March 10, 2014

The Long Journey to ICD-10

Now that I am back from Orlando and have had a weekend to spend at home (then a few very long days to dig out of what seemed like a bottomless inbox), I have finally had a chance to reflect fully on my time at the recent HIMSS conference. When I was there, I reported to you what happened on the exhibit floor and surrounding meetings, but I realize now that some of my most interesting conversations happened on the seemingly never-ending shuttle bus ride from my hotel to the convention center. As the topics brought up on this ride continue after HIMSS, I thought I would share the experience with you.

What was promised to be a 15-minute, six-mile journey turned into a one-hour tour of the area, in which many of us thought we were going to Miami rather than downtown Orlando.

The positive part of this painfully long bus ride was that it gave me plenty of time to talk with some of my healthcare colleagues before finally arriving at the Orange County Convention Center. On the final day of HIMSS, there was marked interest in using computer-assisted coding (CAC) as a way to mitigate some of the productivity issues caused by ICD-10. A big difference in the tenor of the industry that has recently emerged is that we are now seeing many more questions about the importance of workflows to help in the movement of data in order to improve productivity. Providers also want to understand how clinical documentation improvement (CDI) software can support these efforts. This is a big change from years past. Now, people actually know what CAC is, and they are asking the right questions of vendors.

In addition, discussions about education continued. My fellow passengers wondered what kind of ICD-10 education a clinical documentation improvement specialist (CDIS) needs. Is the knowledge of documentation or coding alone enough, or is a combination of both necessary? As a liaison between physicians and coders, my recommendation is that the CDIS needs extensive documentation education to drive (no pun intended) optimal documentation and to identify gaps and risks.

On the other side of things, I believe that these specialists need at least a foundational coding education in ICD-10 to understand the basic rules and guidelines coders must follow. Since most CDI Specialists are nurses and may have limited coding experience, this level understanding is critical. A new trend I am seeing with some of our clients is that they are having their CDI specialists participate in all of the documentation education and all of the coding education so they can become experts in both disciplines. Many of our clients are reporting a much-improved communication stream between their CDIS personnel and coders, as the CDIS is becoming not just a clinical advocate, but a coding advocate as well.

When I finally arrived at the convention center after countless thoughts of tucking and rolling out of a moving bus, these conversations continued. This HIMSS was my favorite yet. I felt that the discussions leading up to the ICD-10 implementation date have been meaningful, and now I am finally seeing some outcomes – and, believe it or not, positivity.

I am looking forward to seeing what next year brings, other than the assurance that I will be taking a cab to and from the convention center.

About the Author

Thomas Ormondroyd, BS, MBA, is vice president and general manager of Precyse Learning Solutions. Heoversees Precyse University (www.precyseuniversity.com), an online learning system and program built to deliver education to prepare healthcare professionals for the challenges of today and tomorrow.