ICD-10 “Snooze” Debate at HIMSS12

HIMSS is busy as I have ever seen as Meaningful Use (MU), ICD-10, ACOs, HIEs, etc. have all the industry in a buzz that I can only compare to the Y2K era.  However, this time the changes imposed are designed to have real clinical and financial impact and as such implicate significant risk.  I am taking a departure from my normal career topics to provide an update on ICD-10.

For those of you that are not aware, last week “HHS Secretary Kathleen Sebelius announced that the department would “initiate a process” to push back the ICD-10 compliance deadline from Oct. 1, 2013, to an unspecified later date.”  The major reason given for the delay is that physicians are burdened with so much other work related to MU and other regulatory requirements, that they won’t have time to be prepared of ICD-10.  As you can imagine, the timing of the news has HIMSS12 all abuzz.

To summarize my observations on the delay at HIMSS12, there is CLEARLY a difference of opinion between the IT and coding communities (HIMSS, AHIMA, etc.) and the Physicians.  IT is strongly saying MOVE FORWARD with Oct 1 2013.  Physicians are saying WE ARE NOT READY.  Specifically physicians are saying that there is a lack of tools to help physicians through the documentations process and the major vendors’ approaches of selecting (SNOMED, ICD-9, or ICD-10) codes from pick-lists to populate problem lists is INADEQUATE.

It will be interesting to follow this debate closely as CMS seeks input to specify the details of the delay.

For details, I am including my tweets from Monday’s HIMSS 12 ICD-10 Symposium.  I have highlighted the bigger points for convenience.

Joe Lavelle @Resultant

Great day at the #ICD10 Symposium, it’s clear that we have work to do to bridge the IT(go) vs. Physician(delay) viewpoint gap. #HIMSS12

“Is education enough or should we be more focused on behavioral changes?” Great question by Cerner Trainer in Audience #HIMSS12#ICD10

“You should plan for your #ICD10 team to be deployed at least thru 2014!” Tori Sullivan, IBM #HIMSS12 (this was considering Oct 1 2013 date)

“Please leverage HIMSS #ICD10 Playbook as much as possible” ow.ly/1GJVnC Tori Sullivan, IBM, Task Force Chair #HIMSS12

“Physicians will only be ready when appropriate tools are available by Practice type (w/o pick lists)” Dr Robert Gold #HIMSS12 #ICD10

“None of the EMRs out there meet the need of the patient or the physician yet.” Dr Robert Gold, CEO, DBCA, inc #HIMSS12 #ICD10 #EMR

“It’s a good thing that #ICD10 is delayed, we are not ready.” Dr Robert Gold, CEO, DBCA, inc #HIMSS12

Top 5 Vendors have same (physician un-friendly) methodology for problem lists. Dr Robert Gold, CEO, DBCA, inc #HIMSS12 #ICD10

“I want to show you how to use data to attract the interest of your medical staff.” Dr Robert Gold, CEO, DBCA, inc #HIMSS12 #ICD10 Great!

“Healthcare is being measured to the extent that we never have before, the medical staff is noticing.” Dr Robert Gold, CEO, DBCA#HIMSS12

We cannot “cram IT systems in” without looking at workflow – Ann Bloudin #HIMSS12.

“STOP thinking of insulating from #ICD10, systems and processes must be transformed!” Ian Bonnet, VP, WellPoint #HIMSS12

Nice to see Siemens and Soarian greeting folks in the taxi queue at#HIMSS12 ow.ly/i/tbdx

Myth “Payers are evil and greedy” Reality “We are trying to partner with providers to make #ICD10 easy” Ian Bonnet, VP, WellPoint#HIMSS12

“We will need a full year for testing” Patrice Devoe, Tufts Health Plan#HIMSS12 #ICD10

“Every dept at Tufts Health Plan will be impacted (either medium or high) by #ICD10″ Patrice Devoe, Director, ICD-10 Initiatives#HIMSS12

“As physicians, we have absolutely no idea what ICD-10 is. We all need training.” Dr Ed Gilbert, Northpoint Cancer Center #HIMSS12#ICD10

RT: HIMSS calls for maintaining Oct 1 2013 for most organizations.ht.ly/9bfbh #HIMSS12 #ICD10 Clear theme that HC IT hates delay!

