HIM New Roles, New Futures Candace J Gibson, PhD, CHIM Assistant Dean, BMSUE

HIM STANDARDS – A NEW DOMAIN OF PRACTICE The Health Information Management Lifecycle

CHIMA – Domains of Practice Data Quality Privacy e-HIM HIM Standards

HIM Lifecycle IM Planning Data Collection, Receipt, Capture Organization Access, Use, and Disclosure Maintenance & Protection (Security) Disposition/ Destruction Evaluation Health Information Management Lifecycle

Stage 1: IM Planning  Information strategies  IM governance and accountability frameworks  Legislation and regulations governing health information - Policies and procedures for the access and privacy of information - Retention and destruction policies  Information classification systems  Education framework; staff competencies and training requirements  Measurement/Evaluation

Stage 2: Data collection, receipt and capture  Data quality frameworks  Data standards (coding and classification, acceptable medical abbreviations)  Clinical documentation standards  Security procedures  Authentication requirements  Version controls  Need to refer back to IM governance and accountability frameworks (including local, provincial and national requirements for data collection); Multi-jurisdictional IM plans

Stage 3: Organization  Following the departmental IM plan  Information models (the qualitative and quantitative analysis of the record for completeness, accuracy, integrity and consistency)  Information classification system framework  Information architecture  Documentation standards  Stewardship and ownership  Security procedures  Authentication requirements  Version controls

Stage 4: Access, use, and disclosure  Provide right environment for easy access to timely, accurate, and available information within security and privacy guidelines and legislation  Includes uses for clinical diagnostic and therapeutic purposes; quality performance assessment; planning, managing, and deploying health services; business analysis; accreditation; research and education  Patient access and request for changes to information  Rules for access and disclosure

Stage 5: Maintenance & Protection  Retention plans (and local, provincial retention requirements)  Records disposal/destruction plan  Security of information; referral to access and privacy policy and procedures  Transfer of records, if applicable  Disaster recovery plan (including essential records)  Information models  Documentation standards

Stage 6: Disposition  When is a record / information deemed non-active?  Implementing decisions on retention and disposition of records - See policies on retention as outlined in Stage 5  Methods of destruction - Physical destruction - Digital destruction  Tracking of completed disposition actions  Discontinuing records systems  Recovery of destroyed records

Stage 7: Evaluation  Purpose of Evaluation - An ongoing part of the cycle - for continuous improvement. - How effective are our IM strategies and processes? - Incorporate changes in standards or legislation, or information technology, or information sharing arrangements.  Process of Evaluation / Evaluation Frameworks  Metrics used - Performance should be compared against benchmarks established in Stage 1 and based on information gathered through re-abstraction studies or other data quality control procedures (e.g., turn-around times, record completion rates, outcomes of re-abstraction studies). - Sharing best practices across organizations

HIM CAREER MATRIX Building a Career Roadmap

Our Approach Background Research approach Analysis Draft career matrix

New Roles – from work with AHS CategoryService ScopeNew Roles/Titles Data Capture The data capture service performs all tasks associated with the capture of health data. This Includes data coded directly from clinical documentation or auto-coded using systems for that purpose, voice and speech recognition systems and scanning or creating a digital image of text based documents. This service will perform audits of the service functions to ensure that best practice and current standards are implemented.  Clinical Data Specialist  Data Profiler  Research Associate  Concurrent Coding Specialist  Code Mapping Specialist  Data Mapping Specialist  Clinical Data Analyst  Central Intake Coordinator Information Integrity This service evaluates the integrity of health information holdings, identifies risks and implements risk mitigation strategies. This service will respond to inquiries into information integrity and complete an auditing role for both internal and external requests.  Health information Safety Officer (includes hybrid record)  Data Integrity Specialist  Risk Management Analyst  Forensic Investigation Officer Identity Management Managing the systems responsible for the unique identification of consumers, providers, organizations and services.  Data Quality Analyst  Data Integrity Specialist  Identity Management Coordinator

New Roles (cont’d) Information Management Governance Using best practices and information management principles, this service develops, maintains and monitors the accountability framework for information. It includes policies, processes, standards and metrics to ensure unified data and information, as well as efficient, effective and secure information assets.  Information Management Liaison  Standards Coordinator  Policy Analyst  Auditor Content Compliance Management of the clinical content to ensure meets information management best practices including performing quality assurance audits on the content. This is the bridge between the provider content for clinical need, and the information needs of the organization as well as internal and external stakeholders.  Content Management Expert  Compliance Officer  Process Improvement Engineer Information/Knowled ge Asset Management Developing, auditing, evaluating, maintaining and mapping clinical information and knowledge assets.  Data Modeler  Health Information Semantics Content Expert  Clinical Terminology Standards Specialist

