Conference takeways: Quality, outpatient CDI, ICD-10 and the real world

I have been quite deficient in blog posts over the previous couple of months.  This is partially due to the work involved in preparing my presentations for the recent 3M Client Experience Summit and the annual ACDIS conference.  In the whirlwind of attending conferences, speaking at sessions, travel, etc., I have some random (and not so random) thoughts and observations that I would like to share!

• It’s all about quality and outpatient CDI

The bulk of the sessions at ACDIS focused on quality or outpatient CDI in one way or another. The leadership tracks included many great sessions, but each emphasized the impact of quality on performance metrics and productivity, as well as how outpatient CDI should be performed and its reporting structure. The clinical tracks focused on the specifics of quality measurement and performance improvement initiatives. The revenue cycle tracks focused on the implications of quality and outpatient CDI on revenue cycle processes. And every one of the general sessions discussed how to stay afloat in the sea of change that is happening in health care (of course due to expansion in quality reporting and outpatient CDI). However, I want to caution everyone a little. The “traditional” CDI work must continue. Let’s not replace “this with that,” but rather include both “this and that” and evaluate what it will take to perform all of these tasks well.

• ICD-10 is still a work in progress

There is still a great need for education and more important, application of both the ICD-10-CM and PCS codes. I heard a great deal of concern about the PCS codes, but there are also many differences between ICD-9-CM and ICD-10-CM. Although education modules, classes, and training workshops can prepare one for using ICD-10-CM, only day-to-day application can teach us what we know (and don’t know). For myself, the more I know about ICD-10-CM, the more questions I ultimately have. And I realize that none of us will be experts in ICD-10-CM for several years. Additionally, the code set is still a work in progress, especially since the code freeze is now over. And let’s not forget that only after reviewing several years of claims data, can accurate and meaningful adjustments be made to DRG weights, codes and designation of CCs and MCCs. 

Thinking about PCS, I have learned that surgeons are inventing or modifying procedures faster than PCS can adapt. This leads to a great deal of confusion, frustration and plain lack of knowledge when applying codes. My same caveat about ICD-10-CM must be applied here as well. The day-to-day application of ICD-10 codes is essential (watch for my upcoming blog on ICD-10-PCS, co-authored with 3M blogger Donna Smith).

• “Getting to Know You!” (sing along if you know it and just ignore it if you don’t!)

The best lesson I learned is the importance of attending conferences and workshops. Not only do you get access to essential education and the chance to eat great food, there are opportunities to hear perspectives from many different regions of the country and learn about different practices that can challenge you, encourage you and educate you. My best “takeaways” were the connections. It was great seeing some of my “old” friends/clients, but it was equally fun making new friends and learning about what is working well at their organizations and where they are struggling. In listening to attendees’ comments in education sessions, at 3M’s booth or during my presentations, I observed that many people not only want to interact with the speakers, but with each other. Learning about real-world experiences in facing challenges and operationalizing ideas is so much better than hearing advice to “just do it.”  I encourage everyone to engage with their new connections in the coming months to take advantage of the collaboration and enthusiasm that you experienced at the 3M Client Experience Summit, ACDIS and other recent industry conferences.

See you at the AHIMA CDI Summit in August! 

Cheryl Manchenton is a senior inpatient consultant and project manager for 3M Health Information Systems.