Wednesday, May 16, 2012

What ICD-10 Consulting Services Might Providers and Payers Need Help With?

Here are some services I think those faced with assessing and remediating their core business assets to accommodate the ICD-10 mandate may want to engage outsiders to assist with: 
  1. Analyze and gain understanding of your core business and IT processes through interviews with business stakeholders and IT architects – uncolored by internal agendas.
  2. Work with your business and IT leadership to plan and integrate short- and long-term technology options into an overall ICD-10 solution strategy specific to your needs.
  3. Provide guidance and hands-on assistance with developing a balanced business technology strategy by leveraging knowledge in both technical and applied business areas.
  4. Define and validate an architectural governance model for ICD-10 and develop tools to enforce its adherence.
  5. Perform a gap analysis on any existing ICD-10 assessment solution strategy.
  6. Conduct “solutioning” sessions involving IT, vendors, business stakeholders and define ICD-10 implementation solutions deemed best compliant with specific, overall needs.
  7. Define “solutioning” approaches and assist with marshalling the approval of key project stakeholders in an objective, third-party fashion.
  8. Define technical implementation roadmaps for ICD-10 implementation - especially in the domain of verification and validation.
  9. Identify and participate in proof of concept creation and validation activities.
  10. Curate and socialize roadmaps and detailed implementation approaches to technology and business communities.
I suggest thinking hard about the above when you're planning and/or working on your ICD-10 project -whether you're on your own or thinking about engaging 3rd party assistance.

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Kick-Starting Your ICD-10 Project: Who Actually Does the Work? – Part 3

This is part 3 of a 3 part blog series on Kick-Starting Your ICD-10 Project. In Part 1 & Part 2 I shared my ideas and tips on how to identify the business artifacts and technology assets in your business portfolio that may require remediation to accommodate ICD-10. In this last part I'll share more tips and ideas on how to assess the human capital assets involved with your ICD-10 project and business portfolio.

It’s all about the Stakeholders, Process Owners & Roles Doing the Work

To move forward with your ICD-10 project, or any project for that matter, you must identify the roles, process owner champions, subject matter experts and other stakeholders that make your business run. A comprehensive list of the key roles your business is dependent on – both internal and external – should be assembled. 

For each area, identify one or more individuals who can be held accountable to commitments:

Identify critical knowledge areas and the unique skills each of these areas require for their ongoing operation and support. One way to quickly identify critical knowledge is to ask your staff the following questions:

  • “If you had to leave suddenly and only had one day left to brief your replacement before October 1st, 2014, what would you put on your list of ICD-9 things to tell them?”

  • "What kinds of ICD-9 related knowledge or skills do you now have that this office will miss most when you leave?”

[BTW...Depending on the people involved and the answers given to the above questions, you may want to consider re-valuing their true value to your business and incent against any sudden departure!  :) ]

Where's the Risk?

Equally important is to identify areas where you’re lacking a qualified SME and/or process owner champion. Consider where gaps in business process and project-specific knowledge exist. A project-focused skills inventory can be leveraged to identify training opportunities and areas likely to require supplemental staffing at certain points of the project and/or during cutover when dual processing and the inevitable slowdown occurs. Don't sacrifice future opportunities and revenue by skimping on the compartively trivial education and training most high-performers relish.

Tying It All Together

Keep this in mind: a good asset inventory isn’t merely a laundry list of business processes, applications and systems that need to be reviewed and revised - but rather a tool to help you identify and prioritize your pathway to successful remediation of your business asset portfolio. All of your assets are directly or indirectly related to and supportive of each other. When an addition or change occurs to one asset, there’s almost always a direct or indirect addition or change to another asset.

The information assets needed to effect your business are not created and maintained on a stand-alone, sequential basis but rather iteratively - as the capture of one piece of information leads to the identification and capture of another.  The key is to set up a framework (i.e. portfolio) and capture needed information is a structured, iterative manner.

By identifying interrelations and dependencies between your assets in a structured and maintainable fashion as you progress, you’ll reveal not only active applications, but also those assets not being utilized to their full potential, or that are redundant to other applications, or that may no longer adequately be supporting your desired business outcomes.

Go Forth...and Come Back as Needed

By considering and acting on some of the information I’ve presented in this series of posts, you’ll have kickstarted the creation of a portfolio of valuable business collateral that'll help ensure the success of your immediate ICD-10 project while providing ongoing value to other projects and your day to day operations - long after your ICD-10 project is but a distant, fond memory!

I hope this information was useful.  For more ICD-10 information, be sure to Follow Me on Twitter

Thanks for reading!


Kick-starting Your ICD-10 Project: Inventorying Software Applications – Part 2

This is part 2 of a 3 part series on kick-starting you ICD-10 assessment and remediation project. In Part 1 I shared some approaches, tasks and ideas to assist with identifying business artifacts impacted by ICD-10. See Part 1: “Kick-starting Your ICD-10 Project: Identifying your Core Assets”

What do you hold in your portfolio? Inventorying Software Applications

To accurately assess ICD-10’s potential impact to your applications, you’ll need to itemize all the operational software, legacy applications and end-user developed applications, interfaces and files that comprise your application portfolio; including all those one-off apps, “sneaker-net” files and that special database maintained by the financial geek that serves as a key part of your monthly revenue management forecasts.

