Conflict of Interest Disclosure

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1 1.townhouse 1.ICD-10 insurance? Creating Opportunities of Hope: Organizational Opportunities for ICD-10 and Meaningful Use John Dingle & Gary Keast, Mayo Clinic DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS. DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS. Conflict of Interest Disclosure John Dingle Mayo Clinic Senior Health Systems Engineering Analyst Gary Keast Mayo Clinic Senior Systems Analyst IT Have no real or apparent conflicts of interest to report Healthcare Information and Management Systems Society 1

2 Session Objectives Grasp the benefits of using ICD 10 in a meaningful way Understand Mayo Clinic s approach for meeting Meaningful Use Stage I and ICD 10 requirements Reflect on how your own facility can organize your efforts 2

3 The only thing more important than the will to win is the will to prepare to win. Vincent T. Lombardi Project Framework Agenda Understanding Mayo environment & project needs Technical Point of View Meaningful Use & ICD 10 gaps Organizational Opportunities Meaningful Use / ICD 10 organizational benefits Collaboration Between Projects Technical modification to address both projects Questions 3

4 Mayo Clinic Environment Rochester, Jacksonville, Scottsdale, and 70 smaller communities in upper Midwest 73 clinics, 21 hospitals (largest 1,265 beds) 6,900 medical staff, 49,000 allied health staff Electronic Health Record (EHR): Cerner Millennium (non Rochester sites) GE Centricity Enterprise (Rochester; includes several other internally developed modules) Meaningful Use Stage I objectives Objective: On request, provide patients withanelectronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies, and for hospitals, discharge summary and procedures) Measure: More than 50% of requesting patients receive electronic copy within 3 business days Standard: Enable a user to create an electronic copy of a patient s clinical information, including (i) In human readable format; and... (2) Procedures. The standard CPT or ICD 9 4

5 Meaningful Use Stage I objectives Objective: Implement capability to electronically exchange key clinical information among providers and patient authorized entities Measure: Perform at least one test of EHR s capacity to electronically exchange information (Y/N attestation) Standard: Electronically receive and display a patient s summary record from other providers and organizations including, at a minimum, diagnostic test results, problem list, medication list, medication allergy list, and procedures in accordance with the standard (B) Procedures. The standard CPT or ICD 9 Meaningful Use Stage I objectives Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach Measure: Generate at least one listing of patients with a specific condition (Y/N attestation) Standard: Enable a user to electronically select, sort, retrieve, and generate lists of patients according to, at a minimum, the data elements included in: (1) Problem list; (2) Medication list; (3) Demographics; and (4) Laboratory test results. 5

6 Meaningful Use Existing Environment Electronic Health Record (EHR) is a separate system from billing system Procedure and problem coding is done in billing system Procedures are entered and/or transcribed into many other non EHR certified systems Problem and procedure lists are not used for patient consumption 1. MD dictates operative notes Meaningful Use Existing Environment for Procedures 2. Note is transcribed into Surgical Information System 3. Note interfaced to medical revenue system, procedures coded 4. Procedure codes are interfaced back to Surgical Information System 6

7 Mayo Clinic Meaningful Use Perspective: Benefits of Using ICD 10 More accurately defined patient services Greater ability to share Patient Health Information (PHI) worldwide Better understandingof healthcare outcomes Improved decision support Additional Benefits Of Going To ICD 10 Better Quality Measurements Public Health Improved disease and outbreak information Organizational Monitoring and Performance Reimbursement More accurate claims and fewer denials 7

8 ICD 10 Where To Start? ICD 10 System Gap Analysis Clearly understand the legislative requirements of ICD 10 Identify subject matter experts within your organization to brainstorm next steps Put together a high h level ltimeline backwards planning Ignore all rumors that the date will change, again 8

9 ICD 10 System Relationship Map ICD 10 Business Gap Analysis Organizational Teams By Site Eight Core Sites By Function Revenue Cycle Terminology Services/Problem List Clinical Systems Operations Diversified Activities 9

10 ICD 10 Business Gap Analysis By Cross Function IT Systems Workflow Process Training Change Management/Communication Risk Management and Compliance Project Framework ICD 10 Initiation Planning Work Breakdown Structure Execution Monitor and Control Closure 10

11 What We Do Know About ICD 10 This is just not: A coding issue A documentation issue A business process issue An IT issue Meaningful Use Short term solution Send direct interface of coded procedures from medical revenue system to certified EHR Most procedures will be coded within 24 hours, p, meeting the Meaningful Use Stage I requirements 11

12 Meaningful Use Long term solution Within surgical recordingsystem use drop down down lists to engage coded procedures at point of care when physician is recording note Interface those codes to EHR Associate procedures with problems within EHR Lookfor other collaboration opportunities between Meaningful Use & ICD 10 projects! Questions 12

13 Contact Information John Dingle - dingle.john@mayo.edu Gary Keast - keast.gary@mayo.edu 13