“Time is the longest distance between two places,” playwright Tennessee Williams opined, but for many healthcare providers facing ICD-10, time isn’t nearly long enough. According to a new study by Aloft Group, 75% of community hospitals haven’t started their ICD-10 conversion yet or are less than a quarter of the way there, and 71% cited a lack of time as their main obstacle. With little more than a year and a half until October 1, 2014, that progress is too slow for comfort.
“I’m a little bit worried for them,” said Vicky Monteith, RN, MBA, Director at Deloitte’s ICD-10 consulting branch in an interview with EHRIntelligence. “We’re starting to see some of the smaller practices and physician group practices starting to wake up and realize that they have to get ready. Some of those folks just don’t have the resources, and they have to do some of the work themselves, but they don’t know what they don’t know.”
“I think now that the date is set, they’re realizing it’s going to be a big burden, and maybe some of them are a little behind. With the [one year] delay, a lot of people put money and resources that they had designated for ICD-10 into other areas. So now they’re trying to find that money again and realize that they might have to spend a little bit more, because now they have to escalate their timelines.”
“One of the very top obstacles is that so many organizations have so much else going on,” added Christine Armstrong, RHIA, MBA, Principal at Deloitte Consulting. “It’s obviously a very busy time in healthcare, and all of these other initiatives – meaningful use, cost reduction, accountable care – they’re a drain on resources. That’s really causing a challenge for a lot of organizations to accomplish everything. The one year delay caused momentum loss. Those people who had some momentum are now trying to pick up again, and that’s difficult.”
Almost half of the respondents in the Aloft poll, which mostly comprised health information directors from community hospitals, say that they don’t have an adequate schedule in place to ensure readiness before the go-live date. And yet 55% apparently have no worries that they’ll make it to the finish line. That could be because only half of them believe that the 2014 date will hold – although they may have changed their mind since CMS Acting Administrator Marilyn Tavenner’s recent announcement at HIMSS13.
So what can providers do as they scramble to catch up? Start going backwards. “We use a reverse timeline,” says Armstrong. “So we start with October 2014, and go backwards with all the things that need to be accomplished. That’s really an eye-opening picture for a lot of clients. Because when you look at all the things you have to accomplish, you don’t have the luxury of waiting until 2014 to start this. Because we work with clients during the implementation process, we’re seeing how long this is taking.”
Those organizations that have been most successful have started out with a very detailed work plan and timeline and a committed governance structure. That includes senior leadership supporting the effort. So making sure that you have senior level commitment and support has really been a game changer for those who feel really comfortable and are far ahead in their process,” Armstrong explained.
With 27% of Aloft participants complaining of a lack of support and 17% adding that they have inadequate troubleshooting skills, a strong, comprehensive plan is vital for avoiding the common pitfalls of poor project management. “And don’t underestimate the amount of testing you really need to do,” Monteith added. “You can start some of your training now to get your physicians and clinicians ready to use terms that can be coded in ICD-10, and that really helps ease the burden as we get a little closer.”