New studies indicate that new habits take about 2 months to become routine. That means the new EHR takes 60 days to even get used to, much less take advantage of cost savings associated with using. For providers, the habit of documentation (and it is a habit) will take some time to change in order to meet ICD 10 guidelines.
60 days, that’s if all your systems are equipped to handle the ICD 10 expanded codes and you have appropriate training lined up to train providers on the ICD 10 requirements. October 1, 2014 is 242 days from now. The latest you can have providers “begin” documenting appropriately is August 1, 2014. And from August until October, review of documentation with meaningful feedback must happen continuously. Who in your organization is preparing providers for ICD 10? Who is reviewing current documentation to provide feedback to providers on what additional/different documentation needs to take place? Who is accountable for ICD 10 conversion success at your organization/practice?
Correct coding from accurate and specific documentation is the only way to ensure a measure of success. Of course, there are many other factors; software, hardware, venders, payers, clearinghouses, billers, and clinical staff. Virtually everyone in your organization/practice will in some way be touched by ICD 10 changes. Providers have the normal pressure on them: seeing more patients, adapting to the EHR, leading the practice, patient wellness, decreasing reimbursements while accommodating a shifting payer mix.
Giving providers education about ICD 10 and time to adapt to new rules will take time and energy and focus. Identifying an owner of ICD 10 within your practice will empower changes that need to be made during the next 244 days.
During conversion your practice can expect staff productivity to drop between 20-40% (as noted in the Canadian conversion study) not only for coding staff, but also for data entry staff. The closer to Oct 1 your staff trains and “practices” the changes, the higher the drop in productivity on October 1. The 60 days new habit rule will apply to them as well. One of the strategies that your practice needs to consider to avoid further productivity loss and resulting revenue loss is cleaning up back-logs. Billing or coding back-logs on October 1 will only slow down the new process even more. Focusing on a clean AR now (meaning a minimal number of accounts greater than 90 days) will not only help your practice now with a pick-up in cash flow; but also ready your practice for a potential cash flow decrease in the months after October 1.