Key additional results of the current research include:

— Lack of response from vendors. More than 52 percent of respondents indicated that they had not heard from their practice management system vendor regarding when software changes would be available to the practice. Almost 50 percent had not heard from their EHR vendor.


— Internal software testing lags. Only 5.9 percent of respondents reported that internal software testing has begun or is complete with their practice management software vendor and 4.7 percent with their EHR vendor.

— External testing delays. Just 11.9 percent of respondents reported that external testing with their clearinghouse has started or is complete. Almost 60 percent reported that they have not even heard from their clearinghouse regarding a testing date. Only 8.6 percent have started or have completed testing with their major health plans, with a concerning 70 percent stating that they have not heard from their major health plans.

— Low confidence for a successful transition. Nearly 60 percent of respondents stated they are "slightly" or "not at all confident" that their major health plans will be ready to meet the Oct. 1, 2014, compliance date.

— Concern about changes to clinical documentation. Among a number of implementation concerns, 88 percent are concerned or very concerned about the expected changes to clinical documentation; 87.5 percent are concerned or very concerned about the loss of clinician productivity after implementation; and 81.1 percent of respondents indicated they are concerned or very concerned with the overall cost of switching to ICD-10.

DMN: Were the practices you surveyed all members of MGMA-ACMPE?
ST: A large majority are members, and some non-members may have responded.

DMN: Why do you think the transition to ICD-10 will be such a daunting task for the health care industry?
ST: Compared to the practice migration to the HIPAA 4010 and then the 5010 electronic transactions, for example, ICD-10 presents a set of unique and complex challenges. First, ICD-10 impacts both the clinical and administrative sides of the practice — requiring not only technical modifications to both practice management system (PM) and EHR software, but also potential modifications to the clinical documentation recorded by physicians and utilized by professional coders. Administrative and clinical staff will also require significant training, and workflow processes will need to be reviewed for the impact of ICD-10 and modified appropriately.

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