As we ease into the new year and a new Congress takes the reins, there’s still chatter about attempts to further delay the ICD-10 start date. I was having a tough time understanding why anyone would think this was a good idea until I started reading some of the responses on a LinkedIn discussion group for health care executives. It appears that the general consensus is that the physicians and those who work with them are against ICD-10 implementation and the rest of us are for it.
After reading the posts, I thought that docs just don’t want to do what it takes to make the change. They don’t want to spend the money to upgrade their billing software and they are naïve to the benefits of ICD-10 coding. They just need to suck it up and do what it takes to make this happen. And then I thought: “What if the physicians are right and I am wrong?”
Now, don’t get me wrong. After reviewing the benefits of ICD-10 over ICD-9, I am still convinced that moving forward with the conversion is the right thing to do. The transition will be difficult at best if not impossible, though, if we try to do so without having providers on our side. So, how do we convince them that moving forward with ICD-10 is the right thing to do? Why are the doctors in our small southeastern Nebraska community ready to move forward while physicians in the rest of the country are dead set against it?
Dale Carnegie is credited with writing, “Those convinced against their will are of the same opinion still.” No, we can’t beat physicians over the head and tell them that we are right and they are wrong and they just need to suck it up and move forward. We need to provide substantial evidence showing that ICD-10 coding is far superior to ICD-9. We need to show them how this will help them in their practices. We need to show them how this change will benefit their patients over the long term. And, most of all, we need to listen to them. Physicians are very intelligent, data-driven people. We won’t get anywhere by telling them what we think.
We need to provide factual data to substantiate our point and mitigate their fears.
When I thought about why the doctors in our small community are ready to move forward with ICD-10 and others are not, I realized that it is because of a number of factors. First of all, they were one of the first practices in the state to move forward with an electronic health record. They are early adopters and change-ready. I also realized that the main reason is because they trust us. We have spent years working with the physicians in our area to develop a culture of trust, and this work pays off in more ways that can ever be anticipated. Because of this culture of trust, the providers know that we are all in this together and together we will make this happen. It has been said that culture will eat strategy for lunch every time and it has been my experience that this is true. If you have a culture of trust in your organization, good for you. If not, now might be a good time to move in this direction. The benefits are unbelievable.
Marty Fattig is CEO of Nemaha County Hospital in Auburn, Neb. He serves on the Health IT Policy Committee's Meaningful Use Workgroup. He's a past president of the Nebraska Rural Health Association.