East Jefferson Conducts Organizational ICD-10 Readiness Assessment

East Jefferson General Hospital is a parish-owned hospital that provides a broad range of inpatient acute care, ancillary, and outpatient services for patients in Jefferson Parish, a suburb of New Orleans. The hospital has 450 beds, and patients are served by a staff of more than 3,000 team members and over 700 physicians. In 2002, East Jefferson became the first hospital in Louisiana to earn the prestigious Magnet Status for nursing excellence from the American Nurses Credentialing Center. In 2006, the organization was one of only a handful of hospitals able to raise their standards high enough to earn the distinction of being renewed as a Nurse Magnet Hospital.

THE CHALLENGE

East Jefferson was in the initial stages of planning for ICD-10 conversion and wanted an independent third party to assess its readiness for ICD-10 migration by performing a gap analysis; identifying risks, opportunities, and potential impacts; and developing an implementation strategy and roadmap.

THE SOLUTION

Because of Aspen Advisors’ recent ICD-10 assessment experience, expertise in revenue cycle operations and systems, and proven assessment and implementation planning methodology, Aspen was engaged to focus on East Jefferson’s business and clinical areas along with its application suite to identify impacts and risks to achieving ICD-10 compliance. Aspen completed a business partner and vendor readiness assessment to assess plans for reaching compliance and to gain knowledge of their timelines and coordination efforts with East Jefferson. Aspen also performed a general business assessment and technology assessment to gain a full understanding of the impacts and to incorporate these into the future phases of this initiative. Specific engagement objectives included:

• Identifying the key impact that the ICD-10 requirements would have on East Jefferson’s core business and systems. The gap analysis focused on the following focus areas:
  • Impacts to the staff, changes to work processes, and coding procedures;
  • Business processes to include key workflows; and
  • Technology environment including interfaces, reports, registries, and vendor systems.
• Developing additional gap analysis of workflows and work processes related specifically to coding performed in HIM, patient financial services, other revenue cycle management departments, and other departments that code using ICD-9;
• Assessing the role and impact of ICD-10 on other East Jefferson initiatives planned or underway;
• Assessing vendor, provider, and payer readiness;
• Providing direction on ICD-10 compliance positioning and strategy;
• Identifying planning recommendations and action plans; and
• Developing executive-level presentations based on findings, including next steps, recommendations, and estimated funding requirements.

THE RESULTS

At the conclusion of the assessment, East Jefferson had a comprehensive understanding of the ICD-10 impacts along with a recommended strategy, action-plan, and funding requirements. The goals of the ICD-10 implementation plan included:

• Complying with HHS’ final ICD-10 rule by the mandated date with minimum disruption to its revenue;
• Maximizing efficiency and accuracy of claims processing of claims through more specific diagnoses coding;
• Maximizing net reimbursement;
• Obtaining sufficient training and education for all impacted areas to ensure a successful implementation;
• Achieving concurrent system and process interoperability for ICD-9 and ICD-10 transactions;
• Achieving clinical documentation readiness; and
• Implementing process improvements for all key components needed to support the new ICD-10 coding requirements.