2014 July 15 - eHI CAMPAIGN - COVERGE RESULTS AND HIGHLIGHTS

Media Coverage Report
“The Final Countdown: Findings from 2014 Survey on Impact of ICD-10”
 Released on June 26, 2014
 Summary as of July 15, 2015
Results and Highlights
 Pitchingefforts to key industry media resulted in 16 stories to datehighlightingthesurvey
findings - including toptier outlets suchas Health Data Management, FierceHealthIT and
InformationWeek Healthcare.
 Social media reach on Twitter hit nearly 75,000 followers, with over 32 retweets. LinkedIn
garnered over 10,000 impressions and18 interactions with our content, makingthis thehighest
performing social campaignin Edifecs’ history – after only 2 weeks!

Social Media Reach Highlights
TWITTER – June 20-July 9, 2014
Edifecs has 651 followers
TOTAL SURVEY/WEBINAR TWEETS RE-TWEETS REACH
21 32 74,415
Tweet River
TWEET FROM: GERRYWIEDER
Source: twitter.com, Posted on: Jun 25, 2014 03:12 PM by GerryWieder
RT @KarlWJohnson Edifecs Sponsors Webinar Unveiling Results of a National Survey on the Anticipated Impact of #ICD10
http://t.co/TjYJPxXnIp
Following: 15330 | Followers: 19391 | Updates: 104150 | Sentiment: Neutral
TWEET FROM: SURVIVALPLANKIT
Source: twitter.com, Posted on: Jun 24, 2014 12:44 PM by SurvivalPlanKit
Edifecs Sponsors Webinar Unveiling Results of a National Survey on the Anticipated Impact of ICD ...: ... publ...
http://t.co/NPoYWETJUm
TWEET FROM: BIOPORTFOLIO
Source: twitter.com, Posted on: Jun 30, 2014 12:14 PM by BioPortfolio
News: #Healthcare Edifecs eHI and AHIMA Survey Reveals ICD10 Readiness Concerns Remain But Some Optimism Over Long...
http://t.co/LI9c1YbEWt
TWEET FROM: EDIFECSTODAY
Source: twitter.com, Posted on: Jun 26, 2014 06:30 AM by EdifecsToday
WEBINAR TODAY: Ready for ICD-10? Join us at 1PM ET to hear experts from eHi, CMS, AHIMA and Edifecs discusssurvey:
http://t.co/4Ev6moxx7m

June 20-July 9, 2014
Edifecs has 5,148 followers
TOTAL POSTS LIKES IMPRESSIONS CLICKS INTERACTIONS
5 12 10,061 53 18
Impressions: Thenumberoftimes each update was shownto LinkedInmembers.
Clicks:Numberofclicks oncontent, company name or logo(all of which link to the content).
Interactions:Numberoftimespeople liked, commentedon, or shared the content.

Media Coverage– 16 articles
Providers Expect Short-Term Pain fromICD-10 Delay
Health Data Management, Greg Slabodkin, June 27, 2014
While most healthcare organizations are generally prepared to begin ICD-10 testing in the near future, they are concerned about the
impact of ICD-10 on workflow, productivity, and reimbursement.
That is the conclusion of a new national survey conducted by the American Health Information Management Association, transactions
processing management and testing vendor Edifecs, and the eHealth Initiative.
The survey, conducted in May and June 2014, assesses the anticipated impact of ICD-10, with responses from 349 stakeholders
including101 clinics/physician practices and 115 acute care hospitals or integrated healthcare delivery systems.
When it comes to healthcare organizations utilizing ICD-10 codes with their health IT infrastructure, 45 percent of respondents
expressed concerns about interacting with accounting and billing systems, 39 percent with EHR systems, 37 percent with analytics
software, and 33 percent with health information exchange.
Overall, in the short term, respondents to the survey believe ICD-10 will make common activities like documenting patient encounters
and adjudicating reimbursement more difficult. In the long term, they expect increased specificity to help improve research,
population health management, quality and performance measurement, and the accuracy of claims.
During the first year of ICD-10 compliance, 38 percent of respondents believe that revenue will decrease, 14 percent predict revenue
will stay neutral, and 6 percent project that revenue will increase. And, 26 percent of healthcare organizations surveyed have not
conducted a revenue impact assessment.
Though the one-year delay in the ICD-10 compliance deadline is expected to cost organizations more money, they are using the
additional time to prepare their workforce for the transition with 61 percent training more staff.
About 27 percent of respondents say they were ready for ICD-10 testing in the third quarter of 2014,14 percent believe they will be
ready by the fourth quarter of 2014,almost 12 percent report they will be ready in the first quarter of 2015,nearly 10 percent are
looking at the second quarter of 2015,and 2.5 percent will be ready in the third quarter of 2015.
In addition, a little more than 10 percent of respondents indicate that they have no plans for ICD-10 end-to-end testing whatsoever.
It’s interesting to note that 53 percent of those with no plans for end-to-end testing are physician practices and clinics, while only one
hospital/ integrated healthcare delivery system has no such plans.
Of the healthcare organizations who are not planning on performing end-to-end testing, 41 percent say they do not know how to
perform testing, 14 percent report that testing costs too much, another 14 percent believe testing is unnecessary, and 6 percent
report that their business partners will not perform testing with them. Moreover, most respondents don’t have a very good sense of
how ready their partners will be for the ICD-10 code switchover.

