The Transformation of HIM

As an HIM professional, what is data to you?

In their paper titled “Health Information Management Reimagined: Assessing Current Professional Skills and Industry Demand”, Kim Beesley, MHIM, RHIA, Alexander McLeod, Ph.D., Barbara Hewitt, PhD, and Jackie Moczygemba, MBA, RHIA, CCS, FAHIMA stated:

“Health information management (HIM) continues its transformation toward health informatics, big data, and analytics while traditional competencies such as coding are waning as computer-assisted coding moves to the forefront of healthcare information systems. Compounding this skill shift is the adoption of the electronic health record, allowing data to be digitally and globally collected on cheaper, more efficient computers, and software capable of handling big data and predictive analytics.”

In other words, the transformative HIM departments are about more than handling coding and e-documents (efaxed, emailed or scanned). They’re about data and its analysis. I’m going to focus on how the HIM department can optimize further and use its core competencies in clinical document management to transform and positively impact the full enterprise of the health system.

Gearing up for this transformation requires asking yourself key questions:

1. Who else, other than HIM, is processing e-documents for indexing and data entry around the health system? Who can you help?

2. What requirements are there for processing those documents (i.e. simple indexing or inclusive of data entry)?

3. Are there technologies that are available to support the transformation?

Who else, other than HIM, is processing e-documents for indexing and data entry around the health system? In other words, who can you help?

 As all HIM professionals know, there is still a great deal of e-documentation coming into the health system in non-interfaced manners (efaxed, scanned, emailed, snail-mail, etc.) with only a portion of them being processed through the HIM department. A 14-hospital system I work with has approximately four million (4,000,000) pages of e-documents coming into their HIM department with seventeen million (17,000,000) pages coming into other departments. The big source of the other documents include the departments:

• Clinical

  • HIM

    • ROI requests

    • Clinical documents

    • Patient Access

      • Referrals

      • Rx Refills

  • Revenue Cycle

  • Labs

  • Transplant

  • Radiology

  • Ambulatory

  • Surgery

  • Etc.

• Other

  • Finance

  • Administration

What requirements are there for processing those documents?

Some of these departments will require a relatively limited document workflow where document classification and patient indexing are the sole requirements. Others, such as lab result reports, will require the document classification, the patient indexing and then include the abstraction of discrete data and the tying of the order number to the EMR. Other’s may require redaction.

Are there technologies that are available to support the transformation?

There are and these are key to the optimization of the workflows. These technologies can take as much as two thirds of the manual labor out of processing e-documents. But choose carefully. Keeping all the different document types and workflows in mind. The cost of not doing so is real and significant.

For example, if you chose a solution that the fits the needs of your current HIM workflows but not the workflow of a department where the documents require data abstraction, you’ll likely end up having to contend with two different solutions from two different vendors requiring two separate interfaces. Adding a third department, and a fourth, you can see the ramifications of not choosing an enterprise solution up front.

Sandra Rockson, RHIA, CCMP, CSM summed it up well in the Q & A from the AHIMA website:

What do you think the future holds for HI and the HI profession?

“It is likely to be dynamic and filled with opportunities for professionals who are adaptable, tech-savvy, and committed to ensuring the quality and security of healthcare data while contributing to better patient care and healthcare system efficiency.”

Additional resource: AHIMA-accredited webinar on how Nemours Children’s Health has optimized its journey to an HIM department that has begun to include the workflows for processing e-documents for another department of the health system; the laboratory (lab results). A process that requires data abstraction with high levels of accuracy and timeliness.