ICD-10 Education & Training Organizational Effectiveness Thought Leadership Group

Reflection 2 The only way to make sense out of change is to plunge into it, move with it, and join the dance. – Alan Watts

3 Training and communications are highly integrated to create the leading practice environment required to achieve desired outcomes, including: –All staff must be fully convinced of the need to achieve the zero risk paradigm and fully apply the new working practices which underlie it –Training in the knowledge and skills required to use the tools and apply the required practices –Tools that make the working practices easy to apply, such as check lists and job aids, among others ICD-10 Training Focus and Desired Outcomes Understanding Acceptance Commitment Ownership TIME Awareness PRODUCTIVITY Training focus Communications Focus

Training Leading Practices 4 The following leading practices have been considered and, where appropriate, built into the integrated training strategy: –An audience segment based approach that focuses exclusively on the content required for that segment for retention and application. This includes the development of role-based and process-orientated training to help drive learning and enable integrated user understanding. –Implementation of sequenced training across core impacted audiences to ensure the correct group is training first in an effort to drive greater informal awareness. –Capture lessons learned and conduct post assessments to continually improve training efforts and develop a repository of institutional knowledge.

5 The training strategy will utilize multiple educational methodologies based on job-specific roles eLearning Modules (Optum & EduCode) –Interactive modules for different audiences –Module assessment scores track progress In-Person Training –Specialty-based provider education for clinical documentation and coding changes –Clinically-focused stand and deliver sessions for CDIs –Compliance team to provide stand and deliver training for coders Practice Training –Practice coding environment with scenarios –Clinical rotation and on-unit training for CDIs ICD-10 Integrated Training Strategy

ICD-10 Stakeholder Impact Map 6 Revenue Integrity/ CDM Low Med High LowMed High Pharmacy Degree of change Level of complexity Admitting/ Regist. Medical Records & HIM Rad Lab Physician/ Medical Groups Home Health / Hospice Patient Financial Services Clinics Long Term Acute Care / SNF Inpatient Nursing Revenue Services Case Mgt RN-CDS Respiratory Therapy Social Work Wound Care Nurses & Dieticians PT / OT / Speech Therapy CDI, Acute Care Staff Revnue Cycle Provider Home Health/SNF HIM/Compliance Legend Source: ICD-10 Assessment

7 Role Specific Education Coders Role: Inpatient coders Outpatient coders Ancillary coders Professional services coders Education: Anatomy and Physiology assessment and refresher courses eLearning to provide a strong foundation in ICD-10 coding concepts Practice exercises, including case studies and medical records Instructor-led education that provides hands-on ICD-10 coding CDI Specialists Role: CDI specialists Acute Care Staff Education: eLearning to provide a strong foundation in ICD-10 documentation guidelines Instructor-led education and training to identify opportunities for documentation improvement Rounding and on-unit training Physicians & Non- Physician Providers Role: DHMF staff Affiliated physicians Nurses / PAs / MAs Hospitalists Residents & Fellows Clinic based physicians Non-physician providers /ancillary Education: eLearning to cover education around new ICD-10 documentation requirements Instructor-led training for physicians to cover new ICD-10 documentation requirements by specialty Revenue Cycle / IT Role: Patient Access Staff Patient Financial Services Revenue Integrity Information Technology Education: eLearning to provide a strong foundation in ICD-10 coding and documentation concepts and guidelines

8 ICD-10 Education & Training Overview Level 1 and Level 2 are the primary responsibility of communications Close alignment between communication and training is critical as awareness drives support for learning High LevelDeep Dive Communication Training Level 1 Awareness Level 2 Information Level 3 Education Level 4 Knowledge Level 5 Expertise ICD-10 Communication ► Awareness (Level 1): High level understanding of the potential business impacts and risks of ICD-10 transition ► Information (Level 2): Deeper understanding of the structure, organization, conventions, guidelines, and features of ICD-10 ICD-10 Training ► Education (Level 3): Detailed job specific training for staff who may be involved in documenting patient activities and handling medical and administrative records ► Knowledge (Level 4): Comprehensive training for staff who are involved in documenting patient activities and medical and administrative records ► Expertise (Level 5): Intensive training on coding conventions, guidelines, assignment and interpretation of ICD-10 CM/PCS codes General awareness is provided through enterprise wide communication while job specific learning is delivered through focused training

9 Level 3 Education Coder Proficiency Assessment through EduCode Biomedical Skill Building: Anatomy & Physiology/Pathophysiology Level 4 Knowledge ICD-10-CM and ICD-10-PCS Code Set eLearning Modules Level 5 Expertise ICD-10 Case Study/Scenarios in Practice Environment In-Person Training as needed ICD-10 Education & Training Plan Health Information Management/Coding Staff

10 Level 3 Education Biomedical Skill Building: Anatomy &Physiology/Pathophysiology Level 4 Knowledge ICD-10-CM Code Set eLearning Modules Level 5 Expertise ICD-10 Case Study/Scenarios in Practice Environment In-Person Training ICD-10 Education & Training Plan Clinics/Professional Fee Coding Staff

