In many ways, success in meeting the ICD-10 mandate comes down to focusing on your most important core assets: the people, business processes and technologies used to provide value and service to your patients. But do you even know what assets are 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 analyses required to kick-start and accelerate your ICD-10 compliance project toward a sound outcome.
With a little planning and by expending some additional effort as you progress through your ICD-10 project, your organization can generate intellectual property that will provide additional value both immediately and long after your ICD-10 project has been completed.
Identifying your business artifacts
Healthcare has a lot of unique terminologies, acronyms, jargon, glossaries and taxonomies and most healthcare entities 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 practice. Consider noting any differences in meaning that individual departments or functions may have for the same term or process.
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:
- Ask your staff what the key resources (procedures, manuals, etc.) they use to do the job are?
- Determine how the artifact is affected by ICD-10.
- Does the artifact generate, receive or pass through ICD-10 attributes?
- Who owns the artifact?
- 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, such as diagnosis related groups (DRGs), whether it is touched by an external entity, etc.
- Organize your artifacts into some sort of content management system to ease their access, use and ongoing need to curate them.
- Socialize their existence and value 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.
Taking inventory of 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. Don’t forget the one-off apps, sneaker-net files and that special database maintained by the financial guru that serves as a key part in your monthly revenue management forecasts.
For each software asset in your portfolio:
- Identify the attributes and metrics that will form the basis for your remediation plan.
- If possible, identify how the software uses ICD codes and the type of impact so you can begin to establish remediation patterns.
- Identify unused and/or applications that are near the end of their lifecycle that can be consolidated, migrated to other platforms and/or retired.
- Collect key ICD-10-related attributes that can be used to plan and manage your assessment and remediation efforts.
A little extra effort now will pay off later
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:
- Serves as the basis for identification of redundant and outdated applications.
- Assists with managing licensing, support and maintenance costs.
- Helps assess and manage PHI risk – diagnosis is key PHI element.
- Contributes to the understanding of application landscape opportunities and risks.
- Implements a managed process for controlling your assets.
- Eliminates redundancy/duplication.
Stakeholders, process owners and roles
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, what would you put on your list of things to tell them?”
- “What kinds of knowledge or skills do you now have that this office will miss most when you leave?”
Equally important is to identify areas where you’re lacking a qualified subject matter expert and 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.
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, and ICD-10 will not be an exception. Artifacts 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.
By identifying interrelations and dependencies between your assets in a structured and maintainable fashion as you progress, you will reveal not only active applications, but also those that are not being utilized, are redundant, or are no longer adequately supporting current business processes.
You will have created a portfolio of valuable business collateral that will help ensure the success of your immediate ICD-10 project while serving ongoing value to other projects and your day-to-day operations.
Steve Sisko, a healthcare business and technology professional who likes to generate, share and curate knowledge about healthcare information processes and systems, writes at ICD-10 Impact to Healthcare Payers and Providers.