Healthcare providers are all looking forward to the day when semantic interoperability is a foregone conclusion. The day when one single, user-friendly platform handles clinic management, EHR data, and the automatic communication of accurate billing codes to payers, with everything represented in the correct terminology, all housed under one roof. But even though Health Language is working on solutions that get you closer to such a reality, the fact is, healthcare is not there yet.
The backend of your clinic’s workflow is no doubt governed by a complex system of interconnected software applications from different vendors, built up over time. Maybe you have come up with workarounds to attest for Meaningful Use despite having legacy systems in place that aren’t up to speed with the latest terminology standards. Maybe you even installed third-party solutions by vendors that no longer offer support. This is why, as the deadline for the ICD-10 changeover approaches, code remediation is not just about shifting from one coding terminology to another. It’s about taking a look at the full scope of your IT systems, how information flows through them, how that information makes it to payers, and if payers are prepared to handle it correctly when it arrives.
This walkthrough will help you understand more clearly the players and their roles in this imposing, but manageable, process.
Who Should Be Involved in the Project?
The IT department: Large providers may have whole IT departments dedicated to maintaining EHR and office management systems. For small providers, it might just be one individual in the clinic. Either way, someone who understands the technology side is necessary for the discussion.
The vendors: The companies that maintain your EHR, billing software, and any other software applications that touch or process an ICD-10 code, should be involved in the process.
The coders: The people in charge of managing health information can be an easy part of the remediation process to overlook. But as the individuals who deal with healthcare terminology on the front lines, they are some of the people with the most insight to offer about potential pain points specific to internal IT systems.
A good project manager (or task force): With IT people on one side and coders on another all working towards the same goal, it is important to have a person or team who can speak both languages, and can bring together a full picture of how your IT systems and business processes all interrelate.
Chart the Flow of Information
Whiteboarding out a chart of how your SNOMED-CT/EHR data, existing ICD-9 codes, payer clearinghouses and payers themselves all interrelate, and identifying where the changes will occur in the process after the ICD-10 rollout, is a good way to identify potential pain points and assign responsibilities.
With a clear, organized understanding of the flow of information as it now exists, and as it will exist, you can move into the next phase of the project, which will involve implementing mapping tools to generate ICD-10 codes and testing them to see how they function in your overall billing workflow.
Is it Late to Start Thinking of IT Systems Remediation Now?
It’s late, but it’s not too late. Whether you were waiting for another delay in the deadline, or were juggling a dozen of other priorities, the time has come that your IT systems are going to need to be remediated. Otherwise you may face losses, and even penalties, after October 1, 2015.
Health Language Can Help
Health Language’s consulting services can not only help you manage the process described above, we can help you take on the most important part of the ICD-10 remediation process: testing your clinical and IT systems.
All the different software programs that constitute your IT systems may appear to work fine in isolation. But you must test the full system end-to-end to see if everything, tech-wise and relationship-wise, works together the way it needs to.
Health Language can work with you to manage this critical testing process, by simulating your ICD-9 claims in ICD-10. Health Language will help you test and test again, iteratively working out bugs until you are confident that all systems, and all players, are capable of handling ICD-10 when it goes live.
How far are you in analyzing your IT systems and readying them for ICD-10?