Focus group suggests that CIOs need to get clinicians enthusiastic about the new diagnostic coding system, but they don't know how to make that happen.
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Healthcare systems preparing for the ICD-10 transition are still not devoting enough attention to preparing physicians for the clinical documentation that will be required when the number of diagnosis codes jumps from 14,000 to 68,000 next year. That's one of the conclusions that Heather Haugen, corporate vice president of the Breakaway Group, a health IT consulting firm, and Breakaway CEO Charles Fred reached after they conducted a CIO focus group.
"The number-one finding was the lack of attention being paid to clinical documentation," Haugen told InformationWeek Healthcare. "The CIOs understood issues related to vendor readiness, their own application readiness, and coder training. But under 5% mentioned provider readiness and clinical documentation improvement."
This is going to be a major challenge for healthcare organizations, Haugen said, considering the lack of physician engagement in the process up to now. Some hospital executives have made matters worse by describing ICD-10 as a coding mandate. When ICD-10 was explained to them that way, she said, "physicians were completely turned off, because that is not important to them."
To get physicians involved in ICD-10 initiatives, Haugen said, organizations need to show them why ICD-10 is important to the organization in areas that physicians do relate to, such as quality improvement and reporting on quality measures. When they do that, she says, physicians "get that this isn't just about a coding change. This is something that has a purpose in our organization, and our electronic health record adoption plan is aligned with ICD-10."
Healthcare organizations must also overcome physicians' considerable fear and distrust of the ICD-10 transition, Haugen said. In a Breakaway Group-sponsored forum involving 100 healthcare thought leaders, the providers said they are dealing with too many challenges simultaneously, including healthcare reform, Meaningful Use, and ICD-10.
"So the resistance to engage in the process was driven by fear that they wouldn't get paid and a distrust of the process and the mandate. And I see that playing out in the position of the AMA and the pushback of some physician groups against ICD-10."
The American Medical Association recently asked Congress and the Department of Health and Human Services to stop implementation of ICD-10.
Hospital CIOs also have a lot on their plates right now, which may be one reason they have postponed dealing with clinical documentation, Haugen said. But they better start soon, she added. "Although the deadline is a while away, there's a lot of behavior change that has to happen, especially in clinical documentation. These processes could all be in place long before Oct. 1 . And the organization could get real value out of that if it increased the specificity of documentation."
The Breakaway Group, a health IT consulting firm that focuses on technology implementation, was acquired in November by ACS, a subsidiary of Xerox that does consulting, data analytics, and web hosting.
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