ICD 10 is the Y2K of the healthcare industry – really?
Few industry experts have called ICD 10 “the Y2K of the healthcare industry” and some organizations are taking it too literally – and they couldn’t be more wrong. In my view, the only thing that these two changes have in common is “the extent of their impact on the enterprise landscape”, and the similarity pretty much ends there.
If you thought that ICD 10 is like Y2K and tools would be able to “get you there”, I want to draw your attention to just a few of the key impacts of ICD 10:
• ICD 10 is impacting the fundamentals of how claims are being paid today and the last I heard “claims” was still the most critical and complex process
• Dual storage and processing systems to support old and adjusted claims
• Contracts need to be renegotiated at new levels of ICD/DRG codes – now, reviewing and revising hundreds of legal documents is not cake walk by any means
• Existing health product offerings need to be aligned to the new ICD/DRG codes
• Medical management modules need to be updated to recognize and use the new ICD codes
The list goes on… but most items you’ll see on the impact list are not simple “if… then… else…” patterns that toolsets would be able to recognize and remediate. Unlike the technical impacts of Y2K, you’ll notice that these are business impacts - that’s why a judicious mix of tools and manual services is a must for successful remediation. And on top of that there is this pressure of the magic phrase “opportunities with ICD 10” - that are supposedly going to give you an edge over your competition.
So the next time, a pure-play technology vendor with little understanding of the healthcare business tries to sell you a 100% automated transition solution, you might as well ask if their tool is ideal for eradicating poverty and world hunger!
