Challenge

ICD-10 is a federally mandated expansion of coding standards for the exchange of healthcare information between providers and payers that will deliver more detailed descriptions of diagnosis and treatment. Although the expanded format promises to improve the accuracy of medical management and will bring the United States in sync with international standards, the impact on systems cannot be overestimated. PeaceHealth Southwest was keenly aware that it needed to move forward to update its existing systems and harness the more granular data ICD-10 could offer toward its mission of providing safe, evidence-based care. It engaged Point B to help drive the effort.

Assessing readiness and anticipating impact

PeaceHealth Southwest Medical Center knew the effects of ICD-10 would ripple across many areas of its care delivery system. The number of new codes would multiply, presenting significant challenges in managing the expanded code set along with maintaining information from the prior code set.
Point B helped PeaceHealth with a comprehensive assessment, which identified many areas to address:

  • A set of core solutions was needed to support new complexities in coding and billing, manage increased volumes of returned claims, and maintain data for both ICD-9 and ICD-10 code sets.
  • Code set changes would affect applications beyond those supported by the Information Systems organization.
  • Application service providers and vendors demonstrated varied degrees of readiness and responsiveness.

Focusing fast to achieve sustainable change

PeaceHealth Southwest Medical Center engaged Point B for its industry and functional expertise. Consultants gathered, analyzed, and consolidated the needs of over 20 departments affected by ICD-10. Working alongside the client, we provided a roadmap for action, guiding phases for execution and communication along the way. We identified 60 separate impacts to people, processes and technology, assessed what it would take to resolve them, and provided solutions for change adoption and sustainability.

PeaceHealth Southwest Medical Center is moving forward on a clear direction for conversion with full traceability of requirements, actions, costs and results. The client understands the needs and means for change, and is in position to translate that insight into impact. PeaceHealth Southwest is prepared to use the mandate as an opportunity to gain greater insights into the health of its patients.