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field "the ICD-9 character field [is] limited to a certain number of characters. If the software has allowed ICD-9 to have a number of characters that can handle ICD-10 standards, that shouldn't be as much of an issue. If not, they will have to redo a lot of their coding to allow for field." a larger data field." But beyond the level of software development, does the parallel hold? The RAND institute predicts $425 $425 MILLION TO $1.15 $1.15 BILLION in ICD-10 IT and training expenses nationwide. Challenge and Change ICD-10 implementation, like Y2K, inspires cycles of denial and alarm, because people tend to get frantic before they prepare. With ICD-10 approaching fast on the heels of 5010, David Dickey, CIO for Global Healthcare Alliance, sees a lot of "panicked people out there." Part of that panic is warranted, considering the need to test during the next 12 to 24 months. "ICD-10 is right down the road," Dickey says. "Right now your systems 28 | Twin Cities MD NEWS I MDNEWS.COM need to be developed and prepped to be able to take in those vast new amounts of code and vast new relationships. You need to ask yourself, 'Could I put ICD-10 code in [my] system today?' "Now that is the real way of looking at it, because in order to successfully test and integrate and work with your payers and work with your physicians and work with the CIO…you need to be loading those codes now so that you can actually test in the future." In the IT World, Crisis Fosters Community… Just as Y2K resulted in greater collaborafield, tion across the IT field, ICD-10 is creating collegiality within health care IT. "On the IT side of health care, we do have a collaborative spirit," Dickey says. "When it comes to changes like 5010 and ICD-10…we openly share those things, and we collaborate around them. We have people raising their hands and saying, 'Yes, I want to contribute, and I want my voice to be heard.' I'm very proud of [the IT] side of the world." At the software level, as well as the human level, ICD-10 militates toward greater connectivity. Despite efforts by various standards organizations to impose order, the different systems of application level technology still don't play together well. The transition between code sets highlights software packages that promote interoperability and pinches those that don't. A major challenge with accountable care organizations (ACOs), says Emdeon Vice President of Product Management Gene Boerger, is they're all on disparate systems. It's difficult to draw on difficult aggregate data to reduce costs, eliminate redundant services and manage care. With ICD-10, the problem could be exacerbated. "You have timing problems," Boerger says. "If I submit claims the day after or two days after ICD-10 goes into place, I'm going to have ICD-9 claims in the same batch. I need to understand that." Security Brief On the surface, ICD-10 implementation doesn't drastically change the healthcare information security picture except insofar as Between $5.5 & $5.5 $13.5 $13.5 BILLION will be spent during ICD-10 implementation.

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