If the health information managers in the audience at the annual AHIMA Convention in Salt Lake City on Tuesday morning were not already overwhelmed by ICD-10, once T.B Ustun, MD, hit the stage, they would be. It was just a few minutes into his speech when he raised the prospect of ICD-11.

Ustun works for the World Health Organization, where he is the team coordinator of classifications, terminologies and standards. His team is developing ICD-11, which he prefers to call ICD-2015, figuring it would help stave off procrastination when it comes to uptake.

[See also: ICD-10 is big, but ‘the sky is not falling’.]

It will have taken the United States 23 years from the time ICD-10 was ready for use until the anticipated October 2013 deadline to adopt the new code system.

Ustun promised ICD-11 would be markedly better than ICD-10, but also that there is no way the United States could skip right over to ICD-11 now that other countries have employed it for years, and many U.S. healthcare organizations are under way to conversion – though not yet ready.

Jim Jacobs, senior vice president, product management and health information management, at QuadraMed, which provides technology and services to help organizations make the transition, says the bulk of the company’s 800 plus customers, fall in the "absolute beginning” category.

They have HIPAA 5010, meaningful use and many other projects under way, he said. "It’s a lot of pressure, a lot of things. If they wait to the last minute, there’s not an Easy Button."

[See also: Would meaningful use Stage 2 delay ignite ICD-10?.]

As Lynne Thomas Gordon, the new CEO of AHIMA’s 63,000-member organization, sees it, not being ready for ICD-10 is not an option. If providers don’t convert to ICD-10, “they’re not going to get paid,” she said.

ICD-10, Ustun told his audience "is written on the wall (he queued up a slide of a brick wall on which ICD-10 was written) and we cannot take it back.

"This is a huge change and most countries, most managers and most professions are not ready for this change," Utsun said. "You will suffer more, I tell you. I will have ICD-11 ready for you by 2015."

To avoid the 23-year uptake experienced for ICD-10, Ustun, a psychiatrist, said he preferred everyone look at ICD-11 as ICD-2015 -- the better to stay on track.

“Let us not call it ICD-11; let us call it ICD-2015, he said.

ICD-11 would be much more streamlined than ICD-10, yet much more effective. Among the problems with ICD-10 he said, the coding system is used in only 117 of 193 countries, it has limited Web presence, and it does not interoperate with electronic health records. ICD-11, he said, would be built on an Internet platform, with digital curation and wiki-enabled collaboration.

Post 2015, coding will be much more automatic, Utsun told the audience.

“It’s like Windows or Mac,” he said. “Your software will be automatically updated. “Why is this this so important?” Utsun asked. “It’s not just about cost; it’s about saving lives.”

Meanwhile, he urged the audience to plunge into ICD-10 work. “ICD-10 is inevitable,” he said. “Do it as effectively as possible.”

[See also: The Challenges of ICD-10 Implementation.]

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