WEDI - Lessons learned from ICD-10 implementation

With the implementation of ICD-10 essentially behind us, it’s tempting to move on to other efforts and breathe a deep sigh of relief.  However, there are valuable lessons we learned from this large undertaking that can help with future efforts of this magnitude.  The transition to ICD-10 was very successful and it’s important to understand why.

The Workgroup for Electronic Data Interchange (WEDI) recently completed two initiatives that draw from the ICD-10 experience.   One is an industry post-implementation survey and the other is an issue brief on testing lessons learned.  Each of these offers insights into approaches that were effective and those that were not. The following contains a few highlights from these products.

ICD-10 Post-implementation Survey

WEDI has been conducting ICD-10 readiness surveys since 2009 to gauge the status of industry implementation progress. On Oct. 1, 2015, the industry converted to ICD-10 in what some have called a non-eventful transition. In order to assess why the transition went so well and to leverage lessons learned for future large implementations, WEDI launched a post-implementation survey in March 2016. It’s important to note that this survey had a low response rate, possibly indicating the reassignment of ICD-10 project personnel and likely a lack of interest in further ICD-10-related activities that are not operational in nature.  Analysis of the responses shows the following:

  • While the changes to the compliance date added cost for many organizations, causing a lack of momentum, it also provided time for additional testing and a smoother transition.
  • Some common themes reflected in the responses indicate the value of starting early, communicating with trading partners, and conducting extensive testing.
  • The CMS ICD-10 website, including Road to 10, the WEDI website and coding materials from industry organizations were cited as being the most helpful.
  • While the impact to productivity was primarily neutral for vendors and health plans, there was a slight decrease in productivity for providers.

ICD-10 Testing Lessons Learned

WEDI’s ICD-10 testing sub-workgroup solicited members to submit a list of items they identified as representing important knowledge gained during the testing phase of ICD-10.   These lists were compiled into a document that provides useful lessons to consider for other large testing efforts.  Some key lessons include:

  • Early communication with vendors is critical to assure that products or services will be available in time for customer testing and that they will offer the desired functionality. Frequently organizations are using significantly older versions of software that must be upgraded to the current release.  Purchase agreements may not always include costs for these upgrades so there may be budget implications as well.
  • Customers should not rely solely on software vendors for testing. Often, software is customized at the customer location.  Business processes can also have an impact.  Just because a product was tested extensively elsewhere, it doesn’t mean it will work the way you expect it to in your environment.  
  • Testing is not just an IT function. Business knowledge is essential to effective testing. Internal processes must be tested to assure they provide the information necessary to properly use products/services.  To accomplish this may also require special training of business staff.
  • Don’t wait until the last minute to test with trading partners. Just like a rush hour traffic jam, it’s not reasonable to have everyone test concurrently.  If you wait too long, your trading partners may not be able to accommodate your testing request.
  • Avoid testing with trading partners until your systems are working correctly. If your internal processes and applications contain too many flaws, test results will be unreliable and precious time and effort will be wasted.
  • Communicate with trading partners regarding the test process. You need to know how to submit test transactions and whether special data requirements exist, such as dates or identifiers.

The above reflects a few key points extracted from the survey and issue brief.  For the full documents, please visit the WEDI website at www.wedi.org.

About the author: Jim served on the leadership team that oversaw the creation of the 2013 WEDI report.  Jim is a past recipient of WEDI’s Chairman’s Award, Distinguished Service Award and the Andrew H. Melczer Excellence in Volunteerism Award.  He is frequently quoted in industry publications and speaks nationally regarding industry issues related to health IT. He also served as a commissioner with EHNAC.