Must we repeat errant history, again?
The oft-evoked argument for adopting ICD-10 is the matter of timing. It took the U.S. nearly twenty years to make the clinical modifications for ICD-10 to work on our soil, so we would not be able to tailor ICD-11 accordingly for decades. But why would ICD-11 have to take so enigmatically long?
To answer that, I asked Jon Lindekugel, president of 3M Health Information Systems; 3M being the company to which CMS essentially outsourced the lion’s share of ICD-10 clinical modification work.
“As you move from one set to another there is a significant multi-year timeframe to create that magnitude of content but it certainly isn’t in the decade timeframe,” Lindekugel told me. “You just look at the timeline and how long I-10 has taken, it took much more time politically to get agreement than it did to create the content.”
So, rather than being hung-up about how long modifying ICD-10 took as some unshakable precedent for ICD-11, perhaps it would wiser to ask whether we as a nation can avoid succumbing to the same errant history that presently has our healthcare system on a classification system one incarnation behind most other developed countries, and take a new tack for the sake of adopting not an aging classification system but, instead, a cutting-edge iteration that is worthy of the enormous shift such a conversion demands.
Readiness or not
Health entities running behind the recommended timelines are not ICD-10 outliers. Not even close.
WEDI’s latest survey, published after HHS proposed the compliance delay, was impressive in that it garnered responses from 2,118 providers, 231 vendors, and 242 health plans – and found an industry adrift en route to ICD-10.
Only about one-third of health plans have completed their assessment, and a quarter are less than halfway done, WEDI determined. Worse, among providers nearly half did not even know when they would complete the impact assessment. That’s right: assessment, as in the early step concerning what ICD-10 will require, prior to implementation, internal testing, external work with partners, actual compliance.
Wait, it gets worse. Even providers and payers that want to begin are bootstrapped by technology vendors, about half of whom are not yet halfway through product development, WEDI found, while a paltry one-third could say they plan to start customer review and beta testing before the second half … of this year.
No matter how much we hear and read the cries that delaying ICD-10 would only punish those payers and providers that have already invested millions in the transition, WEDI’s statistics belie the reality that healthcare, as an industry, is not overwhelming prepared to meet the mandate on time, be that the first day of October in 2013 or 2014.
Why? Or Why not?
Since ICD-11 could be modified in a markedly shorter time than ICD-10, and since approximately half the industry is not in shape to cross the ICD-10 finish line, why can’t the U.S. skip ICD-10 and transition directly to ICD-11 once it’s ready?
Before dragging the entire U.S. health system through the mammoth and incredibly expensive once-in-a-generation ICD-10 conversion, we as a nation really ought to be asking, and answering, that simple question.
But here’s what I expect to happen: AHIMA will fire back, urging HHS to stick to its guns, finalize a one-year delay as soon as possible, and the cacophony of ICD-10 profiteers will publicly step into line, saying that ICD-10 is a “bridge” or some sort of “stepping stone” to ICD-11.
“Perhaps the optimal pathway to ICD-11 really is through the ICD-10, but we need a more comprehensive analysis to make a better-informed decision,” Dr. Murray wrote. “Let’s put on the table the total costs and impact of both pathways and then decide.”
Tom Sullivan is the Editor at Government Health IT. This article was originally published on www.govhealth.com. His email is: tom.sullivan@medtechmedia.com