CMS Developing ICD-10 National Timeline to Help Stakeholders
Health Data Management, Greg Slabodkin, June 27, 2014
The Centers for Medicare and Medicaid Services plans on releasing an ICD-10 “national timeline” to assist stakeholders in preparing
for the expected new October 1, 2015 implementation deadline.
With the one-year delay in the ICD-10 code switchover, CMS recognizes that the timelines have changed, particularly as they relate to
testing which is a critical component of the transition from ICD-9 to ICD-10. Currently in development, the national ICD-10 timeline
will have specific timeframes by which CMS wants all stakeholders ready to test.
“Part of our effort to align industry and regain that momentum is bringing everyone to the table to develop a national ICD-10
timeline,” said Denesecia Green, acting director of the Administrative Simplification Group at CMS, in a June 26 eHealth Initiative
webcast. “It’s a commitment from partners across different sectors. We have about 90 partners that we’re lining up now to commit to
when they are going to test. We’re going to make that publicly available for the groups that are willing to do that.”
According to Green, CMS found that when clearinghouses and other vendors were ready for ICD-10 testing some of the small
providers were not. “I think what this national timeline will do is lay out which payers are going to test and when their testing
timeframes are, so groups can prepare to test with them as appropriate,” she added.
A new national survey finds that about 27 percent of providers will be ready for ICD-10 testing in the third quarter of 2014,14 percent
believe they will be ready by the fourth quarter of 2014,almost 12 percent report they will be ready in the first quarter of 2015,
nearly 10 percent are looking at the second quarter of 2015,and 2.5 percent will be ready in the third quarter of 2015.
In addition, a little more than 10 percent of respondents to the survey indicate that they have no plans for ICD-10 end-to-end testing.
Of the healthcare organizations who are not planning on performing end-to-end testing, 41 percent say they do not know how to
perform testing, 14 percent report that testing costs too much, another 14 percent believe testing is unnecessary, and 6 percent
report that their business partners will not perform testing with them.
Last month, CMS canceled limited end-to-end ICD-10 testing that had been scheduled for late July, when a small sample group of
providers were to have been given the opportunity to participate in end-to-end testing with Medicare Administrative Contractors and
the Common Electronic Data Interchange contractor.
"You should see information on end-to-end testing taking place next year. Details will be forthcoming," stated Green. “CMS is
supportive of end-to-end testing. We’re encouraging other payers to do the same.”

Survey Reveals ICD-10 Readiness, But Concerns Remain
Healthcare Informatics, Rajiv Leventhal, June 27, 2014
While the majority of organizations are ready to begin testing for ICD-10, 45 percent of respondents don’t have a good sense of their
partners’ readiness, according to a new survey conducted by eHealth Initiative (eHI) and the American Health Information
Management Association (AHIMA).
The survey, which was sponsored by Edifecs, a Bellevue, Wash.-based global health information technology solutions company,
revealed that a majority of healthcare organizations impacted by the mandate are using time afforded by an extended compliance
deadline to invest in clinical documentation improvements, workforce training and partner testing, yet concerns over readiness and
financial impact remain. Despite the challenges in the short term, most expect the more specific code set to return value in the long
run.
Key preliminary findings from the survey include:
• Most organizations are prepared to begin testing in the near future. Forty percent of respondents reported they would begin end-
to-end testing by the end of 2014,and 25 percent reported plans to begin by the end of 2015.Of those who stated they had no pl ans
for end-to-end testing, however, 41 percent stated they had no knowledge of how to perform testing.
• Widespread concern about the impact of ICD-10 on workflow, productivity and revenue. Thirty-eight percent of respondents
reported they believe revenue will decrease, while 14 percent believe revenue will remain neutral. Only six percent believe revenue
will increase.
• Optimism that increased specificity can improve research, population health management and quality/performance measurement
and improvement. Respondents answered that common activities such as coding patient encounters, adjudicating reimbursement
claims and negotiating contracts between health plans and providers are expected to be more difficult in the short term. Although the
long-term impact of the ICD-10 transition is expected to improve care in areas such as accuracy of claims, quality of care and patient
safety, not all organizations have a clear plan to derive value from the expanded code set.
• Extensions represent an opportunity for additional training. In order to mitigate productivity loss, 68 percent of respondents stated
they plan to conduct additional training and practice, and 31 percent plan to hire more coders to assist with the transition. More
organizations are also taking advantage of the compliance transition by training more staff for ICD-10 and improving clinical
documentation integrity.
• Clinical documentation integrity is expected to be more difficult. Respondents indicated the task that is expected to be the most
difficult post ICD-10 transition is clinical documentation improvement, particularly documenting and codingpatient encounters. About
61 percent of respondents report planning to utilize the extension to improve clinical documentation integrity.
• Organizations expect to leverage increased code specificity for claims processing and billing, performance measurement and quality
improvement. Respondents stated they plan to leverage the more specific code set for claims processing and billing (65 percent),
quality improvement (62 percent) and performance measurement (51 percent).
Survey respondents included vendors, payers, clinic and physician practices, acute care hospital representatives, consulting firm
representatives among others. The survey, to date, was distributed to a variety of stakeholders in May/ June 2014 and returned 349
responses.

