Shortage of Coders Jeopardizes Health Care Reform

Michael Vizard
Slide Show

Health Care IT Still Needs Critical Care

Despite focusing on compliance and security issues, progress to date has been somewhat limited.

Health care reform may be in serious jeopardy, but it has little to do with politics or any forthcoming rulings emanating from the highest court in the land.

One of the less appreciated aspects of health care reform is an International Classification of Diseases, 10th edition, Clinical Modifications (ICD 10) requirement that calls for a completely new approach to the codes that are used in the electronic medical records (EMR) that hospitals rely on to classify patients. There are not only new codes in ICD-10, there are also additional digits because health care organizations have run out of digits to classify various medical procedures and conditions.

Scheduled to be implemented by Oct. 1, 2013, Pradep Nair, senior vice president for health care at HCL America, a unit of HCL Technologies, says ICD 10 is the health care equivalent of the Y2K projects that required so much coding effort starting back in 1998. But it turns out that there is a serious shortage of people who know how to code for ICD 10. The end result, says Nair, is that there is some serious doubt about attaining the health care IT goals for 2013 that have been mandated by the U.S. Department of Health and Human Services. In fact, if a health care organization is not already working on this transition, Nair says the chances are good that it's unlikely that organization is going to make the deadline.

This is a significant issue, says Nair, because a huge amount of the data that needs to be accessed is locked up in mainframe systems that health care providers and insurers have been relying on for years. The ICD 10 requirements mean that these organizations are being forced to embark on massive application modernization projects. Some health care organizations are so ill-prepared to finance this modernization that Nair says it's likely we'll see some significant mergers and acquisitions across the health care industry.

No one knows where the U.S. government will be compelled to grant extensions, but Nair says that it is unlikely that even a new administration would halt the shift to EMR because both political parties are keen to reduce health care costs. So, no matter what, the pressure is on.

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Nov 18, 2011 9:23 AM Aditya Aditya  says:

Interesting article on the future of coders in the healthcare industry, with the deadline for ICD 10 migration nearing t is important for coders to completely resolve any issues with regards to ICD 10 migration prior to complete adoption.Just read an interesting whitepaper, ICD 9 to ICD 10 transition on strategies for successful transition to the new coding format @http://bit.ly/rUq4Jz

Nov 18, 2011 12:17 PM hoapres hoapres  says:

Another bogus "shortage of programmers" to justify more H1Bs.

The above is cynical but unfortunately probably accurate.

Nov 18, 2011 2:09 PM Barbara Duck Barbara Duck  says:

I agree on the coding and glad I don't write anymore:)  I got stuck in VB 6 and got tired:)  This holds true for so many area and the FDA too needs engineers. 


The real world out there has no comprehension on how complicated data has become today, not to mention the flaws out there as even the Social Security Death Index recently found 30k of living inside:)

Nov 18, 2011 5:08 PM hoapres hoapres  says: in response to Barbara Duck

If we had a "shortage of coders" then we would actually see job advertisements and people actually getting hired instead of just talk.

Nov 18, 2011 7:06 PM Barbara Duck Barbara Duck  says: in response to hoapres

Actually that is a big problem as we can't hire enough engineers in the US, aka developers.  It's getting to be very specific today with multitudes of applications and web apps too. 

FDA for example needs engineers too and we have a lack of qualified US residents and have to rely on getting personnel from outside the US sadly.

Nov 19, 2011 12:47 PM hoapres hoapres  says: in response to Barbara Duck


I believe you.


I have yet to see ads for these jobs and once I start seeing phrases such as "...outside the US..." means one is looking for cheap H1B help.

Nov 20, 2011 2:31 PM Programmer Programmer  says:

A couple years ago, HCL claimed that they would never hire an American.  So now they are whining about a programmer shortage, all while they are getting projects that are paying them with American tax payer dollars?  And people wonder why this country is going down the tubes!

Nov 21, 2011 11:43 AM IAmNumber813 IAmNumber813  says: in response to Barbara Duck

This is a lie: "But it turns out that there is a serious shortage of people who know how to code for ICD 10" says Pradep Nair, senior vice president for health care at HCL America.

How many job ads does HCL have on Dice (or anywhere else) looking for ICD-10 skills? 0

American IT professionals solved the more difficult Y2K problems in the 1990s. Most of the developed world has already converted its computer systems from ICD-9 to ICD-10 years ago without using cheap labor from India.

The major problem with the "Indian" way of thinking (since they're trained as "rote" thinkers) is that most Indians such as Pradep Nair believe that unless someone has performed a certain task before, they are not qualified to do the task. Indians assume that previous IT skills, knowledge, talent, experience are not transferable to a task such as an ICD-9 to ICD-10 conversion project (which is changing mediical diagnostic codes from 3-5 characters to 3-7 characters). Hence, there must be a "serious shortage of people".


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