ICD-10 used to be referred to as the "future of clinical coding," meant to capture all the advances in medical knowledge and technology and help carry us into that Brave New World where computers would provide the information needed to make more deliberate, better-informed decisions. Then, when the launch of ICD-10 was delayed last year, we got a reprieve — though, you might remember all those articles warning of "no time to waste" and "don't take your eyes off the ICD-10 ball." Did you take advantage of the additional time to play catch-up, if you were among the procrastinators?
Since ICD-10 has been in the works for more than 20 years and it's taken us so long to get here, does that mean we can just wait for ICD-11? With all the movement to change models of care, going from fee for service to bundled payments, electronic medicalhealth records, focus on collaboration, accountable care organizations, reducing readmissions, minimizing complications and infections (or preventing them in the first place), is ICD-10 still important?
You bet it is! In fact, I would risk saying that it's even more important than ever. All of the other priorities you've been working on require a thorough understanding of your patient population, including their diagnoses, risk factors and resource utilization in order to have the effective analytics that will help hospitals survive in the changing health care environment. Just think: Wouldn't it be great, as you worked on reducing readmissions, if you could know that the readmissions were due to patients failing to take their medication, and why? As you consider entering into collaborative arrangements, wouldn't you want to know what patient populations you are treating, what risk factors they have, what you can do about them, and what resources they are utilizing?
Can you afford to wait until 2025 to find out?
ICD-11 is still a long way off. It took the United States eight years to adapt the World Health Organization version of ICD-10 and create ICD-10-CM for use in this country. That timeline includes the development of a national version or clinical modification and the HIPAA rule-making process. ICD-10-CM has been updated annually based on requests from physician specialties and other interested parties requiring more and more clinical detail. ICD-11 does not include a procedure classification, and therefore ICD-10-PCS (the inpatient procedure coding for hospitals) would still need to be implemented.
In addition, since the HIPAA rule took effect, the last four years have been devoted to changing the information systems, adapting electronic records, and creating edits and educational materials, among other activities.
Assuming that ICD-11 becomes available on schedule in 2016, the earliest the United States could move to ICD-11 would be 2025. That's 12 years from now. Can we really afford to wait that long? If you don't have the clinical analytics to survive in the changing health care environment we're facing, you may not survive until 2025 to find out.
Nelly Leon-Chisen is director of coding and classification for the American Hospital Association and is on the roster of Speakers Express.
News from the AHA
Helping patients become actively involved in their care
The AHA Committee on Research in 2012 developed a report called "Engaging Health Care Users: A Framework for Healthy Individuals and Communities" to help hospitals actively engage patients and intervene earlier in the disease states. It introduces a continuum for engagement from information-sharing to partnerships and recommends entry points for user engagement. Case studies highlight strategies hospitals have deployed already to engage health care users as active participants in their care. Go to http://www.aha.org/research/cor/engaging/index.shtml.
Membership meeting to be held April 28–May 1 in Washington
Journalists and best-selling authors Bob Woodward and Bob Woodruff, and financial expert and pundit Steve Rattner will be among the prominent keynote speakers at the AHA's 2013 Annual Membership Meeting April 28–May 1 in Washington, D.C. The meeting will offer executive briefings on the most pressing issues facing health care leaders, breakout sessions on a variety of topics of interest to hospitals and an opportunity to earn ACHE credits. Visit www.aha.org.
Experts available to lead hospital seminars, board retreats
Speaker's Express maintains a roster of highly trained facilitators to offer meeting and retreat facilitation of benefit to hospital leadership teams by contributing structure, encouraging participation and helping to build consensus. Speakers and presenters are available for one-day seminars or a multi-day board retreats. To learn more, visit http://www.speakers-express.com.
2013 AHA Hospital Statistics
AHA Hospital Statistics is a resource for analysis and comparison of industry trends, including utilization, personnel, revenues and expenses. The CD includes additional data. Visit www.ahadataviewer.com/book-cd-products/AHA-Statistics.