Health Information Management

Evaluating your organization's mindset

HIM-HIPAA Insider, May 19, 2014

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Today I will focus on the chronological transition to ICD-10 readiness. My intent is to dispel myths and compare real-world experience in the ICD-10 planning space with the commonly disseminated wisdom of the healthcare industry’s coding, compliance and payor advisory bodies. Having said this, let us first discuss the topic of evaluating your organization’s mindset.
 
Most conventional wisdom on the topic of ICD-10 planning dives directly into the process of determining impact and creating a current state assessment for use in assembling a complete roadmap toward compliance.
 
Although basically valid, this approach skips a few crucial steps including the one covered today. Without knowing how your organization sees this behemoth of a transition, you cannot hope to formulate a transition strategy or mitigate any of your risk. This logic applies to both the small group practice as well as the large multi-hospital health system.
 
I have observed on various occasions that despite industry pamphlets, project plans, and seminars, many organizations still pigeonhole ICD-10 into the revenue cycle, IT, or coding space and isolate the majority of their efforts and governance inside that limited mindset. This is a terminal mistake and will cause drastic repercussions ultimately making well-meaning efforts ineffective.
 
Those directors, physicians, or executives that control the multi-year budgeting process must be made aware upfront that the ramification of limiting this process to a single business unit puts the organization’s long term survival in jeopardy. Logically, the case for setting a high priority is easy. Politically or socially this can be one of the hardest steps in getting a project moving forward.
 
The best way to emphasize the importance of the project and gain supporters is to let manager level employees think about the change ramifications that directly affect their areas of responsibility. Effects on people, processes and systems will be drastic in some cases. The objective here is not to cause fear, it is to garner support and inspire action – action you will provide as part of a proactive approach to an impending risk.
 
The pigeonhole mindset is usually the result of the stakeholder or decision maker not seeing the personal ramifications of this transition. If there is no problem to solve combined with a ramification of inaction, you will have no priority.
 
Once the decision maker firmly understands and personalizes the concern, your team can move on to define the scope of the issue.

ICD codes are deeply rooting in almost every major business process inside a healthcare entity. They support clinical care, allow for billing, justify adjudication and can be the backbone of compliance. This makes ICD-10 a strategic concern worthy of both human and capital resources.
 
Change programs of this magnitude require process, systematic, and training investments that will directly compete with EHR dollars in the present and Accountable Care Organizations and Meaningful Use determination in the future. ICD-10 must take its place beside those strategic issues as a large initiative worthy of high priority.
 
Your team will need to instill this mindset in stakeholders like a mantra so that when mundane tasks once again consume their workday you can be assured that this mindset of priority will plant the seed of action.
  • Your stakeholders must not only understand the scope of the risk, but also the scope of the solution.
  • Can a revenue cycle project upgrade systems or provide awareness training to several thousand front office or inpatient staff?
  • Can an IT project change coding processes to maintain coded-per-hour metrics? Can a coding or audit project maintain your standards for days in A/R?
When you ask yourself and your stakeholders these types of questions, you begin to realize that an enterprise problem demands an enterprise solution.
 
The mindset variable can be a decisive one. Be sure to focus on stakeholder understanding and support with a clear picture toward future action. If you as the ICD-10 champion can establish personalized stakeholder priority, enterprise risk awareness and enterprise solution support, you have created a strong foundation for the governing structure that is to come.
 
This article originally appeared on HCPro’s ICD-10 Trainer blog.

 



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