HFMA WEBINAR. ICD-10 Implementation: Effective Steps for Successful Adoption & Strategies

Transcription

1 HFMA WEBINAR Sponsored By: ICD-10 Implementation: Effective Steps for Successful Adoption & Strategies Date: February 27, 2013 Time: 2:00 3:30 p.m. Central (12:00 1:30 pm Pacific/1:00 2:30 pm Mountain/3:00 4:30 pm Eastern) Please log in 10 minutes early and test your computer. To view and listen to this web seminar on your computer click on the following link (or paste it into a browser): 1. Type in your full name where it says "Enter as a Guest Please Enter in Your First & Last Name ONLY! Do not type in GUEST 2. Click Enter Room Your computer will launch the webinar Online live seminars are broadcast over the web via Adobe Connect. You'll need a computer with a browser, Adobe Flash Player 10.1, and Internet connection. Test Your Computer If you have never attended an Adobe Connect meeting before: Test your connection:

2 Meeting login issues Quick things to check first. Check the following simple items to help resolve meeting access issues. Are you connected to the Internet? Disable popup blocker software. Clear the browser's cache. Try connecting from another computer. Are you accessing the correct URL? Audio Issues Close all Microsoft Applications, especially Outlook and Messenger. Having Outlook open absorbs almost 50% of the bandwidth which may cause intermittent audio interruptions. For Technical Support If connection with the presentation is lost or seems frozen, please exit out of the window and log back in to re-establish connection. If you experience difficulties with the audio during the presentation, please report it through the chat Q&A box. CPE Information To receive CPE Credits for this webinar. You must complete it within 2 working days. After 2 working days the meeting code won t be valid and you will not receive CPE Credit. To review your CPE information, please visit the HFMA web site at log into your profile, and retrieve all CPE information (by date) within your "CPE Center. To complete our on-line evaluation: The URL below will take you to our on-line evaluation form. You will need to enter your I.D. # (confirmation ) You will also need to enter this Meeting Code: 13AT5 URL: Your comments are very important and enable us to bring you the highest quality Programs! If you have questions regarding registration please call HFMA Member Services at ( , ext 2).

3 Sponsored By: ICD-10 Implementation: Effective Steps for Successful Adoption & Strategies Wednesday, February 27, :00 3:30 p.m. Central/3:00 4:30 pm Eastern Deloitte Consulting LLP Christine Armstrong RHIA, MBA, Principal Vickie Monteith RN, Director Sutter Health, Sacramento, California Danielle Reno, MHA, CHC, CCS, CCS-P ICD-10 Program Director Memorial Healthcare System, Florida Wendy Iravedra, RHIA, CHP Administrative Director, ICD-10 Project Today s Panel Chris Armstrong, RHIA, MBA Principal Deloitte Consulting LLP National Consulting Leader for the Provider ICD-10 More than 25 years of experience in health care industry Extensive industry experience in the revenue cycle, operational management roles, and corporate director of information systems Danielle Reno, MHA, CCS, CCS-P, CHC ICD-10 Program Director Sutter Health Leads ICD-10 efforts for Sutter Health, a 24-hospital not-for-profit integrated delivery system based in Northern California Currently serves as a Commissioner on the national AHIMA Council on Certification for Health Information and Informatics Management (CCHIIM) Vickie Monteith, RN, MBA Director Deloitte & Touche LLP National Advisory Leader for Provider ICD-10 More than 25 years of experience in health care industry Extensive industry experience in patient access, case management, patient accounting, billing compliance, charge integrity, CDE, (CDM) reviews and compliance program development, (RAC) readiness, ICD-10, nursing and supply chain Wendy Iravedra, RHIA, CHP Administrative Director, ICD-10 Project Memorial Healthcare System Leads the ICD-10 Program for Memorial Healthcare System Prior role was Director of HIM and Privacy Officer for Memorial Has previously served as Chair for the AHIMA Council on Certification 2