For each software asset in your portfolio:

1. Identify the attributes and metrics that will form the basis for your remediation plan.

2. If possible, identify how the software uses ICD codes and the type of impact so you can start to begin to establish remediation patterns. Most common ways ICD-10 will impact your applications include:
  • Field size expansion
  • Data type change
  • Use of decimals (EDI transactions, sorting, field alignment, etc.)
  • Redefinition of code values (Combination codes, External Codes, V Codes, etc.)
  • Longer code descriptions (Search algorithms, screen real estate, etc.)
  • Edit and logic changes (OPL, Body Parts, Workflow, HEDIS measures, etc.)
  • Modifications of table structures
  • Expansion of flat files
  • Systems interfaces (good luck!)
3. Identify unused and/or applications that are near the end of their lifecycle that can be consolidated, migrated to other platforms, and/or retired.

4. Collect key ICD-10-related attributes that you can be used to plan and manage your assessment and remediation efforts.

A Little Extra Effort Now Can Pay Off Handsomely Later On

In addition to collecting attributes to assist with your ICD-10 project planning and management, you should consider capturing asset attributes that can be used to manage the overall cost and value of your application portfolio. There’s likely little extra expense to capture additional information at this point and that expense can pay large dividends down the road.

Key benefits of gathering this additional information now include:

1. Serves as the basis for identification of redundant and outdated applications
2. Assists with managing licensing, support and maintenance costs
3. Assess and manage PHI risk – diagnosis is key PHI element
4. Understand application landscape opportunities and risks
5. Implement a managed process for controlling your assets
6. Eliminate redundancy/duplication that leads to additional licensing and support expenses

Some questions to ask about each of your software assets include: 

1. What can be retired?
2. What can be consolidated?
3. What should be enhanced?
4. What should be replaced?
5. What should be purchased?
6. What should be sustained?

For additional information related to inventorying your core business assets impacted by ICD-10, see my previous post Building an Inventory of Assets for Your ICD-10 Assessment and Other Projects.

This is part 2 of a 3 part series on kick-starting your ICD-10 assessment and remediation project. In the last part, I will identify some tasks, questions and ideas related to addressing Stakeholders, Process Owners and other role-based assets in your portfolio; along with some information on tying it all together.

Monday, May 14, 2012

Kick-starting Your ICD-10 Project: Identifying your Business Processes – Part 1

If you’re a healthcare organization impacted by the ICD-10 mandate, you’ve got a lot of work to do between now and the implementation date - which will likely be October 1st, 2014. Your focus needs to start with your most important core assets: the people, business processes and technologies with which you provide value and service to your customers.

But do you even know what assets you hold in your portfolio? Do you have a formal accounting and understanding of your core assets? Identifying your core assets and clearly understanding their current states as early as possible is a critical foundational component for driving and sustaining the gap, impact and SWOT analyses required to kick start and accelerate your ICD-10 compliance project toward a sound outcome.

Additionally, with a little extra upfront planning and additional effort as you progress through your ICD-10 project, your organization can generate valuable intellectual property that will provide added value both immediately and long after your ICD-10 project has been completed.

What do you do for a living? Identifying your business artifacts 

Healthcare has a lot of unique terminologies, acronyms, jargon, glossaries and taxonomies and most healthcare firms typically assign their own meaning to these definitions. In order to promote a common point of reference and understanding, you should define and maintain a master list of all the nomenclatures and definitions used in your company.

As you define your business terms, create a high-level inventory of your business processes, operating procedures, policies, how-to instructions, and support documents – both business and technical in nature. 

To help identify, define, and categorize your business artifacts: 

1. Ask your staff “What are the key resources (procedures, manuals, etc.) that you use to do your job?” 

2. Determine how the artifact is impacted by ICD-10. Ex. Documentation, User Interface, DB Schema, File Interface, Business Logic, Data Mapping, User Training, etc.

3. Does the artifact generate, receive or pass through ICD-10 attributes?

4. Who owns the artifact? From a subject matter, operational and technical point of view.

5. Consider noting any differences in meaning that individual departments or functions may have for the same term or process.

6. Gather each artifact into a centralized location, tag it with key attributes like its criticality to your overall business, whether the item is impacted by ICD-10 or related elements like diagnosis related groups (DRG’s), whether it is touched by an external entity, etc.

7. Organize your artifacts into some sort of content management system to ease their access, use and your ongoing need to curate them.

8. Socialize the existence of these assets, their value and how ICD-10 impacts each one to your staff.

As you gather and record each artifact, make an attempt to identify primary relationships and dependencies between key processes and functions. This information will prove helpful later on to improve and streamline business processes through consolidation into other processes or applications. 

For additional information related to inventorying your core business assets impacted by ICD-10, see my previous post Building an Inventory of Assets for Your ICD-10 Assessment and Other Projects

This is part 1 of a 3 part series on kick-starting your ICD-10 assessment and remediation project. In the next part, I will identify some tasks, questions and ideas related to Inventorying Software Applications and other technology assets in your portfolio.