Q&A: AHIMA CEO says checkpoints, teamwork key to ICD-10 success

By Jennifer Bresnick for EHR Intelligence

As CEO of the American Health Information Management Association (AHIMA), Lynne Thomas Gordon, MBA, RHIA, FACHE, has been charged with the task of overseeing the 70,000-strong organization during its efforts to help providers gear up for ICD-10 implementation. Thomas Gordon sat down with EHRintelligence to talk about some of the issues facing the industry during its transformation, and how providers can successfully complete the necessary preparations before October 1, 2014 rolls around.

What is AHIMA doing to help providers prepare?

We are asking our members to really try to collaborate with physicians and people who need their help. We tell people to go to our website. If you don’t know what to do, take a look at the free stuff we have out there. We obviously have products and services, but if you just want to know what to do next or how to get started, go to the website. We have also asked our state groups to reach out to physicians, as well. We have almost 70,000 members, and obviously we can’t do it all from Chicago. So we’re trying to galvanize our local chapters. They know what to do.

We know that just like any time you do anything, there are early adaptors and pioneers, and those people are phenomenal at what they’re doing. They’re so far ahead with ICD-10. And then there are those providers who are lagging behind. So if we can encourage our members, who are everywhere, to reach out and help, then we want them to do so. In the long run, ICD-10 is going to be so much better for so many reasons, and we want to be there to help people learn how to get there.

What are some of the main problem areas you’ve seen during the preparation process?

What I’ve heard is that things are moving along well with the exception of one group that people are worried about, and that’s small, rural physicians. The big concern is that the little guys don’t have the support they need. We’re looking at how we can work with those folks to make sure they can get ready. Other than that, I think people are moving along pretty well.

One of the main problems is not having checkpoints. Someone I spoke to said that with ICD-10, you should have a canary in the coal mine. If you have that early warning signal that something’s going to go wrong, then you can fix it. If there’s something that’s not going right, that gives you a chance to fix it before you get too far down the road.

The other thing that we all know, but we still have to tell people, is that there are limited resources. There’s limited time and limited staff. When you talk to your clearinghouse or your vendor, you have to remember: they’ve got to talk to all their other clients, too. They’re not just waiting for your call. Just think about getting a meeting at a hospital. It’s impossible. Just getting the people in the hospital together, much less your vendor, your clearinghouse…people need to make sure they’re not waiting around to try to make that happen at the last minute.

What do you think about the one-year delay and the ongoing resistance to ICD-10?

When the one-year delay came in, it was putting the major breaks on. And of course, all the money went to different places, the resources went elsewhere, and I think it hurt the industry. I know why we did it; it made sense at the time. But now, looking back, I think it was a shame. It’s just like anything: you take care of what you have to. ICD-10 was on the top of the to-do list, and then it not only got pushed to the bottom, it fell off the list completely.

We’ve heard very strongly that it’s definitely going to be October 1, 2014. Some people think they’ll put it off again, and that they won’t have to worry about it. We’re human – it’s human to think that if it’s not immediate, you won’t have to bother. But that’s not how it’s going to work out.

People need to understand more about ICD-11. Even if ICD-11 was ready today, to do the clinical modification for our country is going to take a long time. If I wasn’t part of the process, and if I didn’t know about the modifications that need to be made, I’d wonder why we don’t just skip to ICD-11, too.

But with ICD-9, I like to use this example. Let’s say you move to a new neighborhood, and you want to get a new telephone number. But they said, “We’re sorry, there’s no more room. You can just be grouped with your neighborhood, and we’ll call that one number if we want to get ahold of you.” That’s kind of what’s happening with our system now, because we’ve run out of space. If they really understood that better, they’d realize that we can’t wait for ICD-11.

What is your opinion on computer assisted coding (CAC) for ICD-10?

I do think the artificial intelligence is going to get better and better. I don’t think we’re going to be able to stay with just a human to do the coding, and I don’t think we can rely on the computer to do everything. The best is going to be both of them working together. That way, it will increase productivity, but it’ll make sure you’re getting to the place you want to go. Computer assisted coding is inevitable. If you’ve got normal mammogram, normal mammogram, normal mammogram, it’s crazy to have someone coding that. However, if you have a really complex inpatient case, you have to have a person look over it and make sure it’s correct. I think CAC is an enhancement. These systems could help prompt doctors. Because if you have really good documentation, the coding will follow.

What would be your advice to providers at this point in the process?

Don’t procrastinate. Don’t put off until tomorrow what you can do today. It’s going to take longer than people think. And the other thing is that you should look to the people who can help you. 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.