4 After This Webinar You ll Be Able To: Understand early adoption efforts that are being implemented by providers Describe steps organizations are taking around system testing, financial testing, and providerpayer collaboration Outline leading practices underway in the areas of training, physician adoption, and clinical documentation improvement Understand new technologies being implemented, e.g., computer-assisted coding, cross-mapping solutions and impact on productivity, efficiency and preparedness Gain insight into benefits and operational efficiency opportunities possible through the ICD-10 implementation efforts Describe the primary challenges organizations are encountering with their implementation efforts 3 The ICD-10 Regulatory Timeline to Date Original Final Rule Published 1/16/2009 HHS Delay Announcement New Final Rule Published 8/24/2012 Original ICD-10 Compliance Date 10/1/2013 Revised ICD-10 Compliance Date 10/1/ The new implementation date applies to all covered entities and both ICD-10 inpatient procedure codes and diagnosis codes. Entities that were not on schedule to be ready by October 1, 2013 can use the time to become prepared, and entities that are on schedule can use the delay to conduct more thorough testing and work with their trading partners to decrease the possibility of unforeseen obstacles to implementation and increase the possibility of a smooth transition. Source: CMS Final Rule 45 CFR , 8/24/12 p96 4

5 How is the Market Progressing? Module 1: ICD-10 Overview While Health Plans are in front of others, the health care industry as a whole is behind in preparing for the ICD-10 transition. Completed Assessment & Plan* Completed Mobilization* Truly Remediating* State Health Y R R Providers Y Y R Health Plans G Y Y Federal Y R R Life Sciences (Not Started) Legend On Track Moderate Progress Note: Stoplight colors are based on Deloitte s experience in the market Limited Progress 5 Where is Your Organization? Organizations are at various stages of implementation and readiness. The American Hospital Association s February 2012 survey indicates that only 42% of responded provider organizations had completed an ICD-10 implementation plan. 1 Today Planning and assessment Inventory of people, business processes, and systems impacted Implementation and remediation 1 yr. delay Oct 2014 Financial risk analysis Systems remediation Training and education Communications Operational remediation Code set mapping Change management Testing and collaboration Business readiness Technology testing, including end-to-end testing Collaboration with external partners and vendors Training and education [1] Post go-live Monitor and track progress Deploy adjustments and enhancements Re-train, if necessary 6

6 Less than Two Years Away from Go Live Common Strategies & Actions for Your Organization If you have not yet started planning Leverage industry-wide lessons learned and fasttrack to implementation Develop detailed work plan and secure Get on the collaboration bandwagon Align with in-flight initiatives to create efficiencies Allocate sufficient time for testing and collaboration Start now 7 Less than Two Years Away from Go Live Common Strategies & Actions for Your Organization If you have not yet started planning Leverage industry-wide lessons learned and fasttrack to implementation Develop detailed workplan and secure Get on the collaboration bandwagon Align with in-flight initiatives to create efficiencies Allocate sufficient time for testing and collaboration If you have paused or slowed your implementation Reinvigorate training and communications Assess program work plan Adjust timelines and reconfirm partner / vendor readiness dates, etc. Re-engage stakeholders and leaders to focus on timeline; confirm your Secure your funding Start now Ramp it up 7

7 Less than Two Years Away from Go Live Common Strategies & Actions for Your Organization If you have not yet started planning Leverage industry-wide lessons learned and fasttrack to implementation Develop detailed workplan and secure Get on the collaboration bandwagon Align with in-flight initiatives to create efficiencies Allocate sufficient time for testing and collaboration If you have paused or slowed your implementation Reinvigorate training and communication Assess program workplan Adjust timelines and reconfirm partner/vendor readiness dates, etc. Re-engage stakeholders and leaders to focus on timeline; confirm your Secure your funding If you have continued your momentum through the delay Confirm external stakeholder and partner progress Analyze sufficiency of testing timelines (suggest one-year minimum for internal and external testing) Take advantage of leading position to extend collaboration timeline Share knowledge and lessons learned Start now Ramp it up Lead the way 7 Payer-Provider Collaboration New insights and unexpected considerations Internal vs. external coders Coordination with dual coding strategy Quality review of ICD-10 claims Electronic vs. paper medical records Availability of systems within both the payer and provider organizations Data generation and scope of claims Identification of high impacted DRGs Select number of facilities with high volumes Mutual agreement between provider and payer Both the provider and payer should benefit from the collaboration 8

