We Need to Walk the (Cross) Walk
It is finally here. The United States has officially formalized the implementation of the 10th edition of the International Classification of Diseases, ICD-10-CM. Transitioning from ICD-9 will be a challenge. Sixty-eight thousand codes may cause information management systems to crash, coders and clinicians to drown, and reimbursements to be delayed during the learning phase; however, the ICD-10 concept, as a whole, is sound.
The World Health Organization (WHO) started working on ICD-10 in 1983, and it was ready for launch in 1992. ICD-10 has been adopted at different rates throughout the world. Australia was one of the earliest adopters (1998), and Canada followed shortly thereafter (2000). From 1995 to 2012, ICD-10 was implemented in most European countries and in China, Thailand, South Korea, and South Africa. On October 1, 2015, the United States joined the ranks. WHO promulgated the International Classification of Diseases as a universal tool in epidemiology, healthcare management, and clinical medicine. It enables the collection of population statistics and allows for the monitoring of health and disease. Statistics are used by healthcare providers, federal agencies, medical organizations, and insurers to document vital and mortality statistics. The goal, as stated by WHO, is that medical practitioners around the globe would “speak the same language” and be able to aptly communicate and share medical information. It strikes me that SCA seeks to achieve a similar goal.
SCA is an international organization of anesthesiologists who care for patients with cardiovascular and thoracic cavity disease. Through our educational offerings and member services, SCA delivers high-quality education and hands-on workshop training, and presents cutting-edge research to our community. We already do share health information globally. Our recent support of the 15th International Conference on Cardiovascular Anesthesiology (ICCVA) and continued support for future ICCVA meetings demonstrate that a global language is spoken in our healthcare community. SCA partners with many other anesthesiology societies worldwide to create guidelines, evaluate outcomes, and create metrics to measure our successes.
The implementation of ICD-10 is a good thing for other reasons as well. In addition to allowing us all to speak the same language with our anesthesiology colleagues, ICD-10 will, hopefully, encourage anesthesiologists to become more integral participants in the medical team. The American Society of Anesthesiologists has initiated the Perioperative Surgical Home concept, for which the anesthesiologist is the director. If we haven’t already embraced this concept, as it applies to cardiovascular surgery, we should. Many countries already recognize the cardiac anesthesiologist/intensivist as the director of care from preoperative optimization to postoperative outcomes. We are responsible to manage the adverse effects of pulmonary disease, smoking, anemia, renal impairment, cerebrovascular disease, and coronary insufficiency during surgery and thus should have an important management role throughout the entire perioperative period.
Overall, the struggles that the United States will endure in learning ICD-10 will be balanced by an enhanced medical documentation standard and will allow more accurate assessment of outcomes. Our shared and global goal is to improve the quality and efficiency of delivering patient care, much like the SCA goal for cardiovascular patient care in the perioperative period.