ICD-10-CA: 8 lessons from Canada that can help your ICD-10 planning

Carl Natale
by Carl Natale

Canada's ICD-10-CA implementation did not go smoothly for many reasons. But healthcare professionals were able to learn from the problems and get practices and hospitals on track.

Gillian PriceGillian Price, currently Project Director Canada at QuadraMed, was a consultant doing operational reviews for Canadian healthcare organizations. She offers some takeaways that can help United States healthcare providers transition to ICD-10-CM/PCS coding.

[See also: ICD-10-CA: What really went wrong in Canada]

Take responsibility for your professional development

Price said that the mandatory training sessions were not enough. Medical coders needed do more such as use informal learning resources on their own time. This naturally caused friction. But the medical coders who put in the time, learned the ICD-10 coding more quickly and were more valuable to their healthcare organizations. Especially if ICD-10 induced stress caused an increase in sick time and retirements.

Once comfortable with ICD-10, medical coders were more energized and professional. They used critical thinking skills instead of rote memorization.

Dive into learning ICD-10 as a system and you will become a stronger part of your healthcare organization.

Get your physicians involved early

Price said she learned this by her third ICD-10-CA implementation. Physicians needed to understand ICD-10's scope sooner than later.

Once involved, physicians were able to help choose tools and systems that worked for them. And they were able to champion the changes to their colleagues.

It's advice that gets repeated often now. But it wasn't common practice in Canada, and they paid for it.

Teach documentation sooner

Speaking of physicians and commonly repeated advice: They need to develop better documentation skills so medical coders can accurately assign codes. So when should that training start?

Medical school.

Price said she went to a medical school to find out just how much education was dedicated to training. Four hours.

If better information is needed to treat patients, that process starts with physicians. Every bit of documentation training will help medical coders and the reporting system.

Plan for delays and cost overruns

Price says there will be issues that will create delays. And it's going to cost more than you think. Add another 25 percent to your budget. Price says you will need the extra time and money.

By the way, planning for delays also means starting your ICD-10 project now.

Understand you will not regain productivity

So plan for that now. Price suggests you make workflow reports that help you map out processes. Then look for inefficiencies and redundancies in your organizations. Make it as efficient as possible. "You must take advantage of every automation," says Price.

The goal is to boost productivity now so you can handle the drop that comes with ICD-10 implementation.

It's a whole new way to look at healthcare

Remember Price said that ICD-10 is too different from ICD-9 for crosswalks and mapping to work. She also recommends forgetting about comparability. It's not going to work.

Collaborate and share the pain

Price is very proud of Canada's very collaborative culture. She says it was a key part of learning from mistakes and making ICD-10 transitions smoother.

Sharing information is going to help everyone learn what works and what doesn't. It's going to help moderate the learning curve.

Healthcare providers need better information

Price said that patient treatment did improve with the detailed information from ICD-10 codes. With the new information, physicians learned more about disease and treatment.

Although the road to get to that point was bumpy, Price would say it was a success. And the Canadian medical coders wouldn't go back to ICD-9 codes.