Who has the biggest task getting ready—providers, payers or IT systems vendors?
“I think the lift is fairly well distributed across all three of those groups, and significant for all,” says Carl Dvorak, executive vice president of Epic Systems Corp., Verona, Wis., and chairman of the Electronic Health Records Association, a HIMSS affiliate representing EHR vendors.
The EHRA recently joined a chorus of industry groups, including the American Medical Association and more than 30 medical professional associations, and the College of Health Information Management Executives, in calling for a less aggressive approach by the federal government in drafting Stage 2 meaningful-use criteria.
The Stage 2 rules are currently slated to go into effect in 2013, crunch time for the ICD-10 conversion. The EHR vendors, in their public comments on the Stage 2 criteria, waved a cautionary flag, saying “regulatory pressures on providers are exacerbated by 5010, ICD-10 and other regulations that will go into effect in the next 24 months.”
Dvorak says the nation's ability to meet the 2013 deadline for ICD-10 could be linked to the pace of change on meaningful use. “It will depend on how thoughtfully Stage 2 is constructed and how well the timeline is rethought,” Dvorak says.
Robert Tennant, senior policy adviser for the Medical Group Management Association, says it is still finishing up a membership survey on 5010 readiness, but “preliminary results suggest that our practices are woefully behind, mainly because the vendors are behind,” he says. “They're not getting their upgrades.”
The Version 5010 switch “is almost a test case for ICD-10 in a sense,” Tennant says. “Let me tell you, ICD-10 is 100 times more challenging (than 5010). If we can't get 5010, there's no chance we can get ICD-10 right. If everything goes well with 5010 with vendor upgrades, testing and the plans, if they're able to flip the switch, then ICD-10 has a shot.”
Kathy DeVault is the manager of professional practice resources for the American Health Information Management Association, a decades-long champion of the switch to ICD-10. In 2009 and 2010, AHIMA conducted 13 academies—three-day, eight-hour-a-day sessions—to train 1,300 trainers of ICD-coders.
“We have 21 academies scheduled for 2011,” she says. “We don't have the workforce now. There are places in the country where they can't buy a coder.”
For experienced coders, the conversion to ICD-10 holds two levels of difficulty, DeVault says. “I don't want to minimize ICD-10 and say it's just another update, because it's not. But if you know Spanish, going from ICD-9 to ICD10 CM is like going to French.” There are differences, but also similarities. “But if you're going from ICD-9 (Volume 3) to ICD-10-PCS, it's like going from Spanish to Russian. It's a big difference.”
DeVault and AHIMA are calling for the industry, particularly health information management professionals, to suck it up and meet the deadline.
“This is our time,” DeVault says. “ICD-10 should be owned by HIM, and that's why as an organization we say to our members, you need to step up and be driving this bus.”
Jan Hunt-Shepherd is an assistant professor of healthcare information systems at Western Kentucky University in Bowling Green where there are 55 students enrolled in a two-year certificate coding program. She is a graduate of an AHIMA train-the-trainer program.
“My focus as an educator is getting the coders trained,” she says. Hunt-Shepherd says she hopes the conversion to ICD-10 will create employment opportunities for her newly trained graduates.
Typically, she says, “Providers only want experienced coders, so they're less likely to look at new students, but I think that will change with ICD-10.”