‘Prime time’ for ICD-10 starts now
Healthcare IT News, Mike Miliard, June 27, 2014
Even if the ICD-10 compliance date is farther away than it once was, it will arrive eventually. (For real, this time. We think.) And while
you'd be forgiven for taking a foot of the proverbial gas, this is time that should be spent pushing ahead with preparedness plans.
That's the upshot of a recent survey by eHealth Initiative and AHIMA, which finds that most healthcare organizations are shrewdly
using the extra time afforded by the extended October 2015 deadline to invest in clinical documentation improvements, workforce
training and partner testing.
But concerns over preparedness and the financial impact remain, and while most organizations said they're ready for ICD-10 testing,
they have differing timelines: some are more prepared than others. Forty-five percent of respondents, meanwhile, say they don't
have a good sense of their partners' readiness.
"These results show that 'prime time' for ICD-10 preparedness is now through spring 2015," said Sunny Singh, CEO of Edifecs, which
sponsored the survey, in a press statement. "Testing is vitally important to establish readiness for the ICD-10 transition and to mitigate
any potential revenue impacts."
He added that, "although the mandate has created uncertainties and challenges for all, there is the potential for long-term return in
the form of improved claims processing and billing, performance measurement and quality improvement."
Takeaways from the survey, which polled physician practices, hospitals, payers, vendors and others:
 Some 40 of respondents said they'd start end-to-end testing by the end of 2014,and 25 percent reported plans to begin by
the end of 2015. But of those who stated they had no plans for end-to-end testing, 41 percent said they didn't know how to
perform testing.
 Another 38 percent thought their revenue would decrease, while 14 percent believed it would hold steady. Just 6 percent
thought revenue would increase.
 Most organizations thought thought coding patient encounters, adjudicating reimbursement claims and negotiating
contracts between payers and providers would get more difficultin the short term.
 While the ICD-10 switchover aims to improve accuracy of claims, quality of care and patient safety, not everyone yet has a
clear plan to derive value from more granular codes.
 In order to mitigate productivity loss, 68 percent of respondents planned to conductadditional training and practice, and 31
percent said they'd hire more coders to assist with the transition.
 Clinical documentation improvement was one task that most respondents expect to be the most difficult post-switchover,
especially with regard to patient encounters: 61 percent of respondents say they're taking advantage of the deadline
extension by training more staff for ICD-10 and improving clinical documentation.

Latest ICD-10 survey shows positives, negatives
ICD-10 Trainer Blog, Michelle Leppert, June 27, 2014
More healthcare providers would have been ready for an October 1, 2014 ICD-10 implementation date than people may have
realized, according to a survey by Edifecs, eHealth Initiative (eHI) and AHIMA.
A total of 349 people responded to the survey, which was conducted in May and June to assess the anticipated impact of ICD-10. Of
the respondents, 27.5% worked in acute care hospitals with an equal number working in clinics and physician practices.
The results of the survey show both concern and optimism.
First the not-so-good view. A little more than one-third of respondents (38%) believe revenue will decrease in the first year of ICD-10.
Only 6% believe revenue will go up and 14% think it will stay the same. More than a quarter of respondents (26%) haven’t done any
financial projections.
The majority of respondents (61%) believe coding patient encounters will be harder immediately after implementation, which makes
sense and fits with the coder productivity declines seen in other countries.
Forty-four percent said documentation will be more difficult. I’m not sure what to think about that aspect of the transition. Coders
and CDI specialists will tell you physicians don’t document well in ICD-9. The diseases aren’t changing, but the documentation
requirements for many are. I suspect we will see plenty of additional documentation shortcomings in ICD-10.
That’s not to throw physicians under the bus and blame them. We need to educate them on what we need to see in the
documentation. They’re taught to document for other physicians. We need to show them how to document for coding.
Other areas where respondents think things will get more difficult initially include:
 Adjudicating reimbursement claims (includinghistorical analysis of ICD-9 codes), 41%
 Analyzing and reporting measures on performance, quality, and safety, 24%
 Collecting and exchanging health information, 20%
 Negotiating contracts between health plans and providers, 20%
One-third also believe the efficiency of reimbursement will worsen long term.
So that all seems pretty grim, but you’ll notice a light at the end of the tunnel with some other responses. Forty-one percent of
respondents think coding will be more accurate in the long term (although they don’t specify what “long term” is).
Quality of care will improve, according to 27% of respondents, and 25% believe patient safety will improve.
Respondents believe the increased specificity will help improve research, population health management, and quality and
performance measurement in the long term.
A whopping 68% of the respondents are planning additional training during the delay, which sounds like a wonderful idea. The better
coders, CDIs, and physicians understand the requirements of ICD-10, the sooner we will realize the long-term benefits.

Hospital Administrators See ICD-10 as Problematic for Health IT, Survey Says
Bloomberg BNA, Alex Ruoff, June 27, 2014
Hospital administrators expect that the anticipated conversion to the ICD-10 (International Classification of Diseases, 10th Revision)
code set will immediately make a host of health IT activities more difficult to conduct, according to preliminary results of a new survey
of hospitals and physician practices released June 27 by the American Health Information Management Association (AHIMA) and the
eHealth Initiative.
According to the survey, the conversion to the new code set, expected for Oct. 1, 2015, will make coding and documenting patient
encounters, collecting and exchanging health information and managing risk more difficult for hospital and clinical practice
administrators. However, the survey found, administrators also expect the conversion will improve the quality and safety of the care
provided to patients in the long-term.
Additionally, most health-care organizations, the survey said, are generally ready to begin testing their health IT systems for the
conversion to ICD-10, however most doesn’t have a good sense of how ready they or their partners will be to make the conversion.
The survey results can be found here.

ICD-10 Implementation Not as Costly as Feared
Health Data Management, Greg Goth, June 27, 2014
The cost for physician practices to implement ICD-10 medical diagnosis and in-patient procedure codes may not be anywhere near as
high as feared, according to recent data from the American Association of Professional Coders.
According to AAPC’s Rhonda Buckholtz, vice president of education and training, a client analysis has found that “ICD-10 ready”
medical practices with fewer than 10 providers have spent approximately $750 per person to prepare for the mandate," as reported
in a podcast. "And the cost is even less for practices with 10 to 49 providers. To put this into context, AAPC has trained over 90,000
people toward some piece of ICD-10 implementation, making this cost information all the more compelling."
Results of a separate recent ICD-10 national survey of 349 stakeholders, including101 clinics/physician practices, found that nearly 42
percent of respondents have spent less than $100,000 on the code transition and almost 15 percent have spent between $100,000
and $500,000 to date.
However, the one-year delay in the ICD-10 compliance deadline is expected to cost healthcare organizations more money to get ready
for the code switchover. When it comes to the additional costs associated with the ICD-10 extension, almost 31 percent of
respondents to the survey project that they will spend less than $100,000,while a little more than 12 percent anticipate spending
between $100,000 and $500,000 to be ready by October 1, 2015.
Overall, the American Health Information Management Association estimates that another one-year delay of ICD-10 will cost the
healthcare industry an additional $1 billion to $6.6 billion on top of the already incurred costs from the previous one-year delay.

