GE Healthcare. ICD-10 preparation and new problem search: Centricity EMR v9.8

Transcription

1 GE Healthcare ICD-10 preparation and new problem search: Centricity EMR v9.8 Geoff Lay, Product Manager David Gonzalez, MD, Senior Medical Informaticist December 5th, 2013

2 2013 General Electric Company All rights reserved. This does not constitute a representation or warranty or documentation regarding the product or service featured. All illustrations are provided as fictional examples only. Your product features and configuration may be different than those shown. Information contained herein is proprietary to GE. No part of this publication may be reproduced for any purpose without written permission of GE. DESCRIPTIONS OF FUTURE FUNCTIONALITY REFLECT CURRENT PRODUCT DIRECTION, ARE FOR INFORMATIONAL PURPOSES ONLY AND DO NOT CONSTITUTE A COMMITMENT TO PROVIDE SPECIFIC FUNCTIONALITY. TIMING AND AVAILABILITY REMAIN AT GE S DISCRETION AND ARE SUBJECT TO CHANGE AND APPLICABLE REGULATORY CLEARANCE. GE, the GE Monogram, Centricity and imagination at work are trademarks of General Electric Company. General Electric Company, by and through its GE Healthcare division.

3 Today s discussion What is ICD-10? What does ICD-10 mean to my practice? How will Centricity EMR v9.8 support ICD-10? How do I plan for ICD-10? What documentation is available?

4 What is ICD-10?

5 CMS Regulatory Requirement International Statistical Classification of Diseases and Related Health Problems, 10th Revision ICD-10 is a diagnostic coding system implemented by the World Health Organization (WHO) in 1993 to replace ICD-9, which was developed by WHO in the 1970s. ICD-10 CM = Clinical Modification (Diagnosis Codes) ICD-10 PCS = Procedural coding system (Hospital only) ICD-9-CM ICD-10-CM 3-5 Digits in length 3-7 Digits in length Mostly only numeric Alpha-numeric 14,025 codes 90,000+codes

6 Increase in the level of specificity R46.1 = bizarre personal appearance R46.0 = very low level of personal hygiene W22.02XA = walked into lamppost, initial encounter W22.02XD = walked into lamppost, subsequent encounter V91.07XA = burn due to water-skis on fire W59.21 = bitten by turtle

7 What does ICD-10 mean to my practice?

8 Potential challenges with ICD Clinical documentation (much more specificity) 2. Shortage of experienced and trained coders 3. Productivity decrease (coders and clinicians) 4. Training expenses (coders) 5. Potential for increased reporting requirements 6. Increased claim denials (provider errors and payer processing errors) Source:

9 ICD-10 areas of impact Need to identify all current locations of the implementation of ICD-9 codes the ICD-10 codes will take their place. This includes Practice management/emr systems Encounter forms/superbills Paper and electronic claim formats Payer contracts Public health and quality reporting protocols Interface capabilities Nothing herein shall be construed as legal advice. Please consult your own advisers as necessary.

10 Determine your ICD-10 go-live date Don t let the regulation date drive your business Let the system do the work Train your teams to meet your timeline for ICD-10 Set the system date to your date code in ICD-10 System will send your selected ICD-10 or ICD-9 codes based on system settings Healthcare professionals are responsible for making independent clinical decisions and appropriately billing, coding, and documenting their services.

11 How does Centricity EMR v9.8 support ICD-10?

12 Centricity EMR v9.8 Regulatory compliance Intelligent cross-mapping of terms, with side-byside view New smart/easy term searching, based on the power of MQIC Pre-population of possible ICD-10 matches The base mapped ICD-10 is intended as a starting point and educational tool. It is not intended to determine what ICD-10 code users will select after their ICD-10 transition date. Coding decisions are the sole responsibility of the customer.

13 Practice flexibility for ICD-10 coding 1. New Search Engine 2. Familiarize Clinicians and Coders = Display ICD-9 to ICD-10 base mapped code 3. Decision effort for claims = Mapped ICD-10 to ICD-9

14 Custom lists remain but display both ICD-9 and their base mapped ICD-10 Existing ICD-9 problems are mapped to the base ICD-10 Practices need to review custom problem lists Some codes will not have a base ICD-10

15 EMR 9.8 & Custom Problem Lists Prior to Upgrading to CPS 11/12 or CEMR 9.8 Practices will need to decide on their Problem List strategy 1. Update or create new ICD-10 Custom Lists for the ICD-10 transition date (this will limit the return results in both the smart search and the full search to only the codes in this list) 2. Begin using the smart search

16 Problem Search Pre CPS11/CEMR 9.8

17 Introducing the Smart List. A new form of custom list Search results are based on usage data collected from MQIC. The most often used descriptions (synonyms) for the most often used codes. You can search by Description or by Code The Smart List also learns which problems users edit more than once and updates the priority in the search result Tool is being built to customize priority of codes

18 You have a choice Custom Problem List vs. Smart Search Smart Search Find codes by commonly used descriptions. Search by Description or by Code Train the search by modifying codes with unique descriptions No need to maintain custom list content Custom Problem List Limit the codes returned to those your practice Coders have approved for the list Search by Description or by Code Maintain Custom List based on coding changes.

19 When searching for problems The problem list drop down search will display both ICD-9 and its mapped base ICD-10. Smart search will return common descriptions based on MQIC data.

