HIM Professionals Support the World of Technological Advances
HIM Professionals Support the World of Technological Advances
No time has the HIM PROFESSIONAL had such a profound INFLUENCE over the management of health information and current technological advances. No time has HIM TEAMWORK become so CRITICAL.
The field of information technology (IT) gained value several decades ago by automating manual work processes. It later evolved to the restructuring or re-engineering of clerical and professional desktop work. More recently IT became an integral part of commerce.
With this kind of IT evolution peppered by IT’s advances that far exceed an organization’s ability to change, IT faces greater challenges in the 21st century than ever imagined. For example, today there is greater resistance to IT’s related organizational changes and re-engineering than ever before. In addition, current technological advances are entering organizations at levels at which the tolerance for the learning required is more diminished.
For health care provider organizations, this means that as IT evolves and technological advances continue, even more complex and ambiguous work processes will replace current, already complex and ambiguous work processes. The newer, more complex processes will have greater business value but will require even higher-level computer and systems operations skills. They will also need to inspire even more users with confidence in those skills.
Despite today’s mood of technological supremacy, no wonder health care management continues to have difficulty managing the integration of technological advances into business processes. No wonder too many health care IT projects stumble and cost more time and money than anticipated.
All this is having a huge impact on the way health care provider organizations and their members are transitioning to these changes. Unfortunately, often this is focusing attention away from recognizing those who have the skills in health care systems-building and, instead, bending toward process at the expense of operational goals. Few other health care professionals can provide the kind of expertise needed in this environment than the health information management (HIM) professional. The very essence of the HIM professional’s work is on the analysis of manual and automated systems, as well as the operation and flow of work procedures.
For example, HIM professionals are trained to develop solid skills in such areas as gathering necessary input, resolving data modeling issues and presenting data in a fashion that is certifiable when questions of replicating data are offered. In addition, HIM professionals know best why almost every aspect of record keeping is difficult to standardize because they stand in the first line of defense in managing today’s unreliable, fragmented and non-standardized patient medical, financial and administrative data. HIM professionals understand better why many organizational stakeholders will not trust others enough to share information freely. In other words, HIM professionals understand more than most other health care professionals why almost every aspect of record keeping, data sharing and information management is difficult to automate, but doable.
Therefore, no time has the HIM professional had such a profound influence over the management of health information in health care organizations. No time has HIM teamwork become so critical. No time have practical, politically correct skills become so relevant.
Current Technological Advances
A review of some of the current information technologies in health care reveals a plethora of technological advances. All of these technologies and advances directly impact the HIM professional and require the skills of the HIM professional in order to succeed.
Table 1 lists the most common operations currently performed by HIM professionals in health care provider organizations. Table 2 lists the most talked-about and current technological advances in health care. An overlay of one table on top of the other shows how closely related are these current technological advances with standard HIM operations.
For example, in just five short years, the Internet and its derived technologies are ubiquitous. It started with the protocols for mail (Simple Mail Transfer Protocol [SMTP] or e-mail), news groups and bulletin boards (Network News Transfer Protocol [NNTP]), and the Web (HyperText Transfer Protocol [HTTP]), and moved to intranets, extranets, portals and application service providers (ASPs). No greater effect can these technological advances have on HIM professionals than the creation and storage of (at least pieces of) Web browser-based patient records that are written, for example, in HyperText Markup Language (HTML) for format and Extensible Markup Language (XML) for content.
In rural Wayne, WV, the clinicians electronically record and post all patient clinic notes and receive their Valley Health System patients’ history, medication, laboratory and (analog) X-ray information via the Web. The University of Kansas, the University of Pennsylvania and the University of California Los Angeles Medical Centers store transcribed radiology reports and digital diagnostic images in radiology databases, allowing their clinicians to access the databases via Web servers using a Web browser.
The familiar moniker, e-health, is the use of Internet technologies to integrate all aspects of Business-to-Business (B2B) and Business-to-Consumer (B2C) activities, pro-cesses and communications. In other words, it is the application of commerce to the health care industry. Some of those e-health services where HIM professionals are the finest contributors include:
- implementing the procedures for online appointments/registrations by patients;
- designing and organizing the online pre-visit health screening, evaluation and assessment documents;
- assisting in the online post-visit patient education reminders (e.g., patient confidentiality); and
- developing the online content on health conditions, diseases, wellness, or new developments in health care.
Any HIM professional worth his/her weight in stacks of paper records knows that personal health records (PHRs) won’t eliminate the need for computer-based patient record (CPR) systems (a.k.a., electronic patient record [EPR], electronic health record [EHR], electronic medical record [EMR] systems). CPRs are the provider organization-owned records, and they are optimized to meet all the operational needs of the organization. PHRs are individually owned, containing subsets of the information provided by care organizations. In addition, although there is yet any precedence, most likely the PHR will not be the record subpoenaed in courts of law. That would be like subpoenaing a personal checkbook when the individual’s bank records are under question.
Interestingly, increasing consumer demand for useful PHRs will make it mandatory that an organization’s CPR is capable of sending and re-ceiving data from PHRs. No other health care professional will be able to manage this requirement as well technically and operationally. In addition, it’s the American Health Information Management Association (AHIMA) that has already developed and published more than 40 principles to protect the privacy and ensure the quality of personal health information on the Internet.
Virtual patient records (VPRs) integrate data from potentially dozens of disparate health care sources, such as acute care facilities, ambulatory clinics, insurers and ancillary service providers to create a single view of patient data. VPRs gather transactions from the disparate sources’ disparate information systems and pass the information to an intranet’s Web interface. It is not an easy or inexpensive task to integrate patient data from multiple information systems within or between organizations. However, the alternatives to VPRs are worse, such as eliminating existing information sys-tems, standardizing on one vendor’s suite of products or attempting to connect many diverse systems, even with sophisticated gateways.
While today’s existence of VPRs is very limited, this concept will continue to be tested. The leadership of HIM professionals in this challenge cannot be underestimated.
A quick but useful exercise would be for HIM professionals to match the item(s) listed in Table 1 with the item(s) listed in Table 2. For example, the HIM operation of Medical Report Dicta-tion/Transcription is directly related to the current technological advance of continuous speech recognition. Some of the HIM operations will be cited in all the current technological advances, and vice versa.
And that’s the point. HIM professionals are unique in being able to plan for many technological advances and take advantage of the opportunity to create “successful” organizational transitions from analog to digital. This means that HIM professionals must continue to examine the dynamics of the workplace, the communication methodologies of the staff, and the current processes in place. They must continue to determine what really needs to be accomplished as opposed to “how it has always been.” Then, they must review the processes with the project’s team and adapt them to the development of the new technologies.
This article is not intended to be another plea to volunteer for or accept committee and project teamwork. Instead, this is a plea to lead with those unique sets of skills and get the job done.
Deborah Kohn is the principal of Dak Systems Consulting, San Mateo CA, a national, health care information technology advisory consultancy.