As the ICD-10 debate blazes on, fueled by the one-year delay recently announced by the U.S. Department of Health and Human Services, it helps to put the initiative in perspective, finds an industry veteran.
ICD-10 is a controversial program but it's an important one said Carl Ascenzo, vice president, global healthcare solutions at Virtusa, a Massachusetts-based IT consulting and software development firm, because implementation will bring improvements to healthcare providers and payers.
This is not to say that the program doesn't have downsides, said Ascenzo, who has spent more than 20 years as a senior leader in healthcare IT.
Although he expects ICD-10 to be beneficial to healthcare providers and payers, it is controversial because it is a drain on financial and personnel resources, said Ascenzo.
"(ICD-10) is diverting those precious resources from other initiatives, particularly strategic initiatives, that organizations want to pursue to deal with things like accountable care," he said.
Ascenzo also believes ICD-10 is a touchy topic because stakeholders think their investments of time and money won't be rewarded quickly.
"Although the new level of granularity is going to realize a lot of benefits across the healthcare industry, from research to delivery, I think organizations feel that is a longer term benefit," he said.
Different organizations of varying size and scope have different capabilities when it comes to implementing a large change such as ICD-10, said Ascenzo.
"The other thing is the stratification of the healthcare system, particularly on the provider side, is such that organizations have vastly different priorities and access to resources to do this," he said. "Payers and larger hospital systems have the resources and see the strategic benefit of (ICD-10). The smaller players, although they may see the strategic benefit, don't have the resources to do something this involved."
One possible solution is to stagger implementation so larger institutions lead the way and give smaller businesses more time to tackle the conversion process, said Ascenzo.
"I'm in favor of the staggered approach because I think there will be real reasons in some of the market segments for why they have difficulty complying and not just complying but in a quality manner, which is really important for both clinical and financial reasons," said Ascenzo. "It makes sense to start with larger institutions."
Whatever the implementation strategy, Ascenzo believes the industry should move forward with ICD-10 as quickly as possible and does not favor skipping to ICD-11 because the delay would "be way too long and really postpone the realization of benefits from ICD-10."
"I think it's an evolutionary process of us improving the system," added Ascenzo. "It's a journey that we are on in improving medicine and the delivery of medicine. In an evolution there are improvements and some improvements are much larger than others in the values that they bring. I see ICD-10 as one of those major improvements. The sooner we can get there and fully utilize and harvest the benefits to ICD-10 and its granular way of coding, I think is very, very important. We really should move with all expediency but do it in a way that doesn't impede quality."