Lessons Learned: ICD-10 Implementation around the Globe

flagsICD-10 was developed by the World Health Organization in 1993 and was adopted by the vast majority of countries by 2000. Today, the United States and Italy are the only two major industrialized nations that continue to use ICD-9. Each country had their own unique challenges when transitioning to ICD-10. Some transitions were smooth while others deemed disastrous. Success Down Under Australia is viewed as the gold standard for a smooth transition. Their heavy emphasis on education, training and testing made for a relatively painless transition. This was further enhanced by an exuberance from coders to improve their systems and learn how to use the new system. While Australia’s health system is similar to the United States, one distinct advantage to their transition was that their hospitals had a single diagnosis-related group (DRG). Oh Canada! In stark contrast, Canada’s adoption is considered a disaster. A perfect storm of circumstances created rough waters for Canada’s transition:

  • First, Canada did not allocate enough time for training,
  • Coders were moved from paper-based processes to Windows-based platforms, at a time when the technology was still new causing resistance to change and a delay in training, and
  • Providers relied too much on software vendors and internal IT to solve the problem.

As a result productivity plummeted. Reports indicated that productivity was reduced between 23 and 50 percent and never fully recovered. Lessons Learned So what can the U.S. learn from other countries successes and failures?

  1. Be prepared – it sounds trite but preparation will be the key to coming out of this transition relatively unscathed. Don’t skimp on training. Doctors will not be able to learn this on the fly, coders will need to be recertified, and AR and billing people will need to understand the new coding schema.
  2. Make sure you have willing participants – Talk to your staff early about their willingness to make this transition. If they are not, hire new staff that will. Team support will be a key to success.
  3. Update your technology – engage with someone that has already made the investment in tools, systems and training and can provide a turnkey solution for your practice. By working with a company that is wholly focused on business operations and revenue cycle optimization, practices can maintain control over all clinical decisions and thrive as an independent practice.

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