied. Hmmm. Is that going to finally warrant some consideration?

What do I have to do to get your attention? Camp out on a billboard? Tie myself to the top of a tree? “I’m not coming down until the doctors wake up!” Maybe I should go on a fast and stop eating? No… anybody who knows me knows that won’t work. Everybody is avoiding this project. Doctors, staff, EHR companies. I’m done ranting. I’m convinced ICD-10 urgency doesn’t happen until it’s too late.

You can’t beat human nature that avoids what it fears or what it doesn’t understand. It’s like when the receptionist runs back to the doctor and says, “Doctor… there’s an invisible man in the waiting room!” And the doctor says… ”Tell him I can’t see him.” Chuck?

About the Author

Denny Flint is the chief executive officer for Complete Practice Resources.

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Denny Flint

Denny is the chief executive officer of Complete Practice Resources, a healthcare education, consulting, and software company headquartered in Slidell, Louisiana. He formerly served as the CEO of a large, multi-specialty physician group, full service MSO. Denny has authored or co-authored numerous “common sense” practice management books and implementation manuals. He is an award winning, nationally known consultant, speaker, and educator bringing his expertise to making the complex “simple.” He currently serves on the editorial board of ICD10 Monitor. Educated at the United States Air Force Academy, Denny had a distinguished career as an Air Force pilot and has a long history of commitment to excellence and dedication to his clients’ success.