Stakeholders Concerned about ICD-10 Implementation, Survey Finds
iHealthBeat, Staff, June 27, 2014
Although manyhealthcare organizationssaytheywill be readytobeginICD-10testingthisyear,there iswidespread
concernabout ICD-10's effectonworkflow,productivityandrevenue, accordingtoa survey releasedThursdaybythe
AmericanHealthInformationManagementAssociation,transactionsprocessingmanagementandtestingvendorEdifecs
and the eHealthInitiative, HealthDataManagement reports(Slabodkin, Health Data Management,6/27).
Background on ICD-10
U.S. healthcare organizationsare workingto transitionfromICD-9to ICD-10 code setsto accommodate codesfor new
diseasesandprocedures.The switchmeansthathealthcare providersandinsurerswillhave tochange outabout 14,000
codesfor about69,000 codes.
In April,PresidentObamasignedintolawlegislation(HR4302) that pushedbackthe ICD-10 compliance date until at
leastOctober2015.
In May, CMS confirmedthatHHS plansto soonrelease aninterimfinal rule thatwill setthe new ICD-10compliance
deadline asOct.1, 2015 (iHealthBeat,6/12).
Survey Details
For the survey,researcherspolledavarietyof industrystakeholdersbetweenMayandJune on the expectedeffectof
the transitiontoICD-10 code sets(Edifecsrelease,6/26).The surveyincluded349 respondents,including:
 101 clinicsorphysician practices;and
 115 acute care hospitalsorintegratedhealthcare deliverysystems.
Findingson Readiness
The surveyshowedthatrespondents'readinesstobeginICD-10end-to-endtestingvaried.Itfound:
 27% of respondentssaidtheywere readyfortestinginthe thirdquarterof 2014;
 14% saidtheyexpecttobe readyin the fourthquarterof 2014;
 Nearly12% expectedtobegintestinginthe firstquarterof 2015;
 About10% expectedtobe readyinthe secondquarterof 2015;
 2.5% expectedtobe readyby the thirdquarterof 2015; and
 Slightlymore than10% reportednoplansto conductsuch testing.
Of those withouttestingplans,whichprimarilyincludedphysicianclinicsandpractices:
 41% saidtheydidnot knowhowto conducttesting;
 14% saidtestingwastoocostly;
 14% saidtestingwasunnecessary;and
 6% saidtheirbusinesspartnersrefusedtoperformtestingwiththem(Health Data Management,6/27).
Overall,45%of respondentssaidtheywereunsure if theirbusinesspartnerswouldbe readytobegin ICD-10testing.
However,the surveyfoundthat68% of respondentssaidtheyplannedtouse the additional timebefore implementation
to trainmore staff,while 31%planto hire more codersto helpwiththe transition(Edifecsrelease,6/26).
Findingson ImplementationConcerns
Meanwhile,manyrespondentsraisedconcernsaboutintegratingICD-10codesandtheirhealthITinfrastructure,
including:
 45% whoraisedconcernsaboutaccountingand billingsystems;
 39% withconcernsaboutelectronichealthrecord systems;

 37% withconcernsanalyticssoftware;and
 33% withconcernsabouthealthinformationexchange.
RespondentsalsoexpressedconcernsaboutICD-10'seffectonrevenue.The surveyfoundthat:
 38% of respondentsprojectedrevenuetodecrease;
 14% of respondentsprojectedaneutral effectonrevenue;and
 6% of respondentsprojectedrevenue toincrease.
Overall,respondentsthoughtICD-10implementationwouldmake several commonactivitiesmore difficultinthe short-
term,including:
 Adjudicatingreimbursementissues;and
 Documentingpatientencounters.
However,respondentsthoughtICD-10implementationwouldhave certainlong-termbenefits,including:
 Enhancingresearch;
 Improvingclaimsaccuracy;
 Managing populationhealth;and
 Measuringperformance andquality(Health Data Management,6/27).