New Roles (cont’d) Access, Disclosure and Retention Protect and promote data and information privacy for consumers, providers, users, and the organization. Manage the access, disclosure, retention, archiving and destruction of Personal Health Information from organizational systems.  Release of Information Analyst  Access and Disclosure Specialist  Request Coordinator  Privacy Officer Consumer Support Promotes excellent public relations by fostering and maintaining positive communication with customers in the areas of the Personal Health Record (PHR) and Registration Systems (registration, booking, registries, self- registration)  Information Broker  Registry Agent  Portal Agent  Customer Service Agent Information Analysis and Business Intelligence Information needs are identified and data is collected and analyzed. Utilization management and quality improvement practices are supported and enhanced via the services offered. Data analytics, clinical trials,and research studies are areas of focus.  Health Information and Performance Analyst  Decision Support Analyst  Process Improvement Specialist  Consultant, Clinical Performance  Health Analyst

Levels LevelDefinition Masters 10+ yrs higher level HIM experience Proven senior leadership & executive level experience Masters degree required PhD for academic roles CHIM certification Additional certifications as required (e.g., accounting, PMP) Advanced 7+ yrs higher level HIM experience Proven leadership experience Masters degree an asset; minimum Bachelor’s degree CHIM certification Additional certifications as required Intermediate 3 – 7 yrs HIM experience Bachelor's degree or diploma CHIM certification Additional certifications may be required Entry 0 – 3 years experience CHIM certification Bachelor’s degree or diploma

Bringing it all together Health Information Analytics & Research Information Governance Business Intelligence & Sustainability Information Management HIM Standards Privacy & Security HIM Education The use of health data to strengthen clinical programs of care, health system mgmt & pop., public health, and research. (CIHI definition, 2013) Develops, maintains & monitors the accountability framework for information. The sharing of lessons learned, integration and continuous improvement and sustainability of the organization. Capture and use of health data for improved performance, competitive advantage, innovation, planning & performance. Includes records management, data quality, monitoring & auditing. Standards supporting health information management. For example, terminology asset management, Standards development specific to HIM. Privacy, security, & confidentiality of information. HIM curriculum development, teaching, & research.

Privacy and Security LevelAccess, Disclosure, and Retention Master Chief Privacy Officer (Enterprise) Exp = 10 years; Proven senior leadership & executive level experience Ed = Masters, CHIM, Privacy Certification Advanced Access & Privacy Manager (HIM) Exp = 7+yrs; Proven leadership experience Ed = Bachelor or Masters, CHIM, Privacy Certification Intermediate Access & Disclosure Specialist Exp = 5 yrs Ed = Diploma or Bachelor’s, CHIM, Privacy Certification Entry Request Coordinator Exp = 2 yrs Ed = Diploma or Bachelor’s, CHIM

Health Information Analytics LevelData Analytics and Research Master VP, Analytics and Informatics Exp = 10 yrs +; Proven senior leadership & executive level experience ED = MSc or PhD Advanced Director, Health Analytics Exp = 7 yrs; Proven Leadership experience Ed = MSc Statistical Information Supervisor; Biostatistician Exp = 7 yrs; proven leadership experience Ed = MSc; 2 yr CGA or CMA Intermediate Research Associate Exp = 3 – 5 yrs Ed = Bachelor or Masters Decision Support Analyst Exp = 3 – 5 yrs Ed = Bachelors or Masters, CHIM Entry Data Analyst - Health Information & Performance Exp = 1-3 yrs Ed = Bachelor, diploma, CHIM Research Assistant Exp = 1-3 yrs Ed = Bachelor, diploma, CHIM

Business Intelligence & Sustainability Level Business Intelligence Master Vice President, Business Intelligence Exp = 10 yrs, Proven Senior Leadership & Executive level experience Ed = MBA, CHIM Advanced Director of Knowledge Translation Exp = Proven Leadership level experience Ed = Masters, CHIM Inter- mediate Business Intelligence Analyst Exp = 5 yrs Ed = Masters an asset, CHIM, additional business courses Entry Junior Business Analyst Exp = 2 yrs Ed = CHIM

HIM Career Matrix

HIM Transition Roadmap

AHIMA Career Matrix

Example: Privacy

Example: Data Analytics