By now, almost everyone in the healthcare industry has heard about ICD-10, the diagnosis coding system that will go into effect October 1, 2015. There’s a lot of information out there regarding this so-called upgrade from ICD-9—some positive, some not-so-positive. According to major healthcare organizations like the Centers for Medicare & Medicaid Services (CMS) and the World Health Organization (WHO), one of the main advantages of making the jump to ICD-10 is that it will significantly improve interoperability. The healthcare industry as a whole, however, is not completely sold on the switch. Some argue that it will not solve interoperability issues, while others suggest that interoperability isn’t even the objective of ICD-10.
The actual impact of the change remains to be seen, but at this point in the game, one thing is clear: the task of improving interoperability rests predominantly with the people directly affected by the transition, including clinicians, billers, and administrators. Curious about the connection between ICD-10 and interoperability? Read on to learn more about the switch and how it could alter the healthcare landscape.
Interoperability in a Nutshell
So, what exactly is interoperability? At the most basic level, interoperability is about information exchange. It occurs when diverse systems and organizations work together for an overarching purpose. In a healthcare context, this means successful, seamless data transmission across all healthcare platforms—a goal that requires both effective communication and adequate technology.
The Role of ICD-10
How would ICD-10 aid in the quest for complete interoperability? Well, for one, ICD-10 code sets are super specific, which means the data they produce will be really specific, too. This system also allows for simplified coding of information, making it easier to share than the more complex code sets of yore. Still, for true interoperability to occur, all of the different systems must be able to “talk” to one another—something that currently isn’t happening on a consistent basis across the healthcare spectrum. Electronic patient record systems are growing increasingly prevalent, but—as Forbes contributor David Shaywitz points out in this article—there are a lot of different electronic medical record systems out there, and they’re not all totally compatible with one another. And in this day and age, it would be nearly impossible to achieve constant interconnectivity and communication across all healthcare providers without across-the-board implementation of secure, portable, cloud-based EMR systems.
It’s Up to You
Positive change won’t happen on its own; to achieve interoperability in the healthcare field, all hands must be on deck. Of course, as with any major transition, there are a lot of naysayers out there—and some of them have valid objections.
In a Healthcare IT News post titled “Will ICD-10 Solve Interoperability Problems?,” author John Lynn makes a fairly strong case against the new coding system improving interoperability, writing, “All we have to do is look at the current ICD-9 diagnosing patterns…often a doctor gets stuck searching for the right ICD-9 code. Right or wrong, they end up picking a code that may not be exactly the right code for what they’ve seen. Maybe they choose NOS (Not Otherwise Specified) instead of the specific diagnosis that would be more appropriate. Add in the complexity of diagnosis requirements for getting the most out of your insurance billing and I don’t think anyone would disagree with the assertion that ICD-9 code entry is far from accurate.” In this article, Lynn also questions how healthcare professionals will possibly be able to master a complex set of ICD-10 codes when they are not even correctly coding in ICD-9.
In the article “Chasing the Tail of Interoperability,” author Gary Palgon urges his readers to recognize that interoperability requires more than just “connectivity”—it requires communication. “Organizations seldom encounter ongoing challenges with connectivity, yet the language—or semantics—used across different disciplines changes frequently,” he writes. Thus, all healthcare professionals must take responsibility for their own data by making sure everyone is on the same page and speaking the same language—at least from a technological standpoint.
Sure, there are a lot of challenges associated with implementing ICD-10, and challenges always breed concerns. But at the end of the day, there’s no sense in complaining about the change. It is going to happen; you can’t control that. What you can control, however, is your attitude and your clinic’s preparedness. Start getting ready now. That way, when the change happens, you’ll not only be less stressed, but you’ll also know that you’re actively helping the US healthcare industry progress toward the ideal of total interoperability.