ICD-10 survey indicates ‘surprising’ level of provider readiness
FierceHealthIT, Dan Bowman, June 27, 2014
Providers responding to a recent survey on ICD-10 expressed concerns about the impact the coding switch--set to go into effect Oct.
1, 2015,after being delayed in April--will have on revenue, productivity and workflow.
Of 349 providers surveyed between May and June by the American Health Information Management Association and the eHealth
Initiative, 38 percent said they think revenue will decrease in the year immediately following the transition; only 6 percent said they
think revenue will increase.
Forty percent of respondents, however, said they would be ready to go through with end-to-end testing by the end of this year; 25
percent indicated they would be ready by the end of 2015.
The survey results were made public during a webinar on Thursday.
"I think that what's surprising to everyone is that more people were ready than people actually thought," Denesecia Green, a senior
health insurance specialist with the Centers for Medicare & Medicaid Services, said during the webinar. "One of the things we've been
talking to groups about doing is how do we ... begin to share some of those best practices and stories of how are they moving
forward? ... This survey is very helpful in the sense that it really does validate a lot of the effort and work that has transpired thus far."
Green added that CMS plans to release a "national timeline" to help all ICD-10 stakeholders--from providers to payers to vendors--
prepare for the transition. The timeline will consist of particular timeframes in which each stakeholder will need to be ready to test.
Sixty-one percent of respondents said they think that, in the short term, coding patient encounters will be a more difficulttask; 44
percent said the same for documenting such encounters. For the long term, however, 41 percent said they think transitioning to ICD-
10 will improve claims accuracy, compared to 22 percent who said it will worsen.
Still, providers remain skeptical about ICD-10's impact on reimbursement. Twenty percent believe switching over from ICD-9 will
improve reimbursement efficiency, while 33 percent think efficiency will suffer.
Research recently published in the journal Pediatrics determined that the switch to ICD-10 could have a substantial impact on
pediatricians' financial bottom lines.
A letter sent to the U.S. Department of Health and Human Services earlier this month by the Workgroup for Electronic Data
Interchange presented an ICD-10 transition roadmap to the agency, urging it to ensure Medicare and Medicaid readiness
transparency; expedite, support and expand industry testing; expand provider education; and conductlimited pilots.
To learn more:
- download the survey results (.pdf)

AHIMA: Revenue, readiness remain among top ICD-10 concerns
EHR Intelligence, Jennifer Bresnick, June 27, 2014
Despite the extra year of prep time granted by the ICD-10 delay, a significant number of providers remain worried about how they will
meet the demands of the transition to the new code set, now slated for October 1, 2015,and how ICD-10 will impact their practices in
the aftermath. In a survey conducted by AHIMA and the eHealth Initiative throughout May and June, 38% of providers predicted that
their revenue will decrease in the first year after ICD-10, while 26% of organizations have not even conducted a revenue impact
assessment. Widespread concerns over documentation and productivity remain, but providers also appeared eager to begin testing
and tackle the hurdles laid out before them.
The 349 respondents, representing a variety of providers, hospitals, and other stakeholders, anticipate some serious short-term
problems during the months following the transition. Sixty-one percent said that codingpatient encounters would get harder, while
44% are concerned about difficulties in documenting patient encounters and 41% believe that adjudication of reimbursement claims,
includinghistorical analysis of ICD-9 codes, will also pose a problem. Other barriers to success include interruptions in clinical
workflow, productivity, and claims processing, cited by 57%of providers, a lack of adequate staff, change management issues, and the
readiness of vendors and partners.
But the respondents were quick to note that these immediate concerns would dissipate as the long-term benefits of ICD-10 became
clear. Four in ten providers think the accuracy of claims will eventually increase, while a quarter think the new codes will have a
positive impact on the quality of care and patient safety. Reimbursement will likely get even more efficient, said 20% of respondents,
and a similar number have hope that ICD-10 will foster better payer-provider collaboration.
A majority of providers plan to use the increased specificity of ICD-10 data to help with quality improvement and performance
measurement, while 39% anticipate boosting their outcomes measurement and 25% will scrutinize their resource allocation.
While it may be good news for ICD-10 advocates that providers are starting to recognize that the more detailed code set might being
improvements to the healthcare system, the path towards those positive outcomes remains rocky and uncertain. Testing is the big
obstacle on everyone’s minds, and they are planning to attack it soon. Twenty-seven percent of respondents believe they will be
ready for testing by the third quarter of 2014, while 14% will be ready by the end of the year. Only 2.5% will put it off until the end of
2015,but 10% currently have no plans for testing at all.
Of the organizations who don’t have scheduled testing dates, a whopping 41% say it’s because they don’t know what to do. Others
think it will cost too much, and 14% even believe that testing is unnecessary. The majority of these organizations are physician
practices.
For those who are not letting the extra year get them down, despite many anticipating that the costs of the extension might double
their expenditures, extra training and practice for coders is first on the list of readiness priorities. Sixty-eight percent will bulk up their
education, while 31% will hire more coders and 29% will invest in computer assisted coding (CAC) technology or other health IT tools
to help their staff along as the added time starts to tick away again.

ICD-10 Delay: Organizations Prep For New Deadline
InformationWeek Healthcare, Alison Diana, June 30, 2014
Healthcare organizations are taking advantage of the delay in a variety of ways, such as training more staff, improving documentation
integrity, and conducting more robust testing, according to a survey.
In April, Congress and President Obama agreed to delay implementation of the ICD-10standard for medical diagnosis and billing codes
to Oct. 1, 2015. A study conducted in May and June found that most healthcare providers are using the 12-month ICD-10 reprieve to
prepare for the new coding standard.
The survey of 349 healthcare organizations, vendors, and consultants conducted by eHealth Initiative and the American Health
Information Management Association (AHIMA), and sponsored by the health IT vendor Edifecs, found that organizations are taking
advantage of the delay in a variety of ways. For example, 61% are using the extension to train more staff; 60% are improving
documentation integrity; 47% continue dual coding; and 40% are conducting more robust testing. Only 33% have reallocated
resources.
Some observers have questioned the effects of the delay on the healthcare organizations that were working to meet the previous
deadline, Oct. 1, 2014.To mitigate productivity loss, 68% of survey respondents plan to conduct extra training and practice, and 31%
expect to hire more coders to help with the eventual transition.
By the end of this year, 40% expect to begin end-to-end testing; 25% plan to start this process by the end of 2015.Of the
organizations that aren't planning end-to-end testing, 41% claimed no knowledge of how to perform testing.
"If you were training for a marathon and the race was delayed, you probably wouldn't sit on the couch eating potato chips," Lynne
Thomas Gordon, CEO of the AHIMA, said in a webinar presentation of the study results. "We are telling everyone to keep the
momentum going. Don't stop. Maybe just slow down, but keep the momentum going."
Webinar panel attendees -- includingAHIMA and Edifecs executives, plus a representative from the Centers for Medicare and
Medicaid Services (CMS) -- cautioned that each ICD-10 delay has multiple effects. Executive buy-in wanes as healthcare organizations
lose the sense of immediacy around ICD-10. Students are concerned about the viability of their new skills. And healthcare
organizations reallocate ICD-10 funds to new health IT initiatives.
Delays are expensive, too. A one-year ICD-10 delay would increase costs between 11% and 25%, according to 50% of respondents;
another 37% fear costs would increase 50% if the coding change were delayed 12 months. A two-year delay would be "potentially
catastrophic," 69% of those polled said.
(Source: eHealth Initiative and the American Health Information Management Association)

