By: Barbara Aubry
During its semi-annual policy making sessions, the American Medical Association released its resolutions to stop the implementation of the ICD-10 CM (diagnosis) and PCS (procedure codes) implementation. CMS responded that it does not intend to alter its ICD-10 migration go-live date of October 2013. Specifically, the AMA resolved to “vigorously work to stop the implementation of ICD-10 and reduce its unnecessary and significant burdens on the practice of medicine.” It further resolved that it will “do everything possible to let the physicians of America know the AMA is fighting…on their behalf.” And finally, it announced its intention to work with other national and state medical and informatics associations to determine an appropriate replacement for ICD-9.
What? Are they serious?
I’m lucky – my personal physician is willing to talk regulations with me. She and her partners in a large multispecialty group are fed up. Up to their eyeballs in regulatory changes and demands on physicians and ICD-10 seems to be the proverbial ‘icing on the cake.’ She tells me her patients complain about seeing doctors who can’t fully listen to them because they are busy typing in their EHR data entry system. When there is no eye contact some worry their doctor is not hearing them. At the same time, patients like the convenience of electronic prescribing and the overall idea of technically wired medicine, but do not want to give up any of the ‘humanness’ of the doctor-patient encounter.
In my opinion, there’s an issue with ICD-10 that physicians are less willing to discuss and that is its innate demand for greater documentation specificity, which will force them to improve their documentation practices. A very good thing for data accuracy and continuity of care, but it may come at a cost. Documenting more precisely takes time and in medicine as in so many industries, time is money. Will patients be willing to bear an increased cost of a visit with their doctor? Will payers consider the increased amount of time it may take physicians to document patient encounters in ICD-10? Are they willing to increase reimbursement to help make the transition less painful? Finally, will some physicians continue to resist new technology and automated tools, even if it makes the documentation process much easier?
Healthcare providers have heard enough about ICD-10 to know implementation will be a challenge. The AMA appears to be positioning itself as the David protecting the interests of the small physician practice against the onslaught of the governmental Goliath and its demands and regulations. I hope not. At the end of the day, ICD-10 opens up new opportunities for clinical research, business analytics, and better quality outcomes data. Attempts to postpone ICD-10 and avoid technological improvements and advancements will not benefit the patients they serve.