Change. A simple six letter word that conjures up such a vast range of emotions for those who hear it coming, ranging from excitement and enthusiasm to anxiety and apprehension, either reaction connected with some degree of heart-pounds as they step into the unknown that inevitably lay before them. There are generally two reactions to change, those who welcome it and those who try to refuse it, to understandably stay in the ways that are comfortable to them. After all, the phrase “if it ain’t broke, don’t fix it” is a popular idiom for a reason.
As I ponder the varying natural responses to change, I can’t help but think of the looming ICD-10 implementation, this time with a definitive deadline (finally) of October 1, 2015. What exactly is it about ICD-10 implementation that creates such a cloud of anxiety driven discussion flooding almost every healthcare related news site? Reading all the disdain surrounding the ICD-10 implementation, one cannot help but question, what was so wrong with ICD-9 codes, and why is something that has been immediately met with such hesitance and skepticism from its very own target audience even necessary to begin with? Really, is this just another natural reaction to change, or is all the hesitance actually with rhyme or reason?
Medicine has become immensely more intricate and complex as we enhance our medical technologies and knowledge of various diseases and treatments. This is all, of course, a change for the better. It is a positive change that we are capable of performing surgeries that are becoming less and less invasive. That medicine is becoming increasingly intertwined with material science to enhance wound care and other common medical matters. One of the arguably biggest issues with ICD-9 codes was that it was not able to keep up with the changing pace of medicine. It was created and organized before laparoscopic or laser surgeries were a commonplace practice, and subsequently most of these surgeries are simply grouped in some “other” category in the list of ICD-9 codes. The inability for ICD-9 codes to reflect the rapidly modernizing nature of medicine is not new. In fact, even as early as 1993, the NCVHS annual report noted that ICD-9 codes were rapidly becoming outdated and that ICD-10 represented significant improvement. But won’t ICD-10 run into the same issues in the years to come, you ask? Fear not, because according to the AHIMA, the change to include letters in the ICD-10 coding system allows this system to be much more easily manipulated to account for future progressions in medicine, and it will thus be less at risk for falling behind to keep up with inevitable changes in medicine.
Furthermore, having more specific codes allows for more accurate research and collection of statistical data. Imagine the obstacle of collecting the data to investigate, let’s say the possible factors for one eye to be affected by glaucoma before the other, if there aren’t even codes that account for left versus right versus bilateral glaucoma. The specificity also allows for fewer errors in coding, as well as fewer rejections of reimbursement claims for physicians.
The WHO and other health organizations list many more positive outcomes for ICD-10 implementation that are too confusing for a lowly medical student like me to understand, but I will take their word for it. And while any situation with many pros is met with a list of cons (such is life, unfortunately), I am trying to remain open minded and welcome the infinite changes that will surely (and hopefully) come in the healthcare world as the rest of our technologically advanced society is leaving us behind, shedding their skin in a truly Moore’s law fashion. After all, change is the only constant, is it not?