8 Clinical Documentation: Why it is Important Inpatient: Dictated operating room (OR) written notes Consultations and Reports Physician Assistant and Nurse Practitioner documentation when acting as the physician designee Admission History and Physicals (H&Ps) Narrative Summaries Outpatient/Ambulatory Payment Classification (APC): Dictated OR written notes Consultations and Reports Accurate clinical documentation supports quality, reflects workload and publicly reported scores. This is your opportunity to show how sick your patients are. 9 Memorial Healthcare System Network of doctors and hospitals in South Florida Fifth largest public health system in the country ICD-10 Program started in Spring 2012 FY12 Facts and Figures Hospitals 6 Beds 1,776 Discharges 72,694 Patient Days 360,181 ER Visits 397,280 OP Visits 529,036 Net Revenue Charity Care 2012 Financials $1.518 billion $962 million Source: 1o

9 Support Functions Memorial s Implementation Program Project Management & Governance - Charters - Communication plans - Reporting plans - Document-sharing portals - Initiative reporting - Resource leads - Milestones - Key performance indicators - Risks tracking ICD-10 Executive Sponsors Enterprise Project Management Office ICD-10 Project Administrative Director Project Manager HIM & CDMP Finance Clinical Operations Information Technology Revenue Cycle Physician Integration Memorial Integrated Health Plan Training Epic Team MHS IT/EPIC Team 11 Memorial s Areas of Focus HIM and Coding Developed dual coding strategy Finalized plan for coder staff augmentation and retention Creating new enterprise-wide coding structure Training and Education Finalized training plan Performed coder readiness assessments Technology Established three sub-workgroups Refreshed vendor surveys and rate responses Completed Epic work effort estimator tool Optimizing Epic Clinicals (inpatient & ambulatory) Evaluating coding/clinical advanced technology solutions and cross mapping tools Refining timing for Computer Assisted Coding (CAC) roll-out 12

10 Sutter Health Hospitals Sutter Medical Network Employer Organization 24 facilities in Northern CA, split across 5 regions Integrated delivery system of hospitals, ASCs, medical groups, home health and more Services include trauma, transplants, research, cardiovascular and cancer Integrated, patient-centered physician network 5 Medical Foundations 5 Affiliated IPAs Over 5,200 primary care doctors and specialists $9.1B Northern CA-based notfor-profit organization Annual statistics: 211K discharges 9.5M outpatient visits 47K+ employees Many large-scale programs inflight (EMR, new construction, etc.) 13 Sutter Health s Areas of Focus ICD-10 Program IS Quality Center Technical Services Project Services 14

11 Impact Learning Needs Sutter Physician Training: Segmentation by Practice Setting Inpatient Hospital Physician Office/ Clinic Ambulatory Surgery Centers ED/Outpatient Hospital Diagnosis documenting requirements (by specialty) Operative Note requirements for ICD-10 PCS (by specialty) Specialty deep dive EHR system change job aids Significant impact In-person peer-to-peer workshops will be offered Diagnosis doc requirements for ICD-10 CM (by specialty) General awareness (medical group) ICD-10 Reimbursement ICD-10 CM Coding basics (if they assigns codes) EHR system change job aids Diagnosis documenting requirements for ICD-10 CM (by specialty) General awareness (medical group) EHR system change job aids Diagnosis documenting requirements for ICD-10 CM (by specialty) General awareness (medical group) EHR system change job aids Least amount of impact (involves specialty-specific inperson peer-to-peer workshops) HIGH MEDIUM LOW LOW 15 Engaging Physicians at Sutter Method Target Audience Method Description Established Meetings Online Courses Peer-to-Peer Training Video/Application Technology Physician Leaders Executive Stakeholders Hospitalists Ambulatory Care and Specialty Providers Hospitalists Ambulatory Care and Specialty Providers Hospitalists Ambulatory Care and Specialty Providers Leverage established physician meetings to generate physician awareness and complete physician education Utilize third party vendor curricula for ICD-10 general awareness and tailored training for respective clinical specialties Utilize Precyse University Physician Educators to provide onsite peer led training for general and specialty-specific clinical documentation education Provide video and smart phone application tools to deliver documentation tips as well as recorded peer led trainings 16

