Saturday, January 7, 2012

Transition From ICD-9 to ICD-10 May Cause a Change to a New EMR/EHR, Some Pitfalls to Watch For

We are seeing a lot of posturing by ICD-10 vendors of all types to gain market share by helping clinics and coders learn how to adapt to the ICD-10 coding structure.
One result of these efforts will be that a number of clinics will upgrade or change software to better manage the coding for their clinical care standards. These changes will incur new problems not associated with ICD-10 as well as the run-of-the-mill (tongue in cheek) data migration problems.
It is important, perhaps critical to carefully identify what data you want converted. It does not help to simply check the box "all" when some data types may not be present in your legacy system. For example if you do not have ICD-10 coding in place there is nothing to convert. Along the same lines Race, Ethnicity and Religion are necessary components of a good clinical (EMR) patient record but are rarely present in legacy databases, at least not yet.
However, if your new system requires the new coding structure, there needs to be a path defined to move the "9" codes to "10" codes. Simply stated this can be a translate table. Regardless of how this is defined it will not be simple and should be approached with an eye to detail and a clearly defined end result.
Some will be fooled by a catch-all phrase "yes, we can convert ICD-9 to ICD-10". Sterile examples of that conversion provided during the early stages of the sales cycle will help shape the list of vendors you are considering, down for the final choice.
Before making that final choice however it is prudent to provide the vendors with a representative subset of actual codes you are using and ask them to show you how they will be translated into "10" codes in their EMR system. Your task is then to take that translation and apply it to specific examples in you current patient files and ask yourself the question "is this the result I want for this patient for this visit?" Allow yourself time for this to be an iterative, learning process. Your clinic and your patients are unique. Running a few trails will quickly bring clarity to your decision.
When you select a data migration vendor the same question of translating ICD-9 to ICD-10 codes needs to be asked of them. Not only will this satisfy you that they know what data migration is all about but a heads-up data migration team will appreciate the clarity this exercise adds to their conversion requirements specification.
Turnkey data migrations are rarely satisfactory. Clinic operatives need hands-on evaluation of test and final results before acceptance is granted. It is this author's experience that two test runs of a clinical data migration is the minimum.
The requirement to implement ICD-10 coding is yet another of many reasons for clinics to make the choice to change EMR software or to finally adopt an EMR for the first time. These can be intimidating decisions. Careful planning will reduce the pain and improve the results. The bottom line will be better patient care and a happier staff.

1 comment:

  1. Luckily those medical billing and coding online are already preparing for the launch of the new ICD codes and already have plans for their trainings to be able to keep their students updated. Some organizations are actually saying that instead of launching ICD 10, why not just wait for ICD 11?