Denesecia Green, senior health insurance specialist at the CMS, said during the webinar that her agency wants to ensure the coding
change continues to advance to avoid increased costs and build on healthcare organizations' ICD-10 adoption progress. For one thing,
the delay has already cost her organization; it was fully prepared for an October 2014 rollout of ICD-10 but had to recode systems for
ICD-9.
"Part of our effort to align industry and regain that momentum is bringing everyone to the table to develop a national ICD-10
timeline," she said.
The CMS will centrally locate information on partners' ICD-10 testing dates, Green said; it already has 90 partners lined up. The agency
also will publicly share partners' information on when they are providing supporting materials, training, webinars, or other
informational offerings to healthcare customers. Likewise, it hopes to share best practices to show how many providers are prepared
for ICD-10.
"What is surprising maybe to the healthcare industry overall... is that more people were ready than [some] people actually thought,"
she said. The CMS is talking to stakeholders about how to "share some of those best practices and stories of how they are moving
forward, what tools are they using to do that, and sharing them throughout the whole industry. I think this survey... does validate a lot
of the effort and work that has happened thus far."
ICD-10 advocates will continue informing healthcare colleagues about the benefits of the next-generation coding system, which was
developed in part with physicians, Green said. Executives agreed that the more detailed codingis vital in this age of data, value-based
care, and thinner margins.
"I personally view ICD-10 as a natural extension of Meaningful Use," said Deepak Sadagopan, general manager of clinical solutions at
Edifecs. "ICD-10 really adds more granularity and reduces ambiguity... Better communication results in better care for the patient, and
that's really what this is all about."
Healthcare organizations must do more than test their software, Sadagopan said. System testing is important, but organizations also
must optimize workflows, train users, and prepare documentation to ensure success.
Experts agreed that expanding beyond end-to-end testing should help organizations mitigate any expected revenue damage. In the
short term, healthcare providers worry ICD-10 implementation could hurt their bottom line. A mere 6% say ICD-10 will increase
revenue, whereas 38% fear revenue will decrease, and 14% say revenue will remain flat, the study found. However, 65% plan to
leverage the more specific code set for claims processing and billing; 62%expect to use it for quality improvement; and 51% will use
ICD-10 improvements for performance measurement.

Where ICD-10 movers arefocusing now
Mike Miliard, Government Health IT, July 1, 2014
Those healthcare organizations wisely using the extra time for ICD-10 are focusing on clinical documentation improvements,
workforce training and partner testing.
That’s according to a recent study by the American Health Information Management Association and eHealth Initiative, which also
found that concerns over preparedness and ICD-10’s potential financial impacts are lingering despite the new October 1, 2015
deadline.
Among the tasks widely-anticipated to be tricky after the ICD-10 switch flips, clinical documentation improvement has 61 percent of
respondents training more staff in preparation for CDI – alongside the 68 percent holding additional training and practice to mitigate
the expected productivity loss. And about one-third of survey participants intend to hire more coders toward that same end.
"Although the mandate has created uncertainties and challenges for all, there is the potential for long-term return in the form of
improved claims processing and billing, performance measurement and quality improvement," said Sunny Singh, CEO of Edifecs,
which sponsored the survey, in a prepared statement.
While most organizations said they're ready for ICD-10 testing, some are naturally more prepared than others.
Some 40 percent of respondents, for instance, intend to start end-to-end testing by year’s end, while another 25 percent indicated
they will begin in 2015.Certainly beginning by the end of 2014 or early next year is in accordance with recommended timelines but
the 41 percent who said they do not know how to perform testing and the 45 percent stating they don’t have a good sense of
partner’s readiness, could be problematic as the compliance deadline approaches.
"These results show that 'prime time' for ICD-10 preparedness is now through spring 2015," Singh said. "Testing is vitally important to
establish readiness for the ICD-10 transition and to mitigate any potential revenue impacts."
Even if the ICD-10 compliance date is farther away than it once was, it will arrive eventually. (For real, this time. We think.) And while
healthcare organizations could be forgiven for taking a foot off the proverbial gas, this is time that should be spent pushing ahead with
preparedness plans.