12 Sutter s Testing Approach 1 Define Testing Strategy and Test Plans Identify testing phases, testing timelines and allocate Identify timelines for application remediation Define requirements for test environments Identify automated testing tools 17 Sutter s Testing Approach 1 Define Testing Strategy and Test Plans Identify testing phases, testing timelines and allocate Identify timelines for application remediation Define requirements for test environments Identify automated testing tools 2 Governance Model Implement a testing governance model to enable end-to-end test management across departments 17

13 Sutter s Testing Approach 1 Define Testing Strategy and Test Plans Identify testing phases, testing timelines and allocate Identify timelines for application remediation Define requirements for test environments Identify automated testing tools 2 Governance Model Implement a testing governance model to enable end-to-end test management across departments 3 Payor and Provider Collaboration Schedule testing activities early with payors and trading partners Prepare early and communicate often, allowing for contingencies 17 Sutter s Testing Approach 1 Define Testing Strategy and Test Plans Identify testing phases, testing timelines and allocate Identify timelines for application remediation Define requirements for test environments Identify automated testing tools 2 Governance Model Implement a testing governance model to enable end-to-end test management across departments 3 Payor and Provider Collaboration Schedule testing activities early with payors and trading partners Prepare early and communicate often, allowing for contingencies 4 Define Risk-Based Approach Identify areas of highest business value and risk Develop testing criteria for these functions and systems 17

14 Sutter s Testing Approach 1 Define Testing Strategy and Test Plans Identify testing phases, testing timelines and allocate Identify timelines for application remediation Define requirements for test environments Identify automated testing tools Governance Model Implement a testing governance model to enable end-to-end test management across departments Payor and Provider Collaboration Schedule testing activities early with payors and trading partners Prepare early and communicate often, allowing for contingencies Define Risk-Based Approach Identify areas of highest business value and risk Develop testing criteria for these functions and systems Testing Challenges Enterprise testing scope Large number of impacted systems Pervasive business risk to the organization ICD-10 test data is not readily available Dedicated test environments are required Dependencies on external parties for testing 17 Conclusion

15 Immediate Next Steps It s never too late to set 30-, 90- and 180-day plans to accelerate implementation progress Finalize any outstanding strategic decisions (e.g., dual coding) Begin executing on general and work group-specific work plans Secure to launch and maintain momentum across all work groups Engage payers, trading partners and vendors early and on an on-going basis Align timelines and major milestones Coordinate with any EMR implementation Communicate needs to executives, inform and prepare stakeholders ICD-10 To-do s Steering Committee formed, PMO in place Budgets approved Strategic decisions finalized Communications initiated Education vendor selected Testing timelines developed ICD-10 partners engaged Retention plan developed New technologies selected And more 18 Closing Thoughts Some health organizations began planning for ICD-10 over four years ago; the significant level of effort can not be underestimated Providers just starting implementation efforts can leverage insights and lessons learned to fast-track their approach Coordination across work groups and aligning timelines will be critical to achieving synergies and interdependent milestones Strategies employed during implementation can facilitate both operational and financial improvements and efficiencies 19

16 Questions & Answers Remember to Complete the Program Evaluation CPE Information To receive CPE Credits for this webinar. You must complete it within 2 working days. The URL below will take you to HFMA on-line evaluation form. You will need to enter your member I.D. # (can be found in your confirmation when you registered) Enter this Meeting Code: 13AT5 URL: Your comments are very important and enables us to bring you the highest quality programs! If you have any questions or do not know your id # you may contact Member Services , ext 2 28