CIO Drexel DeFord: ICD-10 'could put us out of business if we don't get it right'

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If there are leaders at your organization who still don't "get" the importance of converting to the ICD-10 coding system, Seattle Children's Hospital & Research Institute CIO Drexel DeFord sums it up bluntly: ICD-10, if not done right, could put healthcare organizations out of business, he says.

DeFord, who is the current chair of the College of Healthcare Information Management Executives (CHIME) will be one of four health IT experts on FierceHealthIT's exclusive ICD-10 preparedness panel at this year's HIMSS conference in Las Vegas: "ICD-10 Readiness for Hospital Leaders." (The breakfast panel requires special registration and takes place on Wednesday, Feb. 22 from 7 to 8:30 a.m.)

In part 2 of his exclusive interview with FierceHealthIT, DeFord explains how his organization laid a foundation for its ICD-10 preparedness projects and talks about the ICD-10 messages that most resonate with C-suite leaders, physicians and researchers.

FierceHealthIT: Your organization is well ahead in ICD-10 preparedness efforts. What were some of the early steps you took to build a solid foundation for the project?

DeFord: There's a lot of detail in the plan that we have-very high level. But we started off by doing familiarization. That involved teaming up with our external auditor. And they were very familiar with what was going to happen with ICD-10, but I really needed to make sure that my chief financial officer got the message. After some good conversations between our CFO and the auditor, it definitely clicked. And now other leaders are involved--the CMO and CFO--the president of the hospital is on the steering committee. Executive buy-in drives the resources that are necessary to actually get this done.

One of the biggest pieces of it was having a really good project manager step into the role, become really familiar with everything that might happen as a result of ICD-10 and then very consciously line up the resources and the leadership support necessary to define and think through the projects.

She has really built out an ICD-10 program with a multitude of projects underneath it. Projects are broken into separate categories. They include health information management projects, clinical care and provider projects, information services projects, our own application readiness testing, and then revenue cycle and finance projects. There's also a cross-project, a foundational project--the overall management of the ICD-10 program.

FHIT: You've mentioned the importance of executive buy-in. What are some of the ICD-10 messages that resonate with C-suite leaders?

DeFord: Every individual organization is, culturally, a little different. At Seattle Children's, while we have a lot of great trust inside of the organization for each other, sometimes the thing that really pushes the CEO or the CFO's button is an external expert resource that they trust in and talk to regularly. In this case, it was our external auditor. We had had conversations about it and our CFO definitely understood this is going to be a big deal--it's going to affect a lot of things.

But she came back from an ICD-10 presentation with our auditor really on fire. She had read it, she knew about it, but to hear someone say it and to really understand this could be something that could put us out of business if we don't get it right.

This is too important to let the vendors just figure it out on their own. Somebody needs to run and control this program to make sure everything gets to where it needs to be by the deadline, so that you've done everything you can to make sure that, in the end, you stay in business.

FHIT: What are the benefits of ICD-10 to clinicians and researchers?

DeFord: When we talk about the physicians we talk a lot about the benefits, ultimately, that will come from ICD-10. More accurate payment for procedures, fewer rejected claims, fewer improper claims, better understanding of health conditions and monitoring and reporting of disease from a public health perspective. And that really rings bells with them.

In the research community, many of them have been messing around for years trying to make coding more specific for the things they are trying to do in the areas they are trying to research. So from a research perspective, they're going to be happy that there's more specificity that will help them be more precise in their research.

There's a lot of ways to go about it. Sometimes it is personality-based organizationally culture-based. You have to be savvy enough to look at the situation and say how am I going to make sure I turn on the light in my organization?

Editor's note: This interview has been edited for length and clarity.

Hear more from DeFord at the FierceHealthIT breakfast panel, "ICD-10 Readiness for Hospital Leaders," on Wednesday, Feb. 22 at the HIMSS conference in Las Vegas. Ford will be joined on the panel by Stephen Stewart, CIO of Henry County Health Center; Carole A. McEwan, ICD-10 migration project manager at SSM Health Care; and Roy Foster, director of regulatory compliance practice at Cerner.

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