Go fish or cut bait

April 24, 2014
Before reading this editorial, please go to your computer and perform a Google search of “ICD-10 delayed.”

Now that you are back, the reactions are pretty extreme, aren’t they? All the vitriol and gnashing of teeth would suggest that the healthcare industry had been ambushed by a nefarious network seeking to eradicate any signs of order and reason in medicine. Instead, the reality of the situation is that a piece of legislation, “Protecting Access to Medicare Act of 2014,” H.R. 4302, was approved by our elected representatives, as is their custom, and then the president signed the bill into law; again, not an act unfamiliar to those of us with a passing knowledge of ABC’s “Schoolhouse Rock” episode “I’m just a bill.”

So what if only days before the most recent delay former Secretary of Health and Human Services, Kathleen Sebelius, stated that her office would remain firm on the Oct. 1, 2014, compliance date? Did you forget April 9, 2012, when Sebelius announced a proposed rule that would delay the compliance date for ICD-10 from Oct. 1, 2013, to Oct. 1, 2014? Her call for that delay was meant to “give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition among all industry segments.”

How did our industry, as a whole, use the extension created in 2012? That’s not a rhetorical question. Seriously, why did we not use the extra time to prepare fully and move away from a four-decade-old coding system? And what makes anyone think that this new extension will be any different than the others? Will we really use the extra time to become compliant in 2015, or will we just kick the can even farther down the road until 2017 when ICD-11 is released?

I asked healthcare professionals based in the UK for their thoughts on our seemingly endless struggles to adopt ICD-10. I might as well have asked them about our preparations for Y2K. “You are all still working with ICD-9? How is that possible?” were the most common sentiments.

Many feel this staccato-style approach to ICD-10’s implementation has the same origin of most every other healthcare change that has happened in the past 75 years: political intrusion. While healthcare in this country has always had amazingly large unintended consequences from congressional action, the heart of the ICD-10 transition is not, and has never been, about political intrusion. It’s about the historic lack of solidarity in healthcare. Our industry’s glut of individual agendas and conflicts of interests are what cause these sorts of policy interruptions and delays. If our industry accepted the fact that one day ICD-10, like everything else in life, will pass on, and that something new will have to take its place, things would be very different today, and our future would be much more under our own control. Instead, we have allowed our government officials, the vast majority of whom have no medical experience whatsoever, to take vital healthcare leadership positions and then dictate the most fundamental operations of our industry. So if you want to see who is at fault for this mess, look in the mirror.

We deserve the chaotic situation we are in. We deserve the feelings of frustration and uncertainty. We brought it upon ourselves, but, unfortunately, we have also brought it upon the group of people we swore we would not harm: our patients. For that glaring sin of omission, we should be careful about throwing stones at politicians.

Act now and take control of the future; your future and your patients’ future. Act now or just sit down and remain quiet.

Either go fish and help the industry make the inevitable shift to, and later beyond, ICD-10, or cut bait and let others make the decisions you are too timid to take on.

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