Physician Assistants Can Help With ICD-10 Implementation

Like it or not, modern medicine is increasingly becoming a data-driven machine. And, practice and inpatient revenue is increasingly being tied to the data as well as the success of outcomes. Documentation is everything in ensuring that we get reimbursed appropriately for the work that we do. This significant shift in the practice of medicine falls especially hard on the practitioners who graduated more than 20 years ago.

The current system for documenting disease and diagnoses, ICD-9, was implemented in 1979. A lot has changed since then. The transition from ICD-9 to ICD-10 codes is rapidly approaching. On Oct. 1, 2014, we will be required to implement ICD-10. The current system is more than 35 years old and does not provide for the level of detail that the new health care system requires be collected.

The new ICD-10 coding system will allow for a significantly higher level of precision, laterality, as well as disease detail which will make it easier to track the costs of healthcare as well as the outcomes for various diagnoses and treatments. The documentation burden is going to fall squarely on physicians and other providers in the healthcare team. This will increase the importance of competence utilizing the EHR but will also increase the time and effort required to meet these new data collection challenges.

The computer era was supposed to mean that we all would work more efficiently, and would get the job done in less time, with less effort. This promise has not panned out completely, and has contributed to a heavier and more complex workload for the average provider.

I have been a strong promoter of the physician-physician assistant (PA) team in my blogs. One good reason to include a PA in your practice team is demographics. One interesting statistic is that nearly one-half of the currently practicing PA profession has graduated from training in the last five years. This alone ensures that these healthcare providers and team members have a strong grounding in computer skills as well as EHR use. The medical student of today has to possess strong computed skills to survive medical training.

I have been training PA and medical students for a number of years now, and I make the EHR a focal point of the student's experience on our rotation. Most of these students will never touch a paper medical record once they begin practice. This is the future of our professions, and in the interim, including a PA in your team will help ease the transition to ICD-10, and full implementation of the EHR.

I have directly observed a significant amount of frustration on the part of physicians and other providers as we have implemented an EHR at our facility. The new ICD-10 coding system will increase the work required to accurately document procedures and visits so that accurate billing can be performed. But, there is a positive tradeoff.

Any provider will then have rapid access to a wealth of patient data, which was previously buried in a paper chart, and required significant effort to find and collate.

Technical and computer skills have never been more important than they are right now. The administrative documentation of medicine has dramatically changed and accelerated over the last decade. There is a profound mismatch between the required technical skills and the actual technical skills of the physician and provider workforce in the United States. The only realistic way that this reality will be changed is as the younger physician and provider workforce replaces the older retiring workforce. In the interim, there is hope.