Strict Preflight Planning Likened to ICD-10

Original story posted on: October 21, 2013

People sometimes ask about my background and what qualifies me to talk about ICD-10. Let me start at the beginning. I was raised by wolves, but ran away to join the circus at 4. Wait, that’s probably going too far back. No, what qualifies me to talk about ICD-10 was that in one of my past lives, I was an U.S. Air Force pilot flying fast jets. So how does this possibly relate to ICD-10? For every mission I flew, we maintained a strict flight planning routine that I think has some parallels to the ICD-10 transition.

Before each mission, we first checked the weather. That’s important stuff, because big black clouds are not conducive to flight operations when your wingman is three feet away flying at 500 knots. For ICD-10, this relates to “checking the weather” in your own theater of operations. Is the environment sunny and clear so you are able to do what you need to, or is the organizational culture dark and dangerous because your team just isn’t ready to accept this important project?


Before we left flight ops for our briefing, we next checked the NOTAMs, or notices to airmen. For ICD-10, this is akin to watching what’s coming out of Washington, D.C. and in the newsletters we rarely read from our payers. What are the rules? What important items do we need to consider in order for our project to be a success?

The most important pre-flight task was when I got my wingmen together to go through a formal briefing. We discussed mission-critical items, such as target objectives, communication plans, joker and bingo fuels, armament, threats, and strike routes.

For the ICD-10 transition, briefings on target objectives are key. First and foremost, how do we get the providers to be the cornerstones for success, engaged and ready in order to meet our objectives? There are a few simple things you can do 0to make sure your providers become productive wingmen, and not a hindrance to your mission. Convert your top 20 codes so you know what you’re dealing with, first of all. Create simple flash cards that help educate your providers, and conduct chart reviews that reveal current documentation shortfalls you can use to create report cards to motivate your docs. Communication plans you’ll need to create for your ICD-10 project are just as important as those plans I briefed as a flight lead. How are we going to communicate? When are we going to communicate? What are we going to share?

Joker and bingo fuels were important numbers to know, though the jargon may be foreign to civilians Keeping these numbers in mind ensured we had enough fuel to complete each mission. I would relate this to budgeting for the ICD-10 transition. What does our estimated versus allocated versus actual cost look like? And let’s not forget about staff resources we need to throw at the project. When people are engaged in ICD-10 transition tasks and milestones, they’re not able to do their real jobs, and task saturation can be a real mission-killer. Let’s also talk about armament. Do you have what you need to complete the transition? Do you have enough staff? Have you dedicated enough time? Is the team aligned for your target objective?

And what about threats? In the Air Force world, that meant briefings about surface-to-air missiles, anti-aircraft guns and hostile aircraft. In the ICD-10 world, your threats will reveal themselves during your impact assessment. Is my IT vendor going to be a problem? Can they answer questions, like “when will you deploy the ICD-10 upgrade?” Will there be downtime as a result of the deployment? Will we lose current customization? Who pays? What about templates? Support? Training? The dual track coding environment? Most importantly, when are we going to test? How are we going to test? What’s that going to look like? Other threats to the success of your mission can include your external stakeholders. Will referring providers and order entry entities like labs and imaging going to be a problem for the transition mission?

Make no mistake: the ICD-10 transition is serious enough to be likened to a combat mission. Your very livelihoods are at stake. Without an aligned, coordinated attack, you’ll have planes flying all over the sky, and chaos will ensue. So as an old flight commander, I ask you to check six, and Godspeed on this very important mission.

About the Author

Dennis Flint is the chief executive officer for Complete Medical Solutions. Dennis formerly served as the CEO of a large, multi-specialty physician group, a full service MSO and was a certified professional coder through AAPC. He has authored or co-authored numerous “common sense” practice management books and implementation manuals. Educated at the United States Air Force Academy, he had a distinguished career as an Air Force pilot flying numerous secret and sensitive missions.

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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.
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.