And exactly how much it will cost to implement ICD-10 still largely unknown. "Pick a number, multiply it by 10, throw it at the wall, and see if it sticks," Oriol said. You can predict staffing needs, but there's no way to tell what impact errors and inefficiencies during the natural learning curve will have. "We have no idea," he said.
Success depends, in large part, on getting the right people to manage the project, the CHIME panelists said. Rady has a steering committee with organization-wide representation, for example. At SSM Healthcare, a 15-hospital system based in St. Louis, health IT and human resources are working together to prepare for training, said project manager Carole McEwan.
One decision both organizations had to make: Should the team that implements ICD-10 be the same group that's working on electronic health records? Here, the two organizations differed in their strategies.
SSM is currently implementing an EHR and many of the same people work on both projects. So the ICD-10 and EHR projects share a steering committee. It's a well-functioning team, McEwan said, so it made sense to build on what was already there.
Rady went with a separate ICD-10 group that also incorporates members of the clinical documentation improvement team. CDI is a foundation for ICD-10 preparation, Birnbaum said. You can't code what you don't document. Bad documentation on the front end pollutes the stream, she added.
McEwan estimates SSM will ultimately provide more than 100,000 hours of training for ICD-10. SSM decided to build its own training system rather than purchase one off the shelf. It will create six classes to deploy throughout the organization.
Physician training is just as important as coder training. "The bottom line is documentation," said Birnbaum.