ICD-10 implementation could force more change than expected

Carl Natale
by Carl Natale

When I write about ICD-10 being part of a bigger picture, it's usually in the context of provider-payer reimbursement models. But there's a different way that ICD-10 implementation is going to force change.

[More information: ICD-10 implementation a small part of the bigger picture]

There's an app for that

First, consider an iPhone app called Cardiograph. It will measure your heart rate and save the results. Westby G. Fisher writes how a patient used the app to save thousands of dollars in medical tests.

The app isn't perfect and can't do everything that doctors need in a cardio-monitoring device. But in this case and others, it's good enough. That's the definition of disruptive innovation.

Here's how it affects ICD-10

ICD-10 implementation is going to cost a lot of money. Healthcare providers aren't just looking at upgrading systems to accept alphanumeric medical codes. They're looking at price tags for computer assisted coding (CAC), business intelligence and electronic health record (EHR) integrated systems. No wonder there's so much vigorous opposition.

Shortsighted or not, there are physicians and medical coders who just want a simple way to generate an ICD-10 code and send it to the health plans. And they will be willing to sacrifice features and benefits for just good enough. As long as it doesn't compromise patient safety, clinicians will be willing to sacrifice financial risk modeling.

This presents opportunities for small technology vendors because the big vendors will ignore the small profit margins and market size. They're making millions on HIT systems that promise to make new business models possible. These apps aren't worth the investment.

That is until the small vendors sell enough to take a bite out of the big vendors' market share. The potential is there. This vigorous opposition is based upon the ICD-10 price tag. Physicians want something inexpensive, simple and good enough. When someone figures out what that looks like, there will be a different kind of talk about new business models.

[More information: Meaningful use and ICD-10 aren't the enemies of innovation]