CIO Drexel DeFord: ICD-10 is coming regardless of CMS delay

Some healthcare CIOs might be cheering the Centers for Medicare & Medicaid Services' announcement that it will re-examine the timeline for implementing ICD-10 coding regulations. But Drexel DeFord, senior vice president and CIO at Seattle Children's Hospital & Research Institute, says he's disappointed.

In part 1 of this exclusive Q&A interview with FierceHealthIT, he explains why healthcare leaders should continue to keep their eye on the current October 2013 ICD-10 go-live date, and how CMS' announcement will affect his organization.

DeFord, who is the current chair of the College of Healthcare Information Management  Executives (CHIME) will be one of four health IT experts on FierceHealthIT's exclusive ICD-10 preparedness panel at this year's HIMSS conference in Las Vegas: "ICD-10 Readiness for Hospital Leaders." (The breakfast panel requires special registration and takes place on Wednesday, Feb. 22 from 7 to 8:30 a.m.)

FierceHealthIT: What should CIOs and other healthcare leaders do now that CMS has promised to "re-examine" the ICD-10 implementation timeline? Should they shift focus back to Meaningful Use?

DeFord: I'm slightly disappointed in [CMS'] decision to put that out there in an environment where we were really trying to get everyone's attention and tell them to move ahead with ICD-10.

I understand that Meaningful Use dollars are important and there are a lot of other things going on. But the bottom line--and this is how I've discussed it with my board and my executive group--is that you have to do ICD-10 or you cannot issue bills and get paid. ICD-10 must be done. Meaningful Use dollars are bonus dollars. But Meaningful Use dollars don't matter if you don't get ICD-10 done.

A lot of organizations, including the government, have the challenge of making a decision that something is more important than anything else. By saying we're going to reevaluate this it's sending the signal that if you were dragging your feet on ICD-10 you're probably going to be OK--keep working on Meaningful Use.

I hope organizations don't do that. I think ICD-10 is going to happen. Whether it happens exactly on that date or not may still be determined, but I think it requires a huge amount of time and effort and we're going to have to do it eventually. I would rather bite the bullet and get on with it.

FHIT: Do you think this announcement will hamper your internal efforts to prepare for ICD-10?

DeFord: Every time we talk to physicians, coders, the board (or anyone else who will listen), that's always a question: "Do you think it will be delayed?" Our organization got started on this in early 2011. The more we dive into it, the more work we realize is associated with it. So we knew early on that, even if there was a delay, it really shouldn't interrupt the work that we're doing.

A delay might be great from the perspective that it gives up more time to get the work done, but our goal and timeline was set to meet the 2013 go-live date. Sometimes having that kind of pressure is very important--otherwise organizations will drag their feet and we'll be having another conversation about another delay a year down the road.

FHIT: Do you think that CMS will make significant changes to the ICD-10 timeline? How far can they push back the current October 2013 go-live deadline?

DeFord: I just look at the rest of the world and where they're at with ICD-10 and I think we're so far behind that it would be very tough for us to say we're going to push it out some long period of time. And if there's going to be a delay I can't imagine it would be much of a delay--but the government surprises me all the time.

Editor's note: This interview has been edited for length and clarity. Look for part 2 of the interview with DeFord in tomorrow's edition.

Hear more from DeFord at the FierceHealthIT breakfast panel, "ICD-10 Readiness for Hospital Leaders," on Feb. 22 at the HIMSS conference in Las Vegas. Ford will be joined on the panel by Stephen Stewart, CIO of Henry County Health Center; Carole A. McEwan, ICD-10 migration project manager at SSM Health Care; and Roy Foster, director of regulatory compliance practice at Cerner.  

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