What keeps you up at night? 1) Coders retiring or getting poached. 2) Physician impact. South Jersey CIO Tom Pacek #HIMSS12#ICD10

What keeps you up at night? The chaos and uncertainty over CMS announcement. Doing all upgrades at once. Siemens, NextGen#HIMSS12 #ICD10

“We have engaged a consulting co. to help keep up with the status of all our vendors.” Tom Pacek, CIO South Jersey HC #HIMSS12#ICD10 #e4

“Most people in our organization did not know what we did for 5010; Everyone is aware of ICD-10.” So. Jersey CIO Tom Pacek #HIMSS12#ICD10

ICD-10 impacts over 20 of our products. Siemens #HIMSS12 #ICD10

What was impact of CMS announcement? NextGen – made no difference to us, we are moving full steam ahead. #HIMSS12 #ICD10

What was impact of CMS announcement? Siemens – made no difference to us; we will be ready in 2012 #HIMSS12 #ICD10

“We do NOT have the ability to provide 100% of our member population for testing,” Major Payer #HIMSS12 #ICD10

Possible ICD-10 delay will add ambiguity to effortsbradjust.us/zWTdgV #ICD10 #HIMSS12

“The testing task is bigger than anything you have undertaken, you will need automation and additional human capital” #HIMSS12#ICD10

Building test environments and keeping them fresh is a HUGE challenge #HIMSS12 #ICD10

Looks like slides from #HIMSS12 can be downloaded free fromfreeman-cloud.com/himss2012/

“This is the largest, most complex implementation that the industry will ever face” Sid Herbert, Humana #HIMSS12 #ICD10

“In my company, we have over 70 major systems affected” Sid Herbert, Executive Program Manager, Humana #HIMSS12 #ICD10

Typical payer impact assessment #HIMSS12 #ICD-0 ow.ly/i/t9Qr#yipes!

Only 2 people in the room (by hands) out of ~300+ have STARTED testing #HIMSS12 #ICD10

Those not able to attend #HIMSS12 in #Vegas, can register for a FULL virtual conference experience. Learn more: ow.ly/9a9EL

Rumors say some will skip to ICD-11. Response: it took 8 years for ICD-10 to get vetted, ICD-11 is over 10 years away #HIMSS12#ICD10

What about revenue impact? It is hard to predict. #HIMSS12 #ICD10 The mapping will be unknown unless you actually perform that step.

Answer: Hopefully we can provide more detailed education & will get relief from new systems and technologies like Computer Assisted Coding #HIMSS12 #ICD10

Audience question: what can we do to address shortage of coders? “My experienced coders will retire & inexperienced ones will fall short” #HIMSS12 #ICD10

“it is the people who don’t come to the ICD-10 conferences that need information the most” #HIMSS12 #ICD10 I could not agree more!

The goals is to REDUCE not ELIMINATE non-specific codes#HIMSS12 #ICD10

Call it “assessing the quality of medical record documentation” vs. “improving the quality of” which assumes it is bad. #HIMSS12 #ICD10

“Do not underestimate the scope and complexity of ICD-10!”#HIMSS12 #ICD10

“it will actually be easier to find the right code” with ICD-10 because of less ambiguity, more specificity, etc #HIMSS12 #ICD10

CMS slides indicating “no delays” now humorous #HIMSS12ow.ly/i/t9qS #ICD10

HIMSS calls for maintaining Oct 1 2013 for most organizations.ow.ly/1GIqia #HIMSS12 #ICD10

Attending the ICD-10 Symposia today, it will be interesting to hear perspectives on the delay. #HIMSS12 #ICD10

Excited to be Tweeting from #HIMSS12 this week!

About the author


Joe Lavelle

Joe Lavelle is the Co-Founder of intrepidNow. Prior to that Joe was an accomplished healthcare IT executive and career coach with a record of successfully meeting the business and technology challenges of diverse organizations including health plans, health delivery networks, health care companies, and several Fortune 500 companies.

Joe is also the author of Act As If It Were Impossible To Fail, available on Amazon.