11 Level 3 Education Impact of ICD-10 Overview – Clinical Level 4 Knowledge ICD-10 Clinical Documentation Improvement Modules ICD-10-CM & PCS Code Set Training Modules In-Person Regional 3-4 Day Training Sessions Level 5 Expertise Clinical Rotation and On-Unit Rounding ICD-10 Education & Training Plan Clinical Documentation Improvement Specialists

12 Level 3 Education eLearning Modules: Impact of ICD-10 Overview – Clinical and/or ICD-10 Coding for Non-Coders – Clinical Level 4 Knowledge ICD-10 Physician Documentation Enhancement eLearning Modules (mapped to appropriate specialty) Local, specialty specific in-person sessions for top percentile admitters ICD-10 Education & Training Plan Physicians (Acute & Ambulatory)

13 Level 1 Awareness and 2 Information General awareness decks tailored to the job role and extent of ICD-10 codes in workflow Level 3 Education Impact of ICD-10 Overview – Clinical Level 4 Knowledge ICD-10 Coding for Non-Coders (Clinical) Impact of Nursing Documentation ICD-10 Education & Training Plan Non-Physician Providers

14 Curriculum by job role is in review by subject matter experts and super users Level 3 Education Impact of ICD-10 Overview – Revenue Cycle Impact of ICD-10 Overview – IT/Reporting Level 4 Knowledge Coding for Non-Coders - Financial ICD-10 Education & Training Plan Revenue Cycle (Acute and Clinic) / IT / Reporting

15 Level 3 Education Impact of ICD-10 Overview – Clinical Level 4 Knowledge: Oasis Answers, Inc. Web-Ex and In-Person Training (Home Health) ICD-10 Coding for Non-Coders – Clinical Impact of Nursing Documentation ICD-10-CM Code Set Training Modules ICD-10 Education & Training Plan Home Care/SNF

16 Curriculum by job role in review by subject matter experts and super users Level 3 Education Impact of ICD-10 Overview – Revenue Cycle Impact of ICD-10 Overview – IT/Reporting Impact of ICD-10 Overview – Clinical Level 4 Knowledge Coding for Non-Coders – Financial ICD-10 Coding for Non-Coders -Clinical ICD-10 Education & Training Plan Health Plan

Thank You

Provider & Non-physician provider CY2013 ICD-10 Go Live CY2014 Provider eLearning eLearning start 2/18/14 eLearning complete 9/30/14 Provider In Person Sessions In person start 4/1/14 In person complete 9/30/14 CDI Specialists In Person (regional 3-4 day sessions) In person start 3/3/14—complete 6/27/14 In person start 7/1/14—complete 9/30/14 CDI Specialists Non-Provider Clinicians Non-provider Clinicians eLearning eLearning start 3/1/14 eLearning complete 9/30/14 CDI Specialists eLearning eLearning start (4/1/14) eLearning complete 9/30/14 PCN Leadership/Education Session Working document to be updated as information becomes available ICD-10 Program Assessment Period Q3Q4Q1Q2Q3Q4 ICD-10 Provider/Clinical TLG Education & Training Map Data Analytics Report 10/4/13 Curriculum Finalization Forms Remediation In-person Session Planning & Logistics Initiate New Clarification Forms * 8/18/14 1 hr pre-test 2/14 Clinical Rotation / On-unit Rounding On-Unit start 8/1/14 On-Unit thru 4/30/15 Includes MS-DRG & APR-DRG AZ APR-DRG AZ APR-DRG In Person (2-3 day sessions) PCN Leadership/Education Session

Complete 5/30/14 Practice Coding HIM/ Compliance Health Plan HH/ SNF Coder ICD-10 eLearning Acute Start 10/1/13 Acute Complete 4/30/14 5/1/14 – 6/30/14 Start 9/9/13 Complete 10/31/13 Assessment Acute only In Person Training CY2013 ICD-10 Go Live CY2014 Working document to be updated as information becomes available Q3Q4Q1Q2Q3Q4 ICD-10 TLG Education and Training Map Initiate New Clarification Forms * 8/18/14 EduCode (Biomedical Skill Building) Lessons Acute Start 9/9/13 Acute Complete 11/30/13 Acute Start 4/1/14 Start 7/1/14Complete 9/30/14 ICD-10 Program Assessment Period eLearning Start 3/1/14 Coder eLearning 8/1/14 – 9/30/14 eLearning 6/19-20/149/12/14 OAI In Person Sessions 11/6/14 OAI WebEx Sessions 8/7-8/14 10/10/1412/12/14 eLearning Start 7/15/14Complete 9/15/14 Revenue Cycle - Clinics Revenue Cycle - Acute 5/1/14 – 6/30/14 eLearning Profee Start 6/1/14 Profee Complete 6/30/14 Profee Start 11/1/13 Profee Complete 9/30/14