A Systematic Process Improvement Approach for Small Practices to Overcome Barriers to ICD-10 Conversion

The deadline to implement version 10 of the International Statistical Classification of Disease (ICD-10) codes has posed significant resource, training, budgetary, and clinical practice challenges.  It is estimated that small provider practices spend approximately $85,000 on the planning, training, conversion, and testing described in CMS recommendations. Additional potential barriers unique to smaller practices include greater proportion of time toward increased documentation, increased billing disruption, and greater impact from lost productivity post-conversion.[1]

A team of physicians, ICD-10 subject matter experts, and process improvement, IT, and other data analysts, are working closely with small practices to help implement these steps effectively, with less impact on the practice, and for a lower cost. The team developed a standard process of assessment to generate a tailored implementation plan. Implementation typically involves software installation and testing based on needs, and customized on-site and web-based training. Preliminary evaluation suggests this process results in successful, cost-effective conversion for small provider practices. Final analysis is ongoing and may include such value-add components as continuous process improvement strategies, advancement toward meaningful use certification, and expanded post-conversion measures of effectiveness.

This model serves as a systematic method of converting providers from ICD-9 to ICD-10, tailored to specific practice concerns and with special consideration for the amplified financial and organizational constraints of small practices. A multidisciplinary approach appears most effective for successful conversion and may be generalizable to transitions in other domains of health informatics.

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[1] Nachimson Advisors, LLC. (2008) The impact of implementing ICD-10 on physician practices and clinical laboratories: A report to the ICD10 Coalition.

Learning Areas:

Administration, management, leadership
Program planning
Public health or related research

Learning Objectives:
Explain the ICD9 to ICD10 implementation plan described in the presentation. Analyze how that implementation methodology can be utilized in other health IT transitions.

Keyword(s): Affordable Care Act, Information Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Sundararaman is a public health physician and Certified Health IT Professional who has helped small practices efficiently and effectively transition to ICD 10.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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