ICD-10 Transition: 3 secrets of success

Carl Natale
by Carl Natale

There's more to being ready for the ICD-10 transition than calling healthcare vendors and scheduling upgrades. There are a lot of assessments and decisions that need to be made.

Connie Tohara, director of Health Information at University of Utah Hospital, says her hospital"is quite a long ways down the path" to meet the Oct. 1, 2014, ICD-10 implementation deadline. Here's a brief look at where they are:

  • Systems affected by the ICD-10 transition are identified (some already have been upgraded)
  • Computer assisted coding (CAC) and clinical documentation improvement (CDI) system has been chosen
  • ICD-10 project plans in place or very close to being in place
  • Training decisions being made
  • Dual coding scheduled for Oct. 1, 2013
  • Documentation assessment started at beginning of year

According to Tohara, there are three elements that got them to this position:

Readiness assessment

The hospital outsourced this aspect. "We were not prepared for the amount of time it would take," says Tohara. They had a hospital to run.

They picked a combination of vendors to do the work. After more than 150 interviews, the hospital got:

  • A timeline
  • A heat map that identified areas that needed immediate attention and the most time
  • A proposed budget
  • A report with recommended actions

"They gave us a number of tools that helped us really get our arms around what needed to happen," says Tohara. It's also worth noting that those tools were not used to implement a plan verbatim. The hospital used the budget and reports as a base for their ICD-10 transition plan.

The assessment was critical because many people at the hospital didn't realize how big this would be. "We were able to educate people," with the information from the assessment said Tohara.

Governance

This has been run by the hospital's project management office. It's overseeing seven work streams and set up a steering committee."We realized that we need some very focused activity and created a series of task forces," says Tohara. These groups are responsible for different aspects - budget, finances, metrics, document assessments. "Between a combination of the steering committee, our work streams and our task forces, and then the oversight of our project management office has worked very well."

"We have moved so quickly because we had the right people in place," says Tohara. "It gives a number of key people the right kind of information they need to make informed decisions."

"We've used project management for many years so that really helps. And we have used the steering committee structure as well. Everyone is comfortable with that."

 Metrics and measurement

This is a significant project in terms of resources needed. By measuring progress, Tohara says senior management can track progress.

The information isn't just for supervisors. It's to ensure that the project is on track. "We have metrics related to all our work streams and task forces so that we make sure that we have that early warning system to know where things are at," says Tohara. It gives them information that allows them to use contingency plans if the project isn't moving as planned.

And they're going to need to show how the new systems perform. "Ultimately our goal is not just to survive the transition from ICD-9 to ICD-10 but we want to be able to optimize our systems," says Tohara. "We wanted metrics that would enable us to demonstrate that increase in value and optimization."

[See also: ICD-10 Transition: It's time to hone your project management skills]

It all boils down to project management - which is more than making plans. There needs to be progress measurement and accountability.