If there's anything that's particularly challenging to CIOs and other healthcare IT leaders these days, it's the need to focus on numerous priorities at the same time. Naturally, the focus on meaningful use has and should be intense right now in the industry. But, warns one expert, hospital organizations don't have the option to ignore the path forward on the ICD-10 transition, either.

I met on Tuesday with Chris Armstrong, a Los Angeles-based principal with Deloitte Consulting, who is working intensively with a growing number of hospitals on preparing for the ICD-10 transition. What is it that people don't get right now? I asked her. "I think it's the magnitude of effort involved in moving to the new code set; the magnitude is greater than most people realize," Armstrong said. "And remember, from a resource perspective, the same people—IT and HIM— are the ones also working on ICD-10 are the same people preparing for meaningful use. So there's a human resource issue." She also said, "There's a certain amount of training needed for the physicians to be able to support the coding. Some payers won't be ready right away for the transition; so there might be dual-processing situations [ICD-9/ICD-10] for a while. And it's not just billing systems that house ICD-9 codes; it's data warehouses, quality outcomes tools, OR systems with preference cards, credentialing, marketing tools and applications, and research, among others."

What are the hospital organizations doing that are doing well in all this so far? "They're starting now, understanding that it's a three-plus-year journey, and they've created action plans," Armstrong said. "They've created a multidisciplinary steering committee—physicians, nurses, HIM, managed care contracting, finance—all of those areas need to be a part of the steering committee. "With an average price tag of anywhere from $10 million to $20 or more for an average-to-large-sized community hospital, the stakes are high," she noted. Of course, the ultimate cost will vary quite dramatically; and, as in virtually every other area affecting healthcare IT leaders, the cost—and complexities—"will really depend on how advanced and up-to-date your information systems are."