5 project management keys to ICD-10 planning

I don't mean to scare you but there is a bit more to this ICD-10 transition than buying software and learning ICD-10 codes.

The ICD-10 transition could affect every department at a healthcare system. So don't focus only on the intricacies of medical coding or billing. Success will depend on organized project management and planning.

Project planning

This isn't all about information technology. There are clinical and business procedures that need to be converted, vendor relationships to be managed and staff members to educate. Progress in all these areas needs to be tracked. ICD-10 implementation is going to require coordination of a lot of moving parts. Project plans must oversee:

• Meetings
• Team delegation
• Recruitment of champions
• Education and training
• Impact assessments
• Vendor, payer and consultant communication

Financial planning

The ultimate cost of the ICD-10 transition is up for debate. But that debate focuses on how much money will be spent on training and systems. In fact, there are more factors that will affect the financial health of a healthcare provider.

Reimbursements can be affected by DRG shifts and shifts in healthcare payers' reimbursement policies. Under ICD-10 implementation, they won't have consistent data to guide reimbursements. So it shouldn't be a surprise if ICD-10 policies favor the payers.

Also, healthcare payer readiness and a decrease in medical coding productivity can increase the accounts receivable cycle. Productivity could be augmented with more staff — which will increase costs.

Productivity

Speaking of productivity. The drop in Canadian medical coder productivity is almost legendary - 40 percent. It's the bogey man of ICD-10 implementation. But there is hope that healthcare organizations can boost productivity now by:

• Using computer assisted coding (CAC)
• Implementing electronic health records (EHR)
• Hiring and training staff
• Enhancing the workplace

That last idea isn't as sexy as CAC and EHRs but maybe a few small measures can help:

• Create a quiet, distraction-free work area
• Offer large and multiple computer monitors
• Limit data to electronic health records (EHRs) or minimize the number of systems with information
• Limit keystrokes needed to complete tasks
• Update training and education available quarterly
• Make resources available online
• Transcribe necessary documentation in a timely manner
• Make remote coding possible
• Raise the temperature on the office thermostat

Communication

Remember that part about ICD-10 implementation affecting just about every department? That means all those staff members need to be informed about the ICD-10 transition. And you need to gather information from various groups:

• Ensure the executive level knows how the ICD-10 transition is working.
• Coordinate with healthcare payers, vendors and consultants.
• Collaborate with other project teams.
• Keep affected staff members informed about changes.

Morale

Not many healthcare professionals are thrilled to be tackling ICD-10 implementation:

• Physicians have reservations about documentation requirements.
• Some medical coders don't want to learn new diagnosis and procedure codes.
• IT staff are juggling other system upgrades.

Start with what needs to be improved in the organization. Recruit clinicians to identify what's making work more difficult. Then fix it. And be sure to work in some clinical documentation improvement (CDI). Improving physician productivity and documentation will go a long way toward making ICD-10 implementation more productive.

Making processes better for the staff and patients will affect how they implement electronic health records (EHRs) and computer assisted coding (CAC) initiatives. That will improve the chances of buying technology that makes things better. Which could make for a smoother ICD-10 transition.

These challenges don't mean that ICD-10 implementation needs to be scrapped. These are all hurdles that can be overcome with planning and effort.