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What will it really take for a healthcare enterprise to be ICD-10 ready?


COMMENTARY

By Eddie R. Williams and Marc Gravez

USA

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During a recent healthcare forum, some health plan and provider representatives said they were “ready for ICD-10.” Other, mostly smaller, providers expressed concern. One of the more interesting comments came from an organization that had managed their ICD-10 implementation as a “project,” until they experienced a series of missteps. After realizing how many multiple interdependent projects were involved, this organization determined that they should have managed ICD-10 as a program

ICD-10-CM/PCS is the International Statistical Classification of Diseases, 10th Edition, and Clinical Modification/Procedure Coding System. ICD-10 is an update to ICD-9, which is 30 years old. ICD-10 is mandated by the World health Organization (WHO). In the United States, ICD-10 affects all entities covered by the Health Insurance Portability and Accountability Act (HIPAA). For an overview of ICD-10, see http://www.cms.gov/Medicare/Coding/ICD10/index.html.

Let’s stop calling ICD-10 implementation a “project,” because it really requires the focus and commitment of a program

For any healthcare enterprise, ICD-10 implementation is significant enough for designation as a program, with governance at that level. There are many dependencies, internal and external stakeholders, significant interfaces, vendors, and sub-contractors involved. ICD-10 affects multiple related projects, all areas of the business, and may profoundly affect your overall enterprise strategic plan.

There is significant potential conflict with ongoing work required for HIPAA, HITECH, Meaningful Use, the ACA, and so on. At many providers, work continues on projects related to these and other Federal mandates. The significance of ICD-10 is similar to Y2K, but with a much wider impact and cost. Your ICD-10 implementation plan requires realistic and thorough evaluation and estimation, including its effect on the revenue cycle and billing reimbursement.

While there have been many recent advances in healthcare business processes and information technology, the healthcare industry remains behind many others because of a lack of automation and the large number of manual activities.

There are many issues to address

Delivery of any quality enterprise solution requires management of conflicting priorities, ensuring that sufficient resources are available to do the job, and a sound testing strategy.

In general, the ICD-10 implementation issues that your organization can control are related to priorities, resources, quality, and risk. In addition, the current US political situation results in uncertainty about the future of healthcare and coverage.

More…

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About the Authors

 

pmwj35-Jun2015-Williams-PHOTO1

Eddie R. Williams

USA

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Eddie R. Williams
has over 25 years of experience as a program and project manager for system/software engineering, Information Technology (IT) development and management in aerospace, DOD, commercial IT and other industries such as healthcare, pharmaceutical, insurance, and academia. He has been a Project Manager, Sr. PM, Program Manager, and Sr. Program Manager. Mr. Williams has been a certified Project Management Professional (PMP) through the Project Management Institute since 1999. Before becoming a certified project and program manager, he held positions such as Systems and Procedures Analyst (programming and creating system/software specifications), Configuration Management Specialist and Manager, Software Product/Quality Assurance Engineer and Manager, Division Administrator/Manager (development methodologies, management and control).

He is also a coach/mentor and educator, has been a speaker at numerous conferences, and is the author of Software/Firmware Configuration Management (Within the System Development Process) and Management Control and Quality. In 2014 he provided program management content through the Program Management Academy: Content contribution to the 2014, Wiley publication, “Program Management For Improved Business Results” for University master’s degree programs.  Eddie can be contacted at http://www.itprofessionalfacilitator.com/.

Learn 10 Proven Strategies to Improve Your IT Project/Program Success! Visit: http://www.itprofessionalfacilitator.com/

To view other works by Eddie Williams, visit his author showcase in the PM World Library at http://pmworldlibrary.net/authors/eddie-r-williams/

 

pmwj35-Jun2015-Williams-PHOTO2Marc Gravez

USA

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Marc Gravez
is a customer-focused technical communication professional. His passion is creating content that empowers people to learn faster, remember more, and work better, bridging the gap between what users know and technologists think users know. Mr. Gravez has more than 20 years of industry experience, including healthcare IT, telecom, cable, networking, banking, and engineering. He is a Past President of the Society for Technical Communication (STC) Philadelphia Metro Chapter. He can be contacted at [email protected].