ICD-10 Will Have Huge Impact on Health Information Management Industry

ICD-10, ACA Will Have Huge Impact on Health Information Management Industry2013 a Year of Re-tooling for Health Information Management Planning

The Affordable Care Act (ACA) is here; the transition to ICD-10 compliance looms. What is a Health Information Management professional to do? We thought there would be no better time than now to discuss the challenges the health information management industry is facing. And there is no one we know better able to weigh in on the coming challenges for the HIM industry than Bonnie S. Cassidy.  Bonnie is the Senior Director of HIM Innovation for Nuance, past president of AHIMA  and serves on the HIMSS Privacy and Security Steering Committee.  Here is what she had to say.

1. A recent report from KLAS, HIM Services 2012: Helping to Weather the Storm, found provider’s health information management plans might be challenged by ICD-10, the Affordable Care Act and other regulatory requirements. What are some sound strategies you can offer providers in re-tooling their HIM plans this year?

Do not stop!  When the delay of the compliance date was announced, some organizations slowed down the pace and resources devoted to their ICD-10 transition plans and focused on Meaningful Use. We have found the greatest health information management success stories come from those that decided to plan as though it was still October 1, 2013. This gives them a year to assess, test and re-assess in a Continuous Quality Improvement (CQI) cyclical approach.  In addition, since it is usually the same 20 people leading the project teams on EHR implementations, Meaningful Use, ICD-10, regulatory compliance and data analytics, it’s important to share work plans and identify opportunities to tip the silos over and find synergy.  Don’t be redundant with work efforts if there are opportunities to share resources, results and effort.  For example, if you have identified your top ten clinical documentation issues for ICD-10, don’t keep it a secret.  Have the ICD-10 education planning include your CDI team and the EHR clinical content team to identify processes that enable the physicians to document the right information needed for clinical care, as well as clinical coding compliance.

2. Looking at the transition to ICD-10, what do you see as the biggest impact to the Health Information Managment industry?

At this time, the compliance date for the U.S. is October 1, 2014.  Health Information Management professionals are the “change agents” in every health care organization leading the successful planning and transition from ICD-9 to ICD-10.  Encoded data is essential to all aspects of today’s healthcare system.  Classification and coding system standards require HIM leaders to evaluate, educate, implement, and maintain ICD-10-CM and/or ICD-10-PCS.  AHIMA has created an ICD-10 Transition AHIMA Leadership Model for HIM professionals which address many of challenges associated with maintaining high quality data in electronic information environments.  This AHIMA Leadership model requires a clear understanding of data content standards and effective coordination and management of the organization’s data requirements.  As experts in the management and use of health records and encoded data, HIM professionals serve as the leaders in healthcare organizations through the transition of ICD-9-CM to ICD-10-CM and/or ICD-10-PCS.

Health Information Management Professionals are responsible for managing the transition to both ICD-10-CM and PCS code sets which are more complex than the predecessor in their length, true alphanumeric structure, and the sheer number of codes.  From retraining the entire coding workforce to increased Accounts Receivable (AR) days, the transition to ICD-10 could drastically affect the productivity and day-to-day operations of any compliant U.S. healthcare organization.  Other critical business and risk mitigation concerns that health information management professionals are strategically planning for include:

  • Productivity losses expected to range from 10% to 50%
  • Increased coding backlog and greater time requirements to assign codes
  • Increased Discharged Not Final Billed (DNFB) and AR days
  • Decreased ability to assign codes from memory
  • Increased anatomy, physiology, and medical terminology requirements
  • Coder shortages

3. Last year Nuance acquired two companies, J.A. Thomas and Quantim. Both companies operate in the ICD-10 space. Can you tell us how these two acquisitions fit into your vision for 2013 and beyond?

Nuance realizes that healthcare providers are facing daunting challenges.  Our focus is helping them infuse intuitive technology into the clinical process to work for them, rather than against them.  This vision drove the Nuance acquisition of J.A. Thomas (JATA) and Quantim (HIM Division of QuadraMed) and today, we’re shifting the focus to the creation of a clinically accurate record that bridges both clinical and business needs.  Together, we’re creating a first-of-its-kind, single platform that supports healthcare providers’ clinical documentation strategies from capture through reimbursement.  This Nuance platform applies the power of intelligent systems to the challenges of clinical documentation – an approach that helps hospitals simplify the transition to ICD-10, and ensure data quality and appropriate reimbursement for the care provided by incorporating proven clinical documentation rules from the start.  What’s truly unique about our offering is the front-end design where we integrate the clinical documentation improvement process into the physician workflow from the start of the patient encounter to help clinicians efficiently create the most complete and accurate clinical documentation at the point of care before it is coded and sent downstream for billing. 

4. Nuance will be attending HIMSS this year in New Orleans. What can we expect? 

You can find Nuance at booth #4025 this year at HIMSS.  In addition to an education session that I’ll be leading on March 7 at 11:15 a.m. CT, “Information Governance includes Core Record Set for Coding and Compliance,” we’ll be making some notable announcements and offering education at our booth related to the following key areas of interest: ICD-10, mobility and intelligent systems for healthcare.  In our booth, we’re providing an interactive demo where participants can get hands-on experience with how a “virtual assistant” can streamline workflow for physicians.  Building off the mobile theme, we’ll also have a customer, Kearney Clinic, and a partner, Montrue Technologies, speaking about best practices for “Tacking the ‘Achilles Heel’ of Mobile Medicine” on March 5 at 9:45 a.m. CT.  And lastly, we have two more Nuance customers, University of Utah Hospitals and Clinics and the University of Pittsburgh Medical Center, speaking at the show on the following topic, “ICD-10: Navigating the Perfect Storm.”  This session takes place on March 6 at 9:45 a.m. CT.

Per your question above regarding our recent acquisitions, enabling providers to streamline the transition to ICD-10 will be a major focus area for us so we’ll actually have a second booth, #5451, that’s dedicated solely to providing insight on ICD-10 readiness and best practices.  This booth will offer experts and information on engaging and training physicians for the ICD-10 transition; insight on technology that can help streamline the transition, such as clinical language understanding and computer-assisted coding; and lessons learned that focus on clinical documentation improvement practices through change management.

Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSS, is the Senior Director of HIM Innovation for Nuance having previously served as the Vice President of HIM Product Management & Innovation with QuadraMed. Bonnie is on the CAHIIM Board of Directors, is a Fellow of AHIMA, and an AHIMA Academy ICD-10-CM/PCS Certificate Holder and ICD-10 Ambassador. Ms. Cassidy is a Fellow of HIMSS and is current member of the HIMSS Privacy and Security Steering Committee. Prior to joining Nuance, Bonnie served as an executive with the Certification Commission for Healthcare Information Technology (CCHIT), Ernst & Young, and was an HIM Administrator at two major teaching hospitals including the Cleveland Clinic Foundation. Bonnie was the 2011 President of AHIMA serving as the Chairman of the AHIMA Board and served on the AHIMA Board as the 2012 Past President Director. Bonnie was the President of the Ohio Health Information Management Association and was honored to receive the OHIMA Distinguished Member Award.