This week I’m attending the mHealth Summit in Washington DC. One of the interviews I’ve had at the event was with Dan Cane, CEO of Modernizing Medicine. You might remember my previous post talking about Modernizing Medicine’s unique interface (and it’s still unique). However, Dan demoed their ICD-10 interface which was like none other I’ve seen.
What I found unique about the Modernizing Medicine ICD-10 interface was that the ICD-10 codes were identified algorithmically as opposed to doing a search. In fact, it begs the question: are there other EHR vendors that algorithmically choose an ICD-10 code as opposed to providing some interface where the user has to search and identify the code? I don’t know of any other EHR software that do this.
Certainly there are plenty of ICD-10 interfaces that let you search for the ICD-9 code and then let you find the ICD-10 code. While it’s an extra step, this can be one way to filter down the vast ICD-10 codes. I’ve also seen other interfaces that after doing a search group the various ICD-10 codes and allow you to drill in to find the right code. However, it’s very different for the EMR to use the data you’ve entered into a note to determine the ICD-10 code for you.
The problem that most EHR vendors have is that they don’t have the EHR data recorded in a way that they could create an algorithm to identify a specific ICD-10 code. Is this even possible to do with a template or macro based EHR documentation system? The only possibility is to take something like Watson together with NLP technology to try and identify the ICD-10 code. The results of such a thing would vary greatly by doctor. Watson can’t magically know right or left (or choose something more esoetric) if you don’t document it.
Why does this matter? If it takes you can extra 1-2 minutes per patient finding the ICD-10 code, that’s going to be a major issue. The moral of the story is that even though your EHR vendor might say they’re “ready” for ICD-10. Are they really ready? Just because a program can do something doesn’t mean it does it well.
Check out all of our ICD-10 Tuesdays series of ICD-10 related blog posts.
What I need is a list of questions I can ask my vendor to smoke this out. See, I don’t think anybody is really “ready.”
ie
Will you use a search function or algorithm? (taken from your article above)
If Search, What is the process of searching? Please give example(s).
If Algorithm, what factors does the program look for? Please give example(s).
Better yet, if KLAS could issue a questionnaire and post the results of such a survey, that would put some pressure on vendors (like they really need more, but then, everyone is in a pressure cooker these days).
Interesting idea. Questions is the starting point. Really testing it doing dual coding is where you’ll really learn if they’re ready and how ready.
[…] recently read an interview of a new vendor that claims they can ‘read’ your notes and recommend appropriate ICD-10 […]
Here are some great questions you absolutely should ask your vendor:
1. What is your solution for ICD-10?
2. When will your ICD-10 functionality be available?
3. Are you using look-up tables or general equivalence mapping (GEM) solutions in your system for ICD-10, or will your system automatically provide the correct ICD-10 codes with the exam notes?
4. How will ICD-10 affect the workflow in your solution?
5. How much longer will it take for me to code a superbill for ICD-10 than it took for ICD-9?
6. How many added steps will there be to select the correct code?
7. How do you prevent invalid or clinically inaccurate ICD-codes?
Most importantly – you should ask to see it. You should time how long it takes per code and calculate how much time you are going to loose. If it takes you 20 seconds per Dx to use their mapping or lookup and you make an average of 3 Dx per patient and see 40 patients – you are going to be spending an extra 40 minutes per day just looking up codes. It adds up!
[…] We all know that the EHR vendor needs to be ready for ICD-10. However, as John posted previously, Is Your EHR Ready for ICD-10, Not Just Say They’re Ready? it’s really easy for an EHR vendor to say they’ll be ready for ICD-10. At the core of […]
[…] the Modernizing Medicine EHR much better than I do. Check out their unique EHR interface and their approach to ICD-10 (which I guess will now have to wait another year to be really valuable). I’ll be doing an […]