Care Technology Governance Committee (CTG) February 6, 2014, Amelyn Culver and Jennifer K. Clarke

2 iTen ICD-10 STEERING COMMITTEE Project Sponsor and Chair: Barrie Strickland Co-Chairs: Mike Hindery, Pam Hudson ICD-10 PROJECT LEAD Amelyn Culver HOSPITAL CODING SheRee Garcia PB CODING Kevin McLaren PATIENT ACCESS Cindi Drew BILLING (HB, PB) Bryan Chamberlin Cliff Skinner IT Jennifer K. Clarke QUALITY MEASURES & REPORTING Brigid Ide PROVIDER DOCUMENTATION & EDUCATION Paul Brakeman Russ Cucina Michelle Mourad

ICD-10 ICD-10: 34 weeks left… UCSF Parallel Period: 2 weeks in… 3 UCSF’s Transition to ICD-10

4 December – JanuaryFebruary - March Request for ICD-10 APeX Training sent by to the following all UCSF MDs and GME distribution lists: Three reminders = 1,000K completions to date Poster for ICD-10 Documentation Requirements sent to managers and nursing staff (see next page); and posted in provider work rooms on each hospital floor. Project Update (In-Service): SOM MSO Group, PB Revenue Cycle team, Patient Access Super Users Monthly meeting, Soft Go-Live announcement at Medical Center Management Meeting on Jan. 28; ICD-10 beverage coasters distributed. Coasters distributed at Chief Residents Dinner (Jan. 28) Department and Division Meetings underway across all specialties.  Next ICD-10 Documentation Poster: Content will be based on SGL findings  Optimizing Provider Tools on Carelinks, including adding tip sheets, Precyse content and link to modules on ICD-10 webpage.  Awareness Campaign: ICD-10 beverage coasters! The design will include 1) ICD-10 code for dehydration and 2) ICD-10 Project timeline and 2) Carelinks web page (cost: $200 for 1K coasters, distribution to SOM and Medical Center Managers)… Accomplishments and Targets to SGL: Communications ICD-10

ICD-10 Poster No. 1: Posted on each hospital floor (provider work rooms) in mid- December before Soft Go-Live. 5 iTen ICD-10

Accomplishments and Targets: Information Technology 6 **Soft Go-Live**February Both ICD-9 & ICD-10 code sets are moving through APeX properly Interfaces and 3 rd party systems are also working as expected The soft go-live had a low impact, which was the goal Among the handful of tickets and issues (5 total), Dermatology experienced issues with its patient history module. We identified the problem as local, and which required some changes to their APeX build and user education; the APeX teams are investigating whether this might be an issue for other departments, but the likelihood of that is low or virtually nil. Team will continue to monitor issues and improve tools (via APeX clinical content ticketing system). Approximately 3800 new diagnosis have been selected since the soft go- live. (Compare to the number of issues – five – this ratio indicates how successful the soft go-live has been for our provider community. 1.IMO v1.4 load 2.Provider Template Build (benchmarks TBD) 3.Work with HIM workgroup to develop reports to track queries 4.Integrated testing 5.3 rd party system and interface testing 6.Ongoing payer testing opportunities: 1.Anthem 2.Blue Shield 3.Kaiser & CMS TBD 7.Reports testing March 1.Projecting 70% of integrated testing with 3rd party systems will be complete. 2.Provider templates and Problem List Preference Lists benchmarks TBD. 3.Reports testing

ICD-10 KPI: Third-Party System Readiness 7

ICD-10 Physician Queries Timeline: Provider Documentation & Education 8 iTen ICD-10 January 15 th, 2014: HIMS begins dual coding. Charts that cannot be completely coded in ICD-10 due to additional documentation needs are sent to the coding specialist. The coding specialist composes a mock ICD-10 query and records 1) ICD- 9 code needing ICD-10 clarification, 2) nature of the clarification 3) the attending physician of record. These queries are also sent to PD&E leadership for review of volume and content. A summary of query content is used to educate physicians on documentation needs. April 1 st, 2014: HIMS now sends queries to physician In Baskets. Queries provide physicians education on necessary documentation. Physicians are required to reply to the query with a clarification, but are not required to change the documentation in the chart (as it requires significant additional work). July 1 st, 2014: In response to a query, physicians are now required to addend their documentation in the chart.

9 ICD-10 Transition Timeline: Soft Go-Live to Compliance ICD-10

10 ICD-10 Questions?