Healthcare organizations use delay to further test ICD-10 readiness
Alex DelVecchio, Health IT Exchange, July 2, 2014
The delay of federal ICD-10 implementation gave providers another year, at a minimum, during which they could perform testing to
measure their ICD-10 readiness. Fewer than half of respondents to a survey indicated they will start on end-to-end testing this year,
with 40% saying they plan to do it before the close of 2014.
An additional 25% replied they would begin end-to-end ICD-10 testing by the end of 2015, according to the survey conducted jointly
by the eHealth Initiative and the American Health Information Management Association (AHIMA) and bankrolled by Edifecs, which
received responses from vendors, payers, clinic and physician practices and others. Of those with no plans to conduct any ICD-10
testing, 41% said they had no understanding of how to do so. More than a third of respondents (38%) believe that ICD-10
implementation will decrease their revenue, while only 6% think revenue will increase.
“Testing is vitally important to establish readiness for the ICD-10 transition, and to mitigate any potential revenue impacts,” said
Edifecs CEO Sunny Singh, in a press release.
The decision to delay ICD-10 until at least Oct. 1 2015 passed the Senate on March 31 and signed into law by President Barack Obama
on April 1. Though the delay grants extra time for testing and fixing weak spots in an organization’s ICD-10 readiness plan, there is
some speculation that it may be detrimental to those that were prepared for the previous deadline. One such complication is the
extra funding needed to support another year of ramping up for the code changeover.
A poll taken at a recent AHIMA ICD-10 Summit found that 88% of those surveyed were disappointed with the decision to delay ICD-10.
Respondents were nearly unanimous in their preference for ICD-10 to roll out on one date, with 90% agreeing to that instead of the
new codes coming out at separate times for different providers. Half of those polled said they would be interested in reporting their
ICD-10 codes beginning on Oct.1, 2014,if provided the opportunity.

Healthcare IT News For VARs
Megan Williams, Health IT Outcomes, July 3, 2014
In the newsthisweek,specialtyEMRofferingsare expanding,andPCsare still dominatingEHRviewingplatforms.
Survey RevealsICD-10 ReadinessConcerns
Edifecs,eHI,andAHIMA sponsoredanICD-10 preparednesssurveylastmonth.The surveyrevealedthatamajorityof
healthcare organizationsare usingthe deadline extensions toinvestinclinical documentationimprovements,workforce
training,andpartnertesting.Organizationsare still alsoconcernedaboutreadinessandthe financial impactof the
codingsystemupdate.More detailsare availableatIT Business Net.
OmniMD ExpandingSpecialtyEMR Offerings
Despite the growthof EMR, onlythree vendorsgainedmarketshare lastyear.Cerner,Epic,andMediTechwere the only
vendorstoincrease theircustomerbase amonghospitals,accordingtoaKLAS report.InformationWeekalso reports that
EMR vendorsworkingwithsmallerfacilitiesare facingincreasinglydifficultbusinessdevelopmentenvironmentsbecause
of competitionfromlarger-facilitycounterparts.Alongthatsame vein,OmniMDplansonexpandingtheirspecialtyEMR
offeringstoinclude atleastfive new surgeryspecialtiesand14 practice specialties.
Study FindsThat Advanced EHR SystemsSave HospitalsMoney
Researchersfromthe Medical Universityof SouthCarolinauseddatafrom2009 from the National InpatientSampleand
the HealthInformationAndManagementSystemsSocietyinarecentlyreleasedstudy.The studyfoundthat
organizationsthatusedadvancedEHRsystemssavedabout10 percentperpatientadmissionwhencomparedto
providersthatdidnotuse similarsystems.More resultsandimplicationsare availableatiHealthBeat.
PCs Still Dominate EHR ViewingPlatforms
While mobile deviceuse isgrowing acrossthe industry,andphysiciansare increasinglybecoming“digital
omnivores,”HealthITOutcomesreports thatmost EHRs are still viewedonPCs.Physicianshave actuallyreported
increaseduse of non-mobile devices.Thisismostlikelyexplainedbythe combinationof the increaseinincentivesfor
usingEHRs, and a lackof mobile optimizationof EHRtools.

Healthcare IT News For VARs
Megan Williams, Health IT Outcomes, July 3, 2014
Healthcare IT Talking Points
In challenge to Larry Page’s claims that Big Data could save 100,000 lives this year through information transparency, FierceHealthIT
presents the counter argument from senior lecturer at the School of Computing and Director of Interdisciplinary Cyber Security Centre
at University of Kent, Eerke Boiten. Bointen outright argues that the industry has a long way to go, and that costs will not drop until
challenges around standards and methods are overcome.
Health IT Analytics reports that 84 percent of financially insecure hospitals are postponing their investment in population health
management and clinical analytics infrastructure. The article cites reasons for the decrease in investment as:
 Trends in Medicare reimbursement
 Declining inpatient volumes
 Rising expenses
 Bad debt
For more news and insights, visit BSMinfo’s Healthcare IT Resource Center.

