ICD-10 Can Be a Catalyst for Beneficial Business Process Change

December 28, 2011  |  Category: Regulatory Updates

[This post originally was published on ICD-10 Hub]

By nature, I’m a glass-is-half-full kind of person. So I look at the transition to ICD-10 and see opportunity for healthcare provider organizations.

While there’s no minimizing the work (and expense) associated with the ICD-10 transition, on the “plus” side it can be a catalyst for some extremely positive business process improvements. One such opportunity is around physician documentation and charge capture – two functions squarely in the bulls-eye of ICD-10-impacted hospital processes, and inextricably linked to a hospital’s revenue cycle management.

Coincidentally, physician documentation – or more specifically, electronic physician documentation – also is expected to be a core component of Stage 2 and 3 Meaningful Use objectives. Combine this with the simple fact that paper-based processes just won’t work in an ICD-10 world (with 4x the number of diagnosis codes compared to ICD-9), and it rapidly becomes clear that it’s in a hospital’s best interests to “sell” physicians on the merits of embracing electronic documentation and charge capture.

But in order for providers to willingly adopt electronic physician documentation and charge capture, the applications have to be efficient and fit into physicians’ familiar workflow.  In other words, a hospital has to do it right.

What exactly does it mean to “do it right”?

1. Start with a proven workflow that already works for physicians (and the support team), and add structure to it. This is the first key to gaining physician adoption; and without physician adoption, ICD-10 implementation just isn’t going to work.

2. Enter data once; don’t make providers re-enter the same data across multiple applications.  Whatever data elements are required, such as ICD-10 codes, add them once – as part of placing an order (indicating the diagnosis that justifies it), or within the clinical documentation, or as part of the charge – and have it automatically cascade through physicians’ workflow.

3. Enable physicians to speak “clinician”, not “data”.  Physicians cannot be expected to memorize the myriad of codes within the ICD-10 scheme. Better to provide them a set of clinician-friendly terms that in turn are mapped to a preferred ICD-10 code, so physicians can use the clinical terminology (including abbreviations, eponyms, and synonyms) they’re familiar with when writing notes and entering charges.

Using ICD-10 as the catalyst for beneficial business process changes makes good sense; and when those changes positively impact billing and revenue, they also can help make dollars. But bear in mind the changes won’t work without large-scale physician adoption. So in implementing new electronic systems, make it a priority not to upset physicians’ established workflow.

Then the glass will be completely full.

Chief Technology Officer & Co-Founder
As co-founder, Sally has helped guide PatientKeeper from its formative stages to its current position as a leader in healthcare applications for physicians. In her CTO role, she is focused on leading PatientKeeper’s innovation initiatives. Prior to PatientKeeper, Sally held a variety of positions related to software development and product management.