Author Name Jennifer Bresnick | Date June 5, 2013
You can order all your coding workbooks, schedule your physician lectures, hand out ICD-10 lollipops by the dozen, and nag your vendors until you’re blue in the face, but the chances of your hospital being fully prepared for ICD-10 without a strong project plan and central leadership are slim at best. The ICD-10 steering committee is a critical component of a successful conversion plan, and is the best defense against important initiatives slipping through the cracks as hospitals scramble to coordinate end-to-end testing, vendor updates, physician and coder education, and employee buy-in to one of the most frazzling and disgruntling transitions in healthcare.
Why should my hospital have one?
The purpose of the steering committee, executive leadership board, project plan commission, or whatever you want to call it, is to provide a centralized authority to establish a direction and achieve consensus when big decisions have to be made. ICD-10 is a project with a very firm deadline. Plain and simple? You won’t get paid for ICD-9 codes used for services provided on or after October 1, 2014. With the majority of hospitals dragging their feet on implementation, and the compliance date approaching quickly, the only way to galvanize a reluctant organization with hundreds of moving parts is by establishing a board that can plan, delegate, and hold all parties responsible for their various tasks.
“It’s going to take longer than people think,” warns AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, FACHE. “It really does take a village. What we’re finding that there are so many systems that are impacted by this coding change that you have to work together with your entire organization to get you where you need to go.”
Who should be on the committee?
While it’s definitely important to get the thumbs-up from the executive leadership of the hospital, the steering committee shouldn’t just consist of your C-suite. It is vital to bring in representatives from the clinical side, recruit physician champions who are enthusiastic about the project, and make sure you’re keeping your coding staff and IT wizards informed about your progress and concerns.
Project management is the key to a successful transition, and having strong, experienced managers to lead the charge can make all the difference. “There are just so many projects that contribute to your overall ICD-10 approach,” explains Bonnie Cassidy, MPA, RHIA, FAHIMA, FHIMSS, former President of AHIMA who now works with Nuance. “But within each one of those, you need people who are good, strong, solid project managers. You want people who get up in the morning and think project management. They’re the ones who are going to be very disciplined, very structured. So if there’s any slippage in any of those projects, they’re going to know right away.”
A steering committee that represents all the major players in the ICD-10 transition – physicians, coders, financial staff, the IT department, and executive decisions makers – can secure the willingness of participants and craft a targeted, encouraging message for employees who may be hesitant to embrace the changes that ICD-10 will bring.
What should the committee do?
A steering committee should set up sub-committees in charge of the major aspects of ICD-10: coder training, physician education, and technical testing and compliance projects. CMS has released a series of checklists and timelines for each of these areas to help guide organizations to the finish line. The committee should establish benchmarks and meet monthly with representatives to ensure that goals are being met in a timely manner.
Communication is one of the biggest challenges of the transition, and the need for hospital-wide buy-in shouldn’t be underestimated. Appointing physicians or nurses as advocates to help other clinical staff understand what will be required of their documentation habits can help ease fears about massive changes to workflow or patient notes. Checking in with the budget department will also be crucial, as the ICD-10 transition is expected to have a major impact on revenue cycles, and all that staff education is an expensive ordeal. Putting your hospital’s CFO on the committee will ensure that there are no monetary surprises at the end of the day.
Make sure that the committee meets regularly and stays active and engaged in the entire ICD-10 process, including the weeks and months after October 1. Your ICD-10 process isn’t going to end on the implementation date: no one really knows what the impact will be on productivity and claims processing, so you’ll need to keep making adjustments if your coders can only do half as much work as they get used to the new system.
There’s no doubt in anyone’s mind that ICD-10 is going to be a headache. But a strong steering committee that takes charge, engages with stakeholders, and makes the tough decisions can help mitigate the pain. If you’re one of the 25% of hospitals that haven’t taken this vital step yet, consider recruiting some leaders right away in order to prevent a big disaster next fall.