AHIMA also had some organizational challenges of its own. Lynne Thomas Gordon had been on the job less than a week before she gave her first keynote speech as CEO of the association. Thomas Gordon, a past state AHIMA president from Georgia and a former AHIMA national delegate, started Sept. 29.
Health information management professionals will be in the midst of conversion to ICD-10 codes in October 2013, or in “727 days, 15 hours and 12 minutes,” Thomas Gordon said during her talk. “The people right here in this room cannot procrastinate. That's because we must be the leaders to get this massive project done and done on time.”
AHIMA board President Bonnie Cassidy explained to delegates why the organization restructured itself—for the future as well as to deal with an executive-level shake-up. Former CEO Alan Dowling and Chief Operating Officer Sandra Fuller left their jobs abruptly in June. Outgoing interim CEO Rose Dunn, introduced by Cassidy, was greeted with two standing ovations. Dunn had stepped up to served as interim CEO, replacing Dowling.
“After 16 weeks, I now know the meaning of relief, and it's not Alka-Seltzer,” Dunn quipped.
Cassidy also introduced her successor, come January, incoming AHIMA President Patty Thierry Sheridan.
Cassidy said that during the recent “turbulent time” the AHIMA board “was called upon over and over” to make smart, critical decisions and did so with “courage and effective stewardship.” Cassidy also rallied the troops.
“We are in the midst of the greatest transformation in the history of our healthcare system,” she said. “We see no reason to believe it will be done successfully unless we provide strong HIM leadership.”
Keynote speaker Dr. T. Bedirhan Ustun joked that AHIMA members might want to tar and feather him for saying it, but they should begin planning now for conversion to the ICD-11 codes sets, already under development and expected to be released in 2015. Ustun is team coordinator of classification, terminologies and standards with the World Health Organization's department of health statistics and informatics. The WHO is the developer of the international versions of the ICD codes.
“It is written on the wall, and we can't take it back that ICD-11 is coming,” Ustun said.
He predicted, “There will be suffering” with the ICD-10 conversion, but he asked, “What can be made out of that suffering?” Ustun said ICD-9, which is still in current use in the U.S., was released in 1975 and adopted by the U.S. after an “acceptable” delay in 1979. But ICD-10 was completed in 1990, so even if the U.S. transition from ICD-9 to ICD-10 goes off on schedule in 2013, the adoption gap will be 23 years.
The use of information technology from the start of the development of ICD-11 could make the next transition much smoother, he said.
“I would like you as the AHIMA community to look at this and help us,” Ustun said.
In addition to the press of change, present-day operational challenges affecting AHIMA members were on the convention agenda at dozens of its educational sessions. The convention drew more than 4,000 attendees, including exhibitors.
Session speaker Suzanne Layne, director of health information management systems at Main Line Health in suburban Philadelphia, said performance in handling medical records at the five-hospital system had varied from mediocre to poor before revamping its health IT operations to base them on functions rather than facilities.
Instead of having medical coders, processors who scan records and quality-control employees who review their work at each hospital, the coders were allowed to work mostly from home, and processing and quality control became centralized functions, Layne said. Management also was centralized, she added.
Under the old system, backlogs ranged from five days to 23 days to return records to physicians for review, Layne said. Now, 98% of records are scanned and processed the day after discharge. Devore Culver, executive director and CEO of HealthInfoNet, the statewide health information exchange based in Portland, Maine, told attendees at his session that trust was the essential element that enabled 31 participating hospitals and 60 group practices thus far to consent to having the medical records of their patients stored in one central data repository.
To address privacy concerns, Maine adopted the opt-out model, where the default mode is that patient records from providers flow to and remain in the exchange unless patients choose not to participate. The consent management directive is created and stored by the exchange, not the providers, according to Culver. So far, 6,751 patients, or less than 1%, have opted out.