ICD-10 Education & Training

1. ICD-10 Education & Training Organizational Effectiveness Thought Leadership Group

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

3. ICD-10 Training Focus and Desired Outcomes 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 Training focus Ownership Commitment Communications Focus PRODUCTIVITY Acceptance Understanding Awareness TIME

4. Training Leading Practices • 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. ICD-10 Integrated Training Strategy 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

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

7. 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 • 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 • 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 • 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 Role Specific Education

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 Training Communication Level 1 Awareness Level 2 Information Level 3 Education Level 4 Knowledge Level 5 Expertise High Level Deep Dive General awareness is provided through enterprise wide communication while job specific learning is delivered through focused training

9. ICD-10 Education & Training Plan Health Information Management/Coding Staff • 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

10. ICD-10 Education & Training Plan Clinics/Professional Fee Coding Staff • 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

11. ICD-10 Education & Training Plan Clinical Documentation Improvement Specialists • 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

12. ICD-10 Education & Training Plan Physicians (Acute & Ambulatory) • 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

13. ICD-10 Education & Training Plan Non-Physician Providers • 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

14. ICD-10 Education & Training Plan Revenue Cycle (Acute and Clinic) / IT / Reporting • 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

15. ICD-10 Education & Training Plan Home Care/SNF • 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

16. ICD-10 Education & Training Plan Health Plan • 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

17. Thank You

18. ICD-10 Provider/Clinical TLG Education & Training Map Q3 Q4 Q1 Q2 Q3 Q4 CY2013 CY2014 Working document to be updated as information becomes available ICD-10 Go Live CDI Specialists In Person (regional 3-4 day sessions) AZ APR-DRG Provider eLearning Non-provider Clinicians eLearning Provider In Person Sessions Data Analytics Report 10/4/13 eLearning start 2/18/14 eLearning complete 9/30/14 CDI Specialists eLearning eLearning start 3/1/14 eLearning complete 9/30/14 In person start 3/3/14—complete 6/27/14 In person start 7/1/14—complete 9/30/14 In person complete 9/30/14 In person start 4/1/14 Curriculum Finalization * 8/18/14 eLearning complete 9/30/14 eLearning start (4/1/14) Initiate New Clarification Forms Forms Remediation In-person Session Planning & Logistics Provider & Non-physician provider PCN Leadership/Education Session PCN Leadership/Education Session ICD-10 Program Assessment Period CDI Specialists AZ APR-DRG In Person(2-3 day sessions) 1 hr pre-test 2/14 Clinical Rotation / On-unit Rounding On-Unit thru 4/30/15Includes MS-DRG & APR-DRG On-Unit start 8/1/14 Non-Provider Clinicians

19. ICD-10 TLG Education and Training Map CY2013 CY2014 Working document to be updated as information becomes available Q3 Q4 Q1 Q2 Q3 Q4 ICD-10 Go Live Assessment Acute only Complete 10/31/13 Start 9/9/13 HIM/ Compliance EduCode (Biomedical Skill Building) Lessons Acute Complete 11/30/13 Acute Start 9/9/13 Profee Start 11/1/13 Profee Complete 9/30/14 * 8/18/14 Initiate New Clarification Forms Coder ICD-10 eLearning Profee Complete 6/30/14 Profee Start 11/1/13 Acute Start 10/1/13 Acute Complete 4/30/14 Practice Coding Profee Start 6/1/14 Acute Start 4/1/14 Complete 9/30/14 ICD-10 Program Assessment Period In Person Training Start 7/1/14 Complete 9/30/14 Revenue Cycle - Clinics eLearning 5/1/14 – 6/30/14 Revenue Cycle - Acute eLearning 5/1/14 – 6/30/14 Coder eLearning eLearning HH/ SNF Start 3/1/14 Complete 5/30/14 Start 7/15/14 Complete 9/15/14 8/7-8/14 6/19-20/14 9/12/14 10/10/14 11/6/14 12/12/14 OAI In Person Sessions OAI WebEx Sessions Health Plan eLearning 8/1/14 – 9/30/14