Despite All the ICD-10 Planning, What If Things Go Poorly?

Because ICD-10 affects so many aspects of provider operations, some problems are to be expected. But what should be done if those difficulties snowball and pose a threat to operations?


Because ICD-10 affects so many aspects of provider operations, some problems are to be expected. But what should be done if those difficulties snowball and pose a threat to operations?

Although no one wants to think of “worst case scenarios” when it comes to ICD-10, providers are well-advised to know what to do if obvious issues arise and can’t be dealt with quickly. A panel of provider executives shared some ideas with Health Data Management’s Fred Bazzoli for dealing with serious ICD-10 issues.

The panelists included:

  • Aaron Miri, CIO at Walnut Hill Medical Center.
  • Jean McCammack, Chief Quality Officer at Walnut Hill Medical Center.
  • Debbie Schrubb, Corporate Director of Health Information Management and Kettering Physician Network Coding at Kettering Health Network.
  • Stephen Stewart, Interim CIO at Schuylkill Health Systems in Pottsville, Pennsylvania.
Fred Bazzoli: What if things are really going south? Who should be in the “war room” and how should senior executives be involved to help resolve problems?

Aaron Miri: Assume a couple days into the transition things are really going south. First, we'd be well aware of it, so folks would be in the loop and in a war room. Second, we would start looking at our processes, manual claims, what we have to do get a successful claim done, and working side by side with physicians.

The good news is that we have our most common procedures mapped out. We've been training on those, so staff know how to do standard-type claims for our normal patient population. And we would implement our normal, manual downtime-type processes, just as if the EHR was down completely or the financials were down. We’d go to paper, and would do, X, Y and Z. Same kind of thing here.

In that situation, the other thing I would suggest is to find the nearest store that sells chocolate or your beverages of choice, map that out and have those maps printed out in the war room so you all know where to go after work.

Stephen Stewart: If things really go south, that's a time when leaders have to stand up and lead. They may not know the solutions to the problems, but they need to keep the troops focused. Let the most knowledgeable members of your leadership team direct the fight, but all leaders should be there in support. I think that’s really important. If the leadership despairs if things go bad, that message will trickle through to the troops in a hurry and just create more problems.

Debbie Schrubb: I agree. I think what we would end up doing is putting the key people who have been working on this project all along in the war room, and that would be the revenue cycle leaders, clinical documentation leaders, the physician leaders and IT management, along with other key executives. When you put that many leaders in a room who are all close to whatever’s going wrong in a system or process, you're going to figure it out.

Communication couldn't be any more critical during this process. Every single day we all need to know what's going on, so if something's going south we can handle it.

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