State ICD-10 Collaboration Aids Readiness in Rural Settings

It’s well understood that small, rural healthcare providers struggle the most when it comes to being prepared for ICD-10-CM/PCS implementation, but the state of Idaho is a notable exception.

Kaelyn Coltrin, RHIT, co-chair of the Idaho ICD-10 Collaborative, shared her experience in preparing a mostly rural state for the transition in her Wednesday morning presentation “Collaborating for Statewide ICD-10-CM/PCS Success” at AHIMA’s ICD-10-CM/PCS and Computer-Assisted Coding Summit.

Kaelyn Coltrin, RHIT, co-chair of the Idaho ICD-10 Collaborative

Kaelyn Coltrin, RHIT, co-chair of the Idaho ICD-10 Collaborative

Idaho has a population of approximately 1.6 million people, and has approximately 29 critical access hospitals and only 17 hospitals considered to be in “urban” settings, according to Coltrin. These statistics alone present significant barriers to ICD-10 readiness by many standards.

Additionally, according to the Idaho ICD-10 Collaborative’s data, most of these organizations had 10 people or less working on electronic health records (EHRs), the “meaningful use” EHR Incentive Program, and ICD-10 implementation. However, according to the collaborative’s own surveys, 75 percent of providers in the state felt ready for ICD-10 testing in 2013 and 2014.

Coltrin attributes the readiness rates to the educational efforts put forth by the Idaho ICD-10 Collaborative, which is a volunteer group of stakeholders that banded together in 2009 after AHIMA’s Idaho component state association launched an ICD-10 implementation task force.

“Given the rural nature of our state and geographically widespread nature, we knew education would be a feature to focus on, to ensure people would have access to affordable education,” Coltrin said.


Build Your Own ICD-10 Collaborative

Coltrin encourages other ICD-10 stakeholders to consider forming similar groups in other states with large rural populations. She notes that in Idaho all members of the collaborative work on a volunteer basis.

“In Idaho, it’s purely grassroots-led. We have no funding, we’re simply together because we have a shared passion,” Coltrin said.

She suggested that interested parties start by crafting a mission statement and by staying adaptable. She recommends the mantra “plan perfectly but execute flexibly.”

Next, it’s important to secure sponsor organizations, identify collaborators, establish an executive committee, and define how the organization will function. Questions to consider include:

  • Will it be volunteer-led?
  • Have open or closed membership?
  • What will be potential sources of funding?


Have the Right People at the Table

One of the keys to Idaho’s success was through inviting the right participants and stakeholders. The group started out with membership by invitation only, but then adopted an open membership plan. This allowed Idaho’s Medicaid director to become involved.

“We were blessed two years in to have the state lead for Medicaid join the collaborative. We needed a little revitalizing. So I have CMS [the Centers for Medicare and Medicaid Services] or Medicaid ICD-10 very intricately involved,” Coltrin said.


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