Hospital CIO Stephen Stewart: ICD-10 'more than a coding issue' for C-suite leaders

Why should docs and C-suite execs care about ICD-10? In part 1 of this exclusive interview with FierceHealthIT, Stephen Stewart, CIO of Henry County Health Center in Mount Pleasant, Iowa, answers that question--and offers health IT leaders advice on how to motivate physicians and healthcare leaders to take ICD-10 seriously by explaining to them the rewards of implementation and the risks of ignoring the regulations.

Stewart 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 Feb. 22 from 7 to 8:30 a.m.)

Stewart will be joined on the panel by CHIME chair Drexel DeFord, senior vice president and CIO at Seattle Children's Hospital & Research Institute; Carole A. McEwan, ICD-10 migration project manager at SSM Health Care; and Roy Foster, director of regulatory compliance practice at Cerner.

FierceHealthIT: Why should CIOs and other healthcare execs care about ICD-10? What makes it more than a coding and training issue?

Stewart: The reason it's more than just a coding issue is that it really changes the way the providers do their job. Yes, there's a lot of training and the coders have to re-learn things. But I have absolute confidence they'll overcome that challenge. There will be a productivity hit. But we can get through that, too.

Ultimately it does come down to the financial ramifications. It's not just getting the coders to put an ICD-10 code where they would have put an ICD-9 code. The problem is getting providers to input the information that's necessary for the coders to do their jobs. It's getting the providers to understand that what they do matters-significantly--and while no, they are not coders, they are the providers of the service and they are the providers of the information. It's absolutely required of them going forward.

FHIT: So how do you get providers to see the importance of their role--how do you motivate them?

Stewart: There is a lot of fear, uncertainty and doubt. From a cynical standpoint, do any of us really believe that the payers aren't going to analyze that more granular data and want to discuss changing reimbursement schedules? I think it would be naïve not to recognize that's not possible if not probable.

But I'm not a cynic where all of this is concerned. More granular data opens the potential for more intense analysis of the data, which from an outcomes standpoint can be really good. It will, in my opinion, ultimately help us get to better outcomes and better patient service and ultimately hopefully to the end goal of upgrading and reducing the overall cost of the healthcare system.

FHIT: What messages about ICD-10 resonate with rest of the C-suite?

Stewart: There are still a lot of executive-level people in healthcare who don't quite understand the potential ramifications. That to me is a big, big deal. And for those facilities that haven't started some champion in those facilities needs to emerge and come forward and say "OK, we've got to wake up and smell the coffee. Rather than practice benign denial, we need to accept the fact that it's coming and figure out the best strategy for our organization."

The financial argument is probably the most compelling. But that creates the response to this out of fear. There is a real potential here for this granular information to contribute to a more positive outcomes for the patient, which is really what we're all in this for. As a general rule, more data allows better practice. And the more data that can be collected with this new coding technology, hopefully the better practices in treating our patients can develop. And everybody wins in that regard. If we treat them better and produce better outcomes, then we reduce the overall cost of healthcare.

I don't think any of us believe there's a snowball's chance that our reimbursement is going to increase. So what we're really talking about is minimizing the decrease. But our win comes from producing better outcomes and reducing costs as a result.

Editor's note: This interview has been edited for length and clarity. Look for part 2 of the interview with Stewart in tomorrow's edition. Stewart will weigh in on whether organizations can count on the government postponing the October 2013 ICD-10 conversion deadline--and how that might affect healthcare organizations' ICD-10 plans.  

For more information and to register for the FierceHealthIT breakfast panel, "ICD-10 Readiness for Hospital Leaders," on Feb. 22 at the HIMSS conference in Las Vegas, visit our website.  

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