20 Custom list drop down results will be limited to the custom list content Example: CCC Abdominal Pain Custom List will display 5 results in the drop down. Notice that the same diagnosis is repeated multiple times for The search works by searching on the first characters of the description or the code from the custom list. Returning the first results that match Since is in the custom list with 3 descriptions that begin with Ab it takes up the first 3 spots in the return.

21 Custom list drop down options When using a custom list you can click the down arrow to display the rest of the list

22 There are options available to make results return without using the down arrow Enter more of the description to return results based on the descriptions in the custom list Customize the descriptions and remove duplicate descriptions in the custom list so the return will provide less duplicates For example entering abdominal pain, eliminates some of the duplicate code results

23 How does the search learn? If a user is using the Smart Search and they select a code from the list then modify the description more than once that description will move higher in the priority order on the search.

24 Full search content is determined by a users default custom list Users can switch between custom lists options from the New Problem Dialog to change the content in the full search. Default Custom Lists can be associated From Options Preferences, Patient Chart, Custom Lists

25 Full search results returned based on the ability to match inputs with results Input abd Results returned Chapters that contain descriptions or codes that include abd Input abdominal pain Results returned codes with descriptions beginning with or containing abdominal pain If more than 60 matches return the Find Problem Dialog returns the Chapters containing the results

26 Familiarizing clinical users with ICD-10

27 Existing problem lists will display both ICD-9 & the base mapped ICD-10 The base mapped ICD-10 is intended as a starting point and educational tool. It is not intended to determine what ICD-10 code users will select after their ICD-10 transition date.

28 Managing patient problem list transition to ICD-10 Practices will need to have a policy/process in place to update patient problem lists for the ICD-10 transition date Practices may choose to review the problem lists for patients scheduled in advance to determine the appropriate ICD-10 problem Practices may choose to create Custom Problem Lists, modify the descriptions for the ICD-10 problems and add an identifier such as a * to indicate a problem is ICD-10.

29 Formal descriptions vs. custom descriptions Custom descriptions will display in the Problem List. The formal ICD descriptions will display when the user hovers the mouse over a code. The formal ICD descriptions display when bypassing the smart search and using full search. Users require a system privilege to modify the description in the patient problem list.

30 How do I plan for ICD-10?

31 Mel Symbols have been updated for Encounter Forms MEL_CHANGE_PROBLEM MEL_REMOVE_PROBLEM New Symbol New Symbol LIST_ASSESSMENTS MEL_ADD_ASSESSMENT MEL_ADD_MEDICATION MEL_ADD_ORDER MEL_ADD_PROBLEM ORD_INDICATIONS ORD_WITH_DIAG ORDERS_AFTER ORDERS_ALL ORDERS_NEW ORDERS_PRIOR PROB_AFTER PROB_LIST_CHANGES PROB_NEW PROB_PRIOR PROB_REMOVED PROBLEM_CUST_LIST Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10 Updated for ICD-10

32 How will my clinical workflows change?

33 Clinical Workflow Summary 1. Providers will be able to utilize smart search or custom lists 2. Providers can become familiar with mappings of commonly used codes 3. When an organization determines their ICD- 10 go live date providers will be need to select ICD-10 codes when ordering services

34 What should practices be doing? Determine when your practice can adopt an ICD-10 compatible version of the product Confirm you are hardware ready Make sure you have a plan to train internal staff on ICD-10 this could include but is not limited to: Understanding internal process changes Identifying current common ICD-9 usage that will need more specificity in ICD-10 Tracking payer adoption of ICD-10 via CEDI Gateway

35 What versions are compliant for which regulatory requirements? Version CPS Version EMR GA Date Oct Oct Dec ETA 2013 Regulation Meaningful Use (MU) 2011 edition 5010(CPS) ICD 10(CPS) ICD 10(EMR) MU2014 edition (Stages 1 & 2) NOTE Prior versions not certified for MU1 or MU2 in 2014

36 Prepare for EMR 9.8 Review the preliminary HW Specifications and watch the Webinar on the Services Portal: Participate in future Webinars Consider GE ICD-10 Service offerings

37 Three ICD-10 services designed to meet the specific needs of direct customers Accelerator 360 Customized An interactive, web-based education and optimization program Education of regulation and operational requirements Review of ICD-10 reports, including any needed configuration, and results interpretation. A combination of virtual sessions and 2 day on-site planning Education of regulation and operational requirements Workflow mapping review of required coding, data exchange, set up and claims management Training plan Pre and Post Go-Live planning A comprehensive full service program that provides a complement of services based on customer needs Accounts for custom needs around workflow, and can include review and testing of interfaces. Aimed at organizations with 30 or more providers and/or multi-specialty practices. VAR customers: contact your VAR representative for available services

38 Centricity LIVE May 4 7, 2014 Denver, CO Visit gehealthcare.com/centricitylive for all the details and register now! Centricity* LIVE 2014 is GE Healthcare s IT User Meeting held in Denver, CO from May 4 th to the 7 th. It is an annual gathering of GE Healthcare customers, Centricity users, administrators and hospital executives coming together to share, learn and network. We look forward to seeing you in the Mile High City and working with you to take healthcare IT to new heights! *Trademark of General Electric Company.

39 Thank you for joining us. Questions NOTE: We will send you an after this session with a link to the services portal, where you can download the slides and watch the recording.

40