WEDI: ICD-10 Delay Hurt Health Care Industry's Preparedness
Abstract
ICD-10 is the 10th revision of the International Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.[1]. Rather than go into details of what the code set does, suffice it to say that this new code set allows for tracking of many new diagnoses at much granular levels (e.g. rather than injury to the thumb, we can now more specifically say, injury to the left thumb) by introducing sub classifications.
The original mandate for ICD 10 implementation was October 1, 2013 which was then extended to October 1, 2014 due to perceived lack of readiness by the participating Providers, Plan sponsors and SW Vendors and now to October 1, 2015, presumably for the same reason. This article sets out to review the readiness levels of various participants viz. Providers (Hospitals and Physician Practices), Payers (Insurance Plan sponsors) as well as Vendors (that create SW products like HER systems CPOE systems etc.) and attempts to draw parallels among them in terms of stakeholder sentiments.
Background
U.S. health care organizations (major groups mentioned above) are working to transition from ICD-9 to ICD-10 code sets by Oct. 1, 2015 to accommodate codes for new diseases and procedures. In April 2014, President Obama signed into law legislation that pushed back the ICD-10 compliance date until at least October 2015.In July, CMS announced a final rule that established Oct. 1, 2015, as the new ICD-10 compliance deadline for payers and providers still making the transition (iHealthBeat, 2/12).
Approach
The article points out that surveys by Workgroup for Electronic Data Interchange (WEDI) conducted to measure progress and stakeholder sentiments vary quite a bit from period to period. Following is a summary of their findings:
Summary of health care providers sentiments: Uncertainty over future delays as the most significant barrier to their implementation progress.
Summary of SW vendors sentiments: Uncertainty over future delays, customer readiness and competing priorities as barriers to preparing for ICD-10.
Summary of Plan sponsors sentiments: Although Competing priorities was quoted as the single most important barrier to their progress, health plans reported better progress, compared with providers and vendors.
Conclusion
It is clear from the above that "Competing priorities" emerges as the single most significant barrier across all major domains (Providers, Plan sponsors, SW Vendors). In a letter sent to HHS Secretary Sylvia Mathews Burwell, former WEDI Chair Jim Daley wrote, "Unless all industry segments make a dedicated effort to continue to move forward with their implementation efforts, there will be significant disruption on Oct. 1, 2015" (Healthcare IT News, 4/6)[2].
