Managing Hybrid Records

Vol. 17 •Issue 26 • Page 15
Virtual Roundtable

Managing Hybrid Records

New 2008 online column will present a virtual roundtable.

(Editor’s note: Starting on Jan. 14, ADVANCE will debut this new online column called “Managing Hybrid Records: A Virtual Roundtable.” Each month, you’ll learn from your peers how to manage in a hybrid world.)

“Hybrid.” To many, the adjective describes a type of car or a rose; technically, it refers to any offspring of different breeds or species. In the world of HIM, the term usually refers to the transition from paper-based records to electronic ones. And aptly, could these two “species” be more different? Enter the hybrid medical record.

With mountains of paperwork for everything from A to Z, it’s no wonder the health care industry is making a slow evolution rather than a mass exodus toward EHRs. According to a work force study conducted by the American Health Information Management Association (AHIMA) in 2006, 50.1 percent of hospitals surveyed indicated that they are planning to adopt an EHR, while 37.1 percent have already adopted one. But there’s a lot of room between planning and complete adoption; the transition to becoming 100 percent electronic can be slow, arduous and full of questions. Gray areas outnumber the obvious black and white as HIM professionals learn how to make it work for their organizations. Added to that, the sheer volume of records—and types of records—makes it nearly impossible not to experience a hybrid stage during the journey.

HIM Peers Share the Journey

The health care industry has always demonstrated a strong commitment to collaboration and education through peer exchange—and HIM is no exception. During the next few months, our virtual roundtable of hospital and consulting experts will share their experiences and insights regarding the hybrid medical record. The panel will consist of HIM directors with widely different viewpoints and experiences, as reflected by their varied organizations:

  • A 31-facility health care delivery system;
  • A large, Northeast 640-bed, long-term care facility with a short-term, post-acute care unit and a medical acute care unit;
  • A mid-sized community hospital.

    Each month, our roundtable will dive deeper into five key issues that every HIM director must address as they manage in a hybrid environment. Panel members will share their unique perspectives, lessons learned and suggestions for success in the following areas:

    1. Re-writing HIM workflow—Electronic records require a complete culture change. As you move from paper to electronic, all HIM processes must be completely re-invented. How can you re-invent the wheel while still maintaining the same old engine–paper records? What changes should you make to ease the transition while ensuring maximum value from your new system?

    2. Advancing personnel—How do you move your staff from “paper aware” to “technology aware”? How do you set expectations and manage milestones while maintaining productivity, morale and energy levels? What retention issues might you face? What will your future staffing requirements be?

    3. Keeping up with your key performance indicators—While your staff, physicians and other departments are making the transition to electronic records, traditional, paper-based key performance indicators (KPIs) must still be managed and maintained. Which KPIs will cause HIM headaches and how can you set executive expectations?

    4. Keeping physicians compliant and happy—How can you ensure that physicians are going to adopt your EHR and keep them pleased during the transition? Hardest to please and loudest to be heard, physician satisfaction must be part of your transition plan.

    5. Measuring success—The hybrid medical record state may last months or could last years. When your transition to electronic records spans the decade, which incremental milestones can be achieved and celebrated? How can you keep the momentum flowing when vendors, technology, physicians and politics continually create hurdles for your success?

    State of HIM

    Based on a series of successful roundtables conducted by HealthPort (formerly SDS) and AHIMA component state associations in 2007, this online column will be a tremendous HIM resource throughout 2008 and beyond.

    As reported by the 2007 state roundtable participants, more than one quarter of all HIM departments are still 90 percent to 100 percent paper-based rather than electronic. Another quarter are still more than 50 percent paper-based, and nearly half of all HIM departments use a blend of in-house staff and outsourcing to handle functions such as transcription, audit and document storage and retrieval.

    Clearly, most HIM departments are in a hybrid state and will likely remain so for at least several years! Through our collaboration, we look forward to helping HIM departments make the most of the hybrid record and transition to a more paperless and efficient world.

    Aaron Brandwein is divisional vice president for HealthPort, formerly SDS.

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