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© 2014 By Katherine Downing, MA, RHIA, CHPS, PMP
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© 2014 Objectives What is health information management (HIM)? Examine current drivers to change and how HIM is contributing to the overall healthcare strategy – Define the driving forces behind changing healthcare documentation – Discuss market needs and how they are guiding change HIM—Transforming Healthcare with Information – Discuss how technology is changing our work
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© 2014 Topics Overview of HIM ICD-10 Meaningful Use Health Information Exchanges (HIE) Accountable Care Organizations (ACO) Electronic Health Records (EHRs) Privacy and Security
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© 2014 HIM An allied health profession that is responsible for ensuring the availability, accuracy, and protection of the clinical information needed to provide healthcare- related decisions
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© 2014 What Is the Health Record? The anchor that guides the continuity of a consumer’s care. Serves as part of the record of business as defined by a healthcare organization. Exists in a paper, hybrid, or electronic environment.
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© 2014 Six Functional Areas of HIM Data Capture, Validation, Maintenance Data/Information Analysis, Transformation, and Decision Support Information Dissemination and Liaison Health Information Resource Management and Innovation Information Governance and Stewardship Patient Health Information Protection
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© 2014 A Day in the Life…
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© 2014 Health Information Management Settings of Practice Healthcare Provider Organizations Healthcare Data Organizations Healthcare Payer Organizations Healthcare Supplier Organizations Planning Organizations, Regulators, and Industry Support Educational Institutions Research Institutions Consumer Organizations Third Party Compliance Organizations
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© 2014 Multiple Initiatives for HIM in 2014 with Overlapping Timelines… 2013201420152016
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© 2014 ICD-10 Push Continues for HIM Professionals Timeline to meet October 1, 2014 will intensify this year – Vendor Readiness – Training – Computer-Assisted Coding (CAC)
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© 2014 ICD-10 Focus ICD-10-CM/PCS Modifications to Work Process Reimbursement Impact Strategy for Immediate Transition Period Assessing and preparing for coder staff competency and training
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© 2014 ARRA/HITECH Framework Meaningful Use at Its Core Medicare and Medicaid Incentives and Penalties Health IT Practice Research Improve Health Outcomes and Efficiency ADOPTION EXCHANGE State HIE Program Standards and Certification Privacy and Security Regional Extension Centers Workforce Training MEANINGFUL USE Office of the National Coordinator, February 20, 2011
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© 2014 EHR and Meaningful Use Compliance Date(s): – October 1, 2013, for hospitals – January 1, 2014, for physician practices and other providers
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© 2014 Meaningful Use
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© 2014 Anticipated Changes and Challenges Meaningful Use Measures Measuring Clinical Quality HIE EHR Safety Privacy and Security Consumer Empowerment New models of care Emerging Areas
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© 2014 Meaningful Use
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© 2014 HIM’s Contribution to Health Information Exchange (HIE) Increased need for accurate and available health information
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© 2014 HIE Defined Refers to the process of reliable and interoperable electronic health-related information sharing conducted in a manner that protects the confidentiality, privacy, and security of the information. – Verb: The electronic sharing of health-related information among organizations – Noun: An organization that provides services to enable the electronic sharing of health-related information
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© 2014 HIE Drivers to Change Payment Reform Model Examples – Bundled Payment Options Need for more data – Accountable Care Organizations (ACOs) Need for more data – Patient-Centered Medical Homes (PCMH) Need for more data
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© 2014 HIE Challenges The ability to accurately link (match) multiple, disparate records relating to a single individual.
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© 2014 HIM Is a Key Contributor to the Implementation of EHRs Implementation leaders Dealing with the legal records issues Master Patient Index Maintenance Data Conversion Workflow analysis and redesign Privacy and Security
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© 2014 HIM Professionals Are Industry Leaders for Privacy and Security FINAL HITECH PRIVACY RULE IS HERE! Compliance Date: September 23, 2013 1.HIPAA Privacy, Security, and Enforcement 2.HIPAA Enforcement Rule— Increased Tiered Penalties 3.Breach Notification 4.Genetic Information Nondiscrimination Act (GINA)
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© 2014 HIM Addresses the Final HITECH Privacy Rule Changes: – Business Associates – Marketing – Fundraising – Disclosure and Sale of Health Information – Electronic Access – Requested Restrictions – Notice of Privacy Practice – Childhood Immunizations – Deceased Individuals – Minimum Necessary/Limited Data Set – Research
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© 2014 “It’s All About t he Data” – Creating Data – Managing Data – Using Data 2014–Year of Data for HIM Professionals
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© 2014 Future Roles To advance technologies that collect and maintain patient data accurately and securely To adopt classification systems to increase the quality of data in clinical documentation To encourage the use of electronic health records is the primary source for monitoring quality of care.
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© 2014 Future State Data capture, validation, and maintenance Data and information analytics, transformation, and decision support Information dissemination and liaison Health information resource management and innovation Information governance and stewardship
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© 2014 Questions
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© 2014 References Health Information Career Pathfinder ahima.org/careers Health Information Management Concepts, Principles, and Practice, Fourth Edition Bureau of Labor Statistics http://www.bls.gov/oco/cg/cgs035.htm
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