EHR + ICD- 10 = Issues. Barbara Drury, FHMISS, President Pricare, Inc.

Transcription

1 EHR + ICD- 10 = Issues Barbara Drury, FHMISS, President Pricare, Inc.

2 EHRs + ICD10 = Issues A. Contractual B. System Opera5ons C. Templated Documenta5on D. Capabili5es E. Trading Partners For the Colorado ICD- 10 Training Coali5on Barbara Drury, FHIMSS, President, Pricare Inc. August

3 A. Contractual Issues 1. Are your support fees current? 2. Does support include updates (or upgrades) that specific government- mandated requirements are included in paid support fees? 3. Are you on the latest release of your EHR souware (or the edi5on that will support ICD10)? 4. Which release of the EHR and/or PMS souware has ICD9 and ICD10 capability? 5. What souware costs (licenses and training) and hardware costs are associated with ge^ng from your EHR release to the correct release? 6. Does your EHR support fee include maintenance of your customized templates or must you budget more? 3

4 B. System Opera5on Issues 1. Do you use a system where PMS and EHR are integrated (bi- direc5onal and/or single vendor solu5on)? 2. Do you use non- integrated systems with a one- way interface (billing codes are a deriva5ve of EHR printout or manual superbill comple5on separate from EHR)? 3. Do you use a separate billing solu5on (paper superbills to your in- house billers or to an outside billing/rcm service)? 4. Who reads the EHR- generated note and harmonizes it with the claim codes? 5. Is the EHR and/or the MD the ul5mate and only source of ICD coding or is a coder or biller the ul5mate source of ICD coding? 4

5 C. Templated Documenta5on Issues 1. Does the EHR provide differen5al diagnosis algorithms or does the template offer suggested pre- built diagnoses? 2. Who maintains the algorithms or suggested diagnoses inserted in the template and presented at point of care? 3. Who maintains the key phrases (macros, templates, drop- downs, problem list, defaults, transcrip5on/vr, alerts, reminders, etc.) in HPI, ROS and assessment sec5ons of the EHR s documenta5on? 4. How many deriva5ve views or varia5ons of the templated documenta5on are in use (think MU visit summary, consult leeer, screen view all different views of the source data)? 5. Are these deriva5ve views date- sensi5ve for pre/post October 2014? Do you need to copy, rename, then re5re ICD9 templates? 6. Will choosing from ac5ve problems entered pre- Oct 2014 populate the note and claim (order/erx) with ICD9 auer Oct

6 D. Capabili5es Issues 1. What is the status of your EHR (and/or PMS) regarding ICD10? 2. What resources are available from your vendor and how do you access that exper5se (vendor, 3 rd party consul5ng, middleware in use by vendor, tes5ng sites)? 3. What aspects of ICD10 are present in the EHR or are some only present in the PMS? 4. Is ICD10 implementa5on date- sensi5ve for pre/post October 2014 and payer- sensi5ve for HIPAA CE or non? 5. How is repor5ng (on paper, on dashboards and electronically) for MU, PQRS, and MD- produc5on being revised to reflect ICD10? 6. Can pre- Oct 2014 templates be re5red or inac5vated to prevent users from accessing auer Oct (also correspondence, referrals, orders, etc.)? 6

7 E. Trading- Partner Issues 1. Who are your trading partners? Are they also your EHR vendor s trading partners? 2. Have you surveyed and aligned the ICD10 readiness and transi5on plans of your trading partners (think EHR basic scrubbing, third party claim scrubbing souware, clearinghouses, orders out to labs or for studies that need a diagnosis, HIE organiza5ons that exchange ICD codes before and auer Oct 2014, payers and their adjudica5on souware, work comp payers staying in the ICD9 world). 3. Are claims and EHR documenta5on an exact match (documenta5on may be ICD10- granular while ICD code is not or ICD10 code may be granular but documenta5on phrases are not)? 4. Are transcrip5onists and billers qualified as ICD10 coders (who is)? 7

8 Daily Deep The five D s Data Dive Document Don t let days or weeks go by without checking the data from the EHR, the data out the door and the responses (or absence of) coming into the system. And document your observations and followup tasks! Like MU, using ICD10 is new to everybody! 8

9 Barbara Drury Pricare Inc

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