ICD-10 will also require staff at hospitals and private physician practices to map and load codes, redo system interfaces, redevelop reports and retrain users. system changes will impact nurses, physicians, patient financial services, case management, utilization review and other staff, in addition to coders.
"It is the kind of thing that people have compared to Y2K. It's probably more complex than Y2K. There's a lot more human interaction than Y2K," said Robert Alger, vice president of health plan IT strategy at Kaiser Permanente.
Kaiser is one of the nation's largest healthcare providers, with 8.7 million health plan members, 167,300 employees and 14,600 physicians.
Alger, who is in co-chairman of Kaiser Permanente's ICD-10 implementation team, said the changeover has impacted well over 100 systems internally, including clinical coding, financial, claims processing and customer reporting systems.
Kaiser, which was well ahead of the curve in implementing EHRs, expects to meet the government's deadline for ICD-10 with time to spare. Alger said his company began its implementation two years go and expects to finish it next year.
Jim Whicker, principal technology consultant for Health IT strategy and policy in Kaiser Permanente's IT division, said many smaller hospitals, as well as public and private health plans, are running up against a deadline they will not likely meet.
Whicker said he feels that the CMS must do a better job in providing guidance, education and outreach to the healthcare industry.
For one, Whicker hopes the agency will come out with a testbed for providers so that they can check to see whether upgraded systems are functioning properly. The agency did not immediately respond to requests for comment on ICD-10.
George Arges, senior director of the American Hospital Association's Health Data Management Group, called ICD-10 an "unfunded mandate" whose implementation is taking money from operational budgets.
"It is pretty costly. A lot of other capital programs and initiatives are being deferred so these hospitals can work on the ICD-10 switchover," he said. "It crosses over so many different information systems. It's very broad in its scope."
At this point, Arges said, the American Hospital Association is watching closely to see how healthcare application vendors, and public and private providers of healthcare plans, are moving forward on ICD-10.
"I've heard from a few Medicaid plans that they're not going to be ready" by the deadline, he said.
The U.S. is one of the last countries to adopt ICD-10, but as such it is also adopting the most thorough revision of the coding system.
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