With the compliance date for ICD-10-CM/PCS implementation finally set in stone, all that's left to do is plan, plan, and execute plans. To help you, we asked Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, COBGC, CPCD, CCS-P, CDIP, senior manager at Blue and Company in Indianapolis, an industry expert on ICD-10, for preparation tips and action steps for ICD-10 implementation.
Keep stakeholders informed of ICD-10 progress
You have an ICD-10 steering committee and have set subcommittees. That's great. But are they active enough? Are they communicating with the true stakeholders?
"In talking to many HIM directors, what I am finding is that these committees and subcommittees aren't always as active as they need to be," Grider says. "They need to stay engaged. Some hospitals have gotten together their stakeholders only once, and some others are doing a little bit but not really following key steps and following through."
Keep your ICD-10 committees active and busy, meeting at least once a month. Help everyone understand the role of the steering committee.
"They're the ones that are going to be driving ICD-10 implementation," Grider says. "That steering committee is in charge, and that committee's chair has to make final decisions and lead the implementation process. I don't think enough people understand what their true roles are."
Stakeholders need to know that ICD-10 implementation doesn't just involve coding or information technology (IT). Your board of directors ultimately "holds the purse strings," Grider says, so educate the board as much as possible about what's involved and where your team is in the process.
Who's on the steering committee?
Typically, the CFO is the chairperson since he or she drives the organization's dollars and has to approve spending. HIM directors and the information systems director form a solid comanaging team for the steering committee and project management. If that doesn't work at your organization, a consultant who project manages ICD-10 implementation may be helpful for those who have the budget for one.
Include staff from the following departments on a steering committee:
You'll also want to include the chief medical officer, physicians, and physician champions.
As for subcommittees, organizations can choose, for instance, to have the radiology department manager head the communication committee. Staff members who don't serve on the steering committee can sit on these subcommittees.
Grider says organizations may want to set up these types of subcommittees:
Keep stakeholders informed of ICD-10 progress
You have an ICD-10 steering committee and have set subcommittees. That's great. But are they active enough? Are they communicating with the true stakeholders?
"In talking to many HIM directors, what I am finding is that these committees and subcommittees aren't always as active as they need to be," Grider says. "They need to stay engaged. Some hospitals have gotten together their stakeholders only once, and some others are doing a little bit but not really following key steps and following through."
Keep your ICD-10 committees active and busy, meeting at least once a month. Help everyone understand the role of the steering committee.
"They're the ones that are going to be driving ICD-10 implementation," Grider says. "That steering committee is in charge, and that committee's chair has to make final decisions and lead the implementation process. I don't think enough people understand what their true roles are."
Stakeholders need to know that ICD-10 implementation doesn't just involve coding or information technology (IT). Your board of directors ultimately "holds the purse strings," Grider says, so educate the board as much as possible about what's involved and where your team is in the process.
Who's on the steering committee?
Typically, the CFO is the chairperson since he or she drives the organization's dollars and has to approve spending. HIM directors and the information systems director form a solid comanaging team for the steering committee and project management. If that doesn't work at your organization, a consultant who project manages ICD-10 implementation may be helpful for those who have the budget for one.
Include staff from the following departments on a steering committee:
You'll also want to include the chief medical officer, physicians, and physician champions.
As for subcommittees, organizations can choose, for instance, to have the radiology department manager head the communication committee. Staff members who don't serve on the steering committee can sit on these subcommittees.
Grider says organizations may want to set up these types of subcommittees:
- Budget (allocating funds)
- Forms (developing orders and templates in the EHR that may need to be changed, or tweaking paper orders)
- Education (determining focus areas and training dates)
- IT (assessing impact on all current systems)
- Communication (developing and executing the communication plan)
Conduct monthly steering committee meetings
How should you run an effective steering committee meeting?
First, there needs to be a clear agenda, Grider says. "I always like to start with what's going on with ICD-10 in the industry," she says. "Talk about what the AMA is up to and what the industry is talking about. It's the project manager's responsibility to find out and keep up."
