On October 1, 2015, the US healthcare industry underwent one of the most significant changes it has experienced in recent decades. On that day at midnight, simultaneously and nationwide, the ICD-9 (International Classification of Diseases-Version 9) code sets that were currently used to report medical diagnoses and inpatient procedures for the past 30 years were replaced by ICD- 10 code sets. It is difficult to overestimate the magnitude and scope of this event. The purpose of this nomination is to recognize the excellent work performed by the ICD-10 Program team over four years that resulted in an extraordinarily smooth transition for all eight UW Medicine entities as well as the Seattle Cancer Care Alliance. The transition to ICD-10 impacted every area of clinical and administrative operations with a profound impact on physicians.
While the transition to ICD-10 was mandatory, it was also an excellent opportunity for UW Medicine to accrue benefits in the areas of quality measurement, public health, research, organizational monitoring and performance, clinical and operational alignment, convergence of political and regulatory mandates, and reimbursement. UW Medicine, led by the ICD-10 Program team, was an industry leader in best practices for the transition.
Significant accomplishments of the team included:
- Defined a best practice ICD-10 implementation approach that others can easily translate to successful implementations in a variety of healthcare provider settings.
- Implemented a comprehensive ICD-10 Physician Education Plan for 4000+ physicians with 94% overall compliance rate Completed Coder training with 100% passing exam rates and implemented dual-coding (i.e. practice coding in ICD-10 while billing in ICD-9) for all UW Medicine entities
- Implemented Epic (Electronic Health Record) ICD-10 Clinical Go-Live across UW Medicine
- Successfully completed ICD-10 integration testing at all sites
- Completed payer testing with Aetna and Medicare and implemented reimbursement shift analysis processes and corresponding risk mitigation approach
- Implemented Computer Assisted Coding at all hospital locations
- Restructured the ICD-10 Program to meet the needs of a one year delay imposed by Congress
- Incorporated students and interns as integral members of our team, to continually grow new talent in the healthcare delivery industry.
- Completed the four year project on time and under budget
The UW Medicine ICD-10 Program has been featured in multiple national professional journals including the Healthcare Financial Management Association (HFMA),American Health Information Management Association (AHIMA) and the University Health Consortium.
Additionally, members of the team were invited to present its approach and results in various national and local forums, highlighting the work in various work streams. These include:
- Health Information Management Systems Society (HIMSS) National Convention, Spring 2013
- HFMA WA State Conventions, Summer and Fall 2012, Fall 2013
- Workgroup for Electronic Data Interchange (WEDI) National Convention, Summer 2013, Spring 2014
- University Health System Consortium (UHC) National Convention, Fall 2013
- One Health Port Administrative Simplification Workshop, Spring 2014
- Local ICD-10 Education events, Spring 2014
The four members specifically nominated for the award were supported by over 25 other UW Medicine ICD-10 program team members. Physician champions played an integral role in the success of the program but need to be recognized as well. They are unfortunately not eligible to receive this award.
Sarah Lucas performed in an exemplary fashion throughout the duration of the program. Her leadership, decisiveness and vision provided the impetus for success through a very long time period of the program. She brought great people into the program and mentored them in their roles.
Sally Beahan brought her outstanding knowledge of Health Information Management to the program. She directed the coding and clinical documentation teams across the organizations gaining consensus on policies, procedures, and tools to assure standardization and efficiency.
Carol Garsi provided excellent leadership of the ICD-10 coding activities including a massive training and certification effort across on the entities. She led by example with her own commitment to learning and becoming expert in ICD-10 coding
Becky Revand provided vitally important leadership of the integration to the Cerner electronic medical record. She was the primary troubleshooter for various technical issues and workflow related changes.
In the true spirit of entreprenuership these team members deserve to be recognized as a distinguished team for their contributions to the ICD-10 program. In the beginning no one knew what the program should look like, or what was involved. They just knew it had to be done. Sarah, along with her team, developed goals, vision, organization structure, job descriptions, and infrastructure. They turned ICD-10 into a strategic opportunity that could be leveraged to both achieve stated strategic initiatives as well as significantly move UW Medicine along a path of integration. Applying that leverage meant approaching the ICD-10 transition as an opportunity to engage in conversations and collaboration with every project or operational area that was touched. They were, by anyone’s definition eminently successful.