EDITOR’S NOTE: This is the first in an occasional series of articles written by healthcare students attending The College of Saint Scholastica in Duluth, MN.
“If you change the way you look at things, the things you look at change.” –Wayne Dyer
As the headlines indicate, ICD-10 is struggling to gain momentum in the United States, even with the extra year that the implementation was delayed. The U.S. is among the last developed countries to implement ICD-10, a factor that inhibits the American healthcare industry’s ability to collect and utilize accurate, complete information to achieve quality care.
The time is now to push through the hardships and struggles that constitute the current focus of many in the industry and embrace the benefits of this transition. It certainly makes more sense than continuing to delay implementation and continuing to use ICD-9, which is considered obsolete, according the U.S. Department of Health and Human Services.
We need to accept the coming changes and start preparing for a system that will enable the industry to move to a level playing field with all other developed countries.
There are many known benefits of ICD-10 as compared to the outdated ICD-9. Understanding these benefits allows for room to grow instead of promoting fear of change (or struggles associated with change). The benefits of ICD-10 also reflect the benefits of other health systems implemented throughout the world, many of which have allowed for measurable successes.
With patient care as the primary focus, the benefits are vast and comprehensive. A brief overview of some of the benefits the American healthcare industry can expect to see following effective implementation of ICD-10 are as follows:
Increased Clinical Detail
Every year, new diagnoses and procedures are discovered or developed, requiring an evolving, up-to-date classification system to capture that information accurately. With ICD-10’s significantly improved in-depth specifications regarding site locations, including laterality, patient records will more exactly reflect actual clinical diagnoses and procedures, which in turn will improve comprehensiveness and quality of care. Furthermore, the collection of clinical information from research, epidemiological studies and clinical trials will be captured more precisely for current and future analysis.
By using more precise codes to reflect care rendered, organizations and providers can expect to see a significant increase in reimbursement as well as a decrease in claim rejection. ICD-10 offers the detail needed to optimize reimbursement through codes that capture diagnoses and procedures with high degrees of specificity. Furthermore, implementation will streamline the claims adjudication process.
Additional cost savings will come from using coded information for designing payment systems, leading to more modern payment models and redesigning healthcare delivery systems to generate optimal reimbursement and contained costs.
With implementation, there also will be much-improved capability of measuring the quality and effectiveness of care rendered by providers. Information about that care will be collected in a more comprehensive manner. These measurements will help drive healthcare forward into a more patient-centered system offering high-quality care while minimizing risks. Furthermore, from these measures, clinical, financial and administrative performance will improve via enhanced understanding of the true array of clinical offerings, which can be adjusted based on review of the data collected.
Another performance improvement will involve the development of operational and strategic plans, as well as the setting of health policy to ensure that the current and future needs of the organization (as well as all their customers) are met.
Quality of Care
In healthcare, it all comes back to overall patient experience and the quality of the care they receive. By utilizing resources to capture and analyze each patient’s complete experience more accurately, there is opportunity to significantly improve care for each encounter, financial performance, and the overall quality of operations throughout the industry. With ICD-10, room for improvement is evident in a variety of areas. The clinical data that can be generated with ICD-10 will lead to more comprehensive evaluation of treatment, offering the potential to save millions of lives. There is the added benefit of more effective tracking for bioterrorism and public health.
Clearly, ICD-10 is a necessary tool that the industry needs to recognize, accept, and embrace. These benefits show just how essential it is to implement the new coding set.
The implementation of ICD-10 should be seen as an exciting prospect that will lead to an improved healthcare system in which accurate collection of all patient care, including diagnoses and procedures that are new and cutting-edge, can be accomplished. Healthcare is a constantly evolving field, and staying stagnant is not an option any longer. Although there are struggles ahead, the benefits far outweigh the detriments; simply put, ICD-10 is what the patients in every American organization and care facility need.
I urge you to consider these benefits and accept the calling to view the changes that are upon us as an opportunity instead of a hindrance. Embrace the fact that the professionals of today are the future of tomorrow.
“Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change that we seek.” –Barack Obama
About the Author
Kayla M. Zirbes currently attends The College of St. Scholastica and is pursuing a degree in health information management, which she plans to utilize to help advance the profession as well as the future of healthcare. She has begun by serving on the American Health Information Management Association (AHIMA) Student Advisory Council and will graduate in May 2013 summa cum laude.
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