Looks Like ICD-10’s Coming … But Should It?

Kate Huvane Gamble, Managing Editor, hsCIO.com

We all have things we’d rather postpone, whether it’s a dentist appointment, filing income taxes, or cleaning out the garage. With tasks like these, sometimes you just have to bite the bullet and get it done. On the other hand, some tasks are put off because of a lack of resources, or because you simply aren’t ready.

During the past few weeks, the subject of whether ICD-10 should be postponed has become a hot topic.

Some say that delaying the conversion of ICD-10 would diminish the value of healthcare IT by preventing access to the best data available; that postponing the inevitable just doesn’t make sense. Others maintain that the tight timeline associated with the transfer is hindering IT efforts by monopolizing the resources needed for other projects; that it’s simply too much, too fast.

A few weeks ago, Dan Rode, VP for advocacy and policy at AHIMA, expressed his support for keeping the Oct. 1, 2013 deadline. “Without ICD-10 data, there will be serious gaps in our ability to extract important patient health information that will give physicians and the healthcare industry measures for quality of care, provide important public health surveillance, support modern-day research and move to a payment system based on quality and outcomes,” he said in a statement.

The AMA took the opposing view, urging House Speaker John Boehner to delay the conversion and asking lawmakers to synchronize federal incentive programs.

By developing a better sequence for Medicare incentives and coordinating their requirements, Congress can ensure that the system is better prepared for health reform, wrote AMA CEO James Madara, MD. “Stopping the implementation of ICD-10, and calling on appropriate stakeholders… to assess an appropriate replacement for ICD-9 will help to keep adoption of EMRs and physician participation in quality and health IT programs on track and reduce costly burdens on physician practices.”

Both sides have a valid point. As a journalist, I can recall many instances when I wanted to postpone a deadline, but I was always told that a delay in getting copy to the editors would lead to delays in page layout and approvals, which could result in the company forking over more money to the printer. Postponing one phase of a project can result in a snowball effect.

But this isn’t a publication we’re talking about; it’s the entire health IT ecosystem. And the more I hear CIOs speak about this issue — with words like “overwhelming” used alarmingly often — the more I understand Dr. Madara’s concerns, and start to lean toward that side.

In a recent interview with Anthony Guerra, Laishy Williams-Carlson, CIO at Bon Secours Health System, said, “What scares me is just everything coming together at the same time — ICD-10 and what we need to do to position ourselves for ACOs… throw in a little Stage 2 of Meaningful Use and a couple of hospitals that still need to go live and you realize that you’re not slowing down for a long time.”

Stephen Stewart, CIO at Henry County Health Center, told healthsystemCIO.com he believes health IT is “on a path for the perfect storm. With ICD-10 and 5010 and Meaningful Use Stage 2 and all these things coming together in a relatively short period of time, there is definitely an undue amount of stress.” He described the current pace of activity as “frenetic.”

Robert Slepin, CIO at John C. Lincoln Health Network, stated that although he believes initiatives like ICD-10 are the right thing to do, he cautions, “There are undesirable effects and consequences of asking the industry to do so much at one time.” He expressed his support for delaying ICD-10, adding, “The change burden here is enormous, certainly for IT, but more importantly for the people at frontline — the physicians, nurses, and others that are delivering care.”

The last thing that CIOs — or any leaders for that matter — want to do is force too much change on clinicians. And although most believe that the conversion needs to be done, it seems that a growing number of CIOs think it’s happening too quickly.

So what’s an organization to do? Get ready. In his blog, John Halamka, CIO at Beth Israel Deaconess Medical Center, has written extensively about the challenges of implementing ICD-10. And while he feels, “The billions of dollars required to implement it will not improve quality, safety, or efficiency,” he doesn’t believe the conversion is going to be pushed back. Therefore, his organization is moving forward. Joanne Burns, CIO at University of Missouri Health Care, is doing the same.

It appears CIOs might not have another choice. Many have it on their radar and are even in the early stages of planning — even if they have no idea how it’s going to get done.

Ready it or not, here it comes.


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