D'Arcy Gue

ICD-10 and Meaningful Use / MIPS: Competing or Supporting Initiatives?

July 18, 2013

ICD-10, Meaningful Use / MIPS 3 Minute Read

ICD-10 and Meaningful Use / MIPS: When Worlds Collide.” This was the curiously provocative title of an educational session during the HIMSS 2013 Conference in New Orleans. Clearly, it was intended to unnerve the most hardened healthcare professional.

The fact is, healthcare professionals are hardened, but in a good way. Give us HIPAA, ARRA, HITECH, ICD-10, you name it…we’ve been handling federal mandates for a while, and are doing it pretty well. We can see that, in terms of long range objectives, these initiatives are all tied together. An easy example: without meeting HIPAA’s standards to protect electronic health information (PHI), the industry’s move from paper to Stage 1 Meaningful Use / MIPS of electronic health records (EHRs)  would have been “meaningless” and even “cyber-dangerous.”icd-10 and Meaningful Use / MIPS

Similarly, the idea that ICD-10 and Meaningful Use / MIPS are competing problems, rather than complementary initiatives, is misleading. Understandably, many of those who have managed the daunting realities of meeting MU Stage 1 requirements — new systems, staffing, costs and other business priorities — have leaned toward this perspective. ICD-10 was delayed a year to help us out.

Now, for most of us, Stage 1 is done. It’s time for Stage 2.  Meaningful Use / MIPS Stage 2 objectives cannot be achieved without ICD-10.

As HHS Secretary Kathleen Sebelius noted recently: “Any further delay [of ICD-10] would be a distinct disadvantage to CMS and the industry because ICD-10 is integrated into other e-health initiatives. CMS is depending upon the granularity of ICD-10 data to contribute to ‘improved quality and outcomes data, provide cost effective approaches to delivering health care, and supply us with information for better research.’”

Objectives of Meaningful Use / MIPS Stage 2 include (but aren’t limited to):

  • Health information exchange across healthcare organizations and their disparate IT systems
  • Patient engagement via EHR access to provider-based patient portals
  • Improvements in the reporting of quality measures by using correct, appropriate data that is codified

Without applying the highly accurate granularity of ICD-10 — the coding standard of the rest of the world — to our documentation and systems, it will be very difficult to achieve the above. Other consequences of Meaningful Use / MIPS without ICD-10 are:

  • Information exchange would be vagueness-in, vagueness-out.
  • Patients would be confused by portal-based personal health data that is incomplete, even inaccurate.
  • Quality measurement would remain tethered to obsolete documentation.

Yes, the deadlines overlap. Or, rather, consider that they are aligned. Vendors are taking note: how many want to roll out two upgrades,  rather than just one that addresses these interwoven mandates?

Increasingly, we are seeing that hospitals also are recognizing the benefits of aligning these two initiatives, by emphasizing clinical documentation improvement measures that will positively impact clinical, financial and administrative performance.  At the same time, by combining efforts such as education and workflow changes, they can minimize certain costly redundancies.

Farzad Mostashari, the National Coordinator for Health Information Technology (ONC), recently said that he believes ICD-10 can be a motivator for providers. “I’m seeing that if we can get the synergy going … people seeing if I have a Meaningful Use / MIPS certified EHR, if I have clinical documentation, then it’s easier for me to get to ICD-10.  Then that’s another reason for me to move forward.”

All of this is a lot of work, once again. But the industry’s Meaningful Use / MIPS accomplishments have been impressive thus far. Let’s keep that momentum going, and reap the rewards.

For a report on the rewards of ICD-10 and the positive impact it will have on the healthcare industry, download our Benefits of ICD-10 report.




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