Stress that the meeting is mandatory and not optional. Failure to do so could result in a slow death of the committee itself.
Some members may just not show, "and that's the best way to kill this whole process and kill the committee quickly," Grider says. "It's a good idea to create the meeting well in advance."
Take minutes at each meeting, and review all action items from the prior meeting's minutes. If Mary Smith was identified as establishing the framework for an education plan at one meeting, have Mary Smith describe her efforts in that regard during the subsequent meeting.
Review project plan timelines and next-meeting items. Leave a slot on the agenda for the steering committee chairperson to review the budget.
"Always have a budget review," Grider says. "Each meeting should be fairly consistent."
Complete impact assessment and identify all areas/departments and systems affected
Have you thought about sending out a survey to get the pulse of department systems and processes? You may not want to, Grider says, because you may never get the results back or it may take too long to get a response. Instead, create an interview schedule and meet with each department head for 20 or 30 minutes. Go over work flow, how staff use codes, and what reports and systems they use. Find out whether their documentation is effective.
"From all your questions, more questions can evolve," Grider says. "We've found systems and process issues that could have been a compliance or Joint Commission issue and were able to fix them by interviewing department heads."
Through the interviews, you'll be able to collect information on all the systems and software on which your organization operates. You'll be able to determine which departments see patients, who is responsible for checking patients into the facility, what type of orders the physician provides, whether the orders and the applicable codes assigned meet medical necessity, and how these various processes are carried out. You'll gather information about scheduling and whether the facility uses electronic forms or paper within their various workflows.
Collect all the information from the interviews and develop summaries for each department. You may learn in these types of impact assessments that one department performs services without a physician order and one follows up to ensure a physician order came through. Create a list of all software and records which departments use in their operations.
How should you run an effective steering committee meeting?
First, there needs to be a clear agenda, Grider says. "I always like to start with what's going on with ICD-10 in the industry," she says. "Talk about what the AMA is up to and what the industry is talking about. It's the project manager's responsibility to find out and keep up."
Stress that the meeting is mandatory and not optional. Failure to do so could result in a slow death of the committee itself.
Some members may just not show, "and that's the best way to kill this whole process and kill the committee quickly," Grider says. "It's a good idea to create the meeting well in advance."
Take minutes at each meeting, and review all action items from the prior meeting's minutes. If Mary Smith was identified as establishing the framework for an education plan at one meeting, have Mary Smith describe her efforts in that regard during the subsequent meeting.
Review project plan timelines and next-meeting items. Leave a slot on the agenda for the steering committee chairperson to review the budget.
"Always have a budget review," Grider says. "Each meeting should be fairly consistent."
Complete impact assessment and identify all areas/departments and systems affected
Have you thought about sending out a survey to get the pulse of department systems and processes? You may not want to, Grider says, because you may never get the results back or it may take too long to get a response. Instead, create an interview schedule and meet with each department head for 20 or 30 minutes. Go over work flow, how staff use codes, and what reports and systems they use. Find out whether their documentation is effective.
"From all your questions, more questions can evolve," Grider says. "We've found systems and process issues that could have been a compliance or Joint Commission issue and were able to fix them by interviewing department heads."
Through the interviews, you'll be able to collect information on all the systems and software on which your organization operates. You'll be able to determine which departments see patients, who is responsible for checking patients into the facility, what type of orders the physician provides, whether the orders and the applicable codes assigned meet medical necessity, and how these various processes are carried out. You'll gather information about scheduling and whether the facility uses electronic forms or paper within their various workflows.
Collect all the information from the interviews and develop summaries for each department. You may learn in these types of impact assessments that one department performs services without a physician order and one follows up to ensure a physician order came through. Create a list of all software and records which departments use in their operations.
Source: http://www.hcpro.com/HOM-287459-6962/Three-action-steps-for-ICD10-implementation.html
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