ICD-10 Delay: Organizations Prep For New Deadline
Staff, Medical Coding News, July 3, 2014
In April, Congress and President Obama agreed to delay implementation of the ICD-10 standard for medical diagnosis and billing codes
to Oct. 1, 2015. A study conducted in May and June found that most healthcare providers are using the 12-month ICD-10 reprieve to
prepare for the new coding standard.
The survey of 349 healthcare organizations, vendors, and consultants conducted by eHealth Initiative and the American Health
Information Management Association (AHIMA), and sponsored by the health IT vendor Edifecs, found that organizations are taking
advantage of the delay in a variety of ways. For example, 61% are using the extension to train more staff; 60% are improving
documentation integrity; 47% continue dual coding; and 40% are conducting more robust testing. Only 33% have reallocated
resources.
Some observers have questioned the effects of the delay on the healthcare organizations that were working to meet the previous
deadline, Oct. 1, 2014.To mitigate productivity loss, 68% of survey respondents plan to conduct extra training and practice, and 31%
expect to hire more coders to help with the eventual transition.
By the end of this year, 40% expect to begin end-to-end testing; 25% plan to start this process by the end of 2015.Of the
organizations that aren’t planning end-to-end testing, 41% claimed no knowledge of how to perform testing.
“If you were training for a marathon and the race was delayed, you probably wouldn’t sit on the couch eating potato chips,” Lynne
Thomas Gordon, CEO of the AHIMA, said in a webinar presentation of the study results. “We are telling everyone to keep the
momentum going. Don’t stop. Maybe just slow down, but keep the momentum going.”
Webinar panel attendees — includingAHIMA and Edifecs executives, plus a representative from the Centers for Medicare and
Medicaid Services (CMS) — cautioned that each ICD-10 delay has multiple effects. Executive buy-in wanes as healthcare organizations
lose the sense of immediacy around ICD-10. Students are concerned about the viability of their new skills. And healthcare
organizations reallocate ICD-10 funds to new health IT initiatives.
Delays are expensive, too. A one-year ICD-10 delay would increase costs between 11% and 25%, according to 50% of respondents;
another 37% fear costs would increase 50% if the coding change were delayed 12 months. A two-year delay would be “potentially
catastrophic,” 69% of those polled said.
Denesecia Green, senior health insurance specialist at the CMS, said during the webinar that her agency wants to ensure the coding
change continues to advance to avoid increased costs and build on healthcare organizations’ ICD-10 adoption progress. For one thing,
the delay has already cost her organization; it was fully prepared for an October 2014 rollout of ICD-10 but had to recode systems for
ICD-9.
“Part of our effort to align industry and regain that momentum is bringing everyone to the table to develop a national ICD-10
timeline,” she said.
The CMS will centrally locate information on partners’ ICD-10 testing dates, Green said; it already has 90 partners lined up. The agency
also will publicly share partners’ information on when they are providing supporting materials, training, webinars, or other
informational offerings to healthcare customers. Likewise, it hopes to share best practices to show how many providers are prepared
for ICD-10.
“What is surprising maybe to the healthcare industry overall… is that more people were ready than [some] people actually thought,”
she said. The CMS is talking to stakeholders about how to “share some of those best practices and stories of how they are moving
forward, what tools are they using to do that, and sharing them throughout the whole industry. I think this survey… does validate a lot
of the effort and work that has happened thus far.”

ICD-10 advocates will continue informing healthcare colleagues about the benefits of the next-generation coding system, which was
developed in part with physicians, Green said. Executives agreed that the more detailed codingis vital in this age of data, value-based
care, and thinner margins.
“I personally view ICD-10 as a natural extension of Meaningful Use,” said Deepak Sadagopan, general manager of clinical solutions at
Edifecs. “ICD-10 really adds more granularity and reduces ambiguity… Better communication results in better care for the patient, and
that’s really what this is all about.”
Healthcare organizations must do more than test their software, Sadagopan said. System testing is important, but organizations also
must optimize workflows, train users, and prepare documentation to ensure success.
Experts agreed that expanding beyond end-to-end testing should help organizations mitigate any expected revenue damage. In the
short term, healthcare providers worry ICD-10 implementation could hurt their bottom line. A mere 6% say ICD-10 will increase
revenue, whereas 38% fear revenue will decrease, and 14% say revenue will remain flat, the study found. However, 65% plan to
leverage the more specific code set for claims processing and billing; 62%expect to use it for quality improvement; and 51% will use
ICD-10 improvements for performance measurement.

ICD-10 Delay Survey Reveals Concerns Around Economics And Workflow
Megan Williams, Business Solutions Magazine, July 14, 2014
Even with the extension of the ICD-10 implementation deadline, some healthcare providers are anxious about the process.
The American Health Information Management Association’s transaction processing management and testing vendor,
Edifecs, released a survey that polled industry stakeholders between May and June of 2014 on what effects they expected to see from
the transition to ICD-10 code sets.
Survey Details
The survey included 349 respondents, of which 101 were clinics or physician practices, and 115 were acute care hospitals or
integrated health care delivery systems. Respondents also included vendors, payers, consulting firm representatives, and others.
Key Findings
Key findings of the survey relate to testing plans, potential workflow interruptions, economic impact, training, difficulty of clinical
documentation, and code specificity.
 Testing Plans. Mostorganizations are prepared, with 40 percent of respondents indicating that they would begin end-to-end
testing by the end of this year. Another 25 percent indicated they would by the end of 2015.For those who reported they
had no plans to perform end-to-end testing, 41 percent indicated they did not know how to do so.
 Potential Workflow Interruptions. Many healthcare providers are concerned about how the code change will impact
workflow, productivity, and revenue. A miniscule 6 percent believe that revenue will increase as a result of the change, while
38 percent believe revenue will decrease, and 14 percent believe it will remain neutral.
 Concerns Around Economic Impact. Despiteconcerns about economic benefit, heathcare providers overall are optimistic that
the increased specificity that the code set brings can potentially improve research, population health management, and
quality/performance measurement and improvement. At the same time, they answered that common activities including
coding patient encounters, adjudicating reimbursement claims, and negotiating contracts between health plans and
healthcare providers will likely be more difficult in the short term. Still, in the long-term, the transition is expected to improve
metrics like claim accuracy, care quality, and patient safety. Unfortunately, not all organizations have a clear plan to extract
value from the transition to the expanded code set.
 Opportunity For Additional Training. Healthcare providers also plan to take advantage of the one-year delay to perform
additional training — 68 percent plan to conductadditional training and 31 percent have plans to hire additional coders to
help with the transition.
 More Difficult Clinical Documentation. Clinical documentation is expected to be more difficult. Of all the tasks that change
with the upgrade, respondents indicated that they expect the transition to cause problems around clinical documentation,
particularly around coding patient encounters. Healthcare providers plan to use the extension to improve the integrity of
clinical documentation.
 Improved Code Specificity. Lastly,healthcare providers expect to see benefit from leveraging the increased code
specificity for claims processing and billing (65 percent), performance measurement (51 percent) and quality improvement
(62 percent).

2014 July 15 - eHI CAMPAIGN - COVERGE RESULTS AND HIGHLIGHTS

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