1. Workforce Transformation Health Information Management Alberta Health Services
Kathleen Addison
Senior Provincial Director, HIM, AHS

2. Agenda HIM Organizational Structure Vision Measures of Success
Why Do We Need to Change
New Expectations
HIM Business Transformation Program (BTP)
Relating New Roles to HIM BTP
What Are We Doing About It
Your opportunities
Conclusion
Questions

4. HIM Vision One Patient – One Record
Electronic access to longitudinal health information through a single access point

5. HIM Measures of Success
Adoption of standards-based technology and establishing/ implementing leading practice.
Through
enablement of people, process and technology
Expand services to support information integration/ interoperability.
Technology enabled health information management workflow to support the full life cycle of health information.
A workforce with the credentials, knowledge and skills to work in a fully electronic health information environment.
e-HIM® or Electronic Health Information Management is the process by which electronic health records (both institutional and personal) are created, managed and retained for both business and legal purposes.
Local Service Delivery
Centralized Provincial Services
Standardization

6. Why Do We Need to Change Overarching Trends:
Shift to supporting, optimizing, and utilization of e-Health technologies;
Continued expansion of EHR repositories to inform clinical decisions – data standards, data quality & information governance becoming more critical;
Health system use of data (information to change care delivery) will expand & become more critical;
Introduction of SNOMED CT coding into point of care systems (i.e. Clinical Information Systems) and the need for maintaining reference sets, data mapping, provider education, monitoring data quality, supporting automated coding, etc.;
The paper health record is the legal record of care.
The “bulk” of health records are generated in paper format and are primarily site or program based.
Information contained in most clinical information systems is printed and stored.
Management of the hybrid health record.
Clinical and organizational risk in managing multiple sources, formats and versions of the same information.
The amount of paper generated exceeds physical storage capacity.
New/redeveloped sites are planned and designed for the electronic health record and without adequate physical storage capacity for the paper health record.
High labour costs due to manual paper processes and duplication of effort i.e. number of times the health record is “handled” from receipt to archive.
The amount of medical dictation exceeds the supply of traditional Transcriptionists.
Health Record Completion by physicians is primarily a manual process.
Little to no infrastructure to enable client “self serve” i.e. remote access to health information.

7. Why Do We Need to Change Overarching Trends:
(Cont’d)
Overarching Trends:
EHR/EMR information sharing will be the norm; more multi-disciplinary/multi-site teams, more integration with other jurisdictions will create the need for more skilled HIM Professionals in information management issues;
Changes in professional practice for the electronic environment;
Increasing use of mobile and cloud computing;
Increasing involvement of consumers in entering and using health information (Personal Health Portal / Personal Health Record);
Increasing and diverse range of data quality and data integrity issues;

8. Why Do We Need to Change Overarching Trends:
(Cont’d)
Overarching Trends:
Integration of new technologies into the healthcare system;
Clinical devices connected to EHR’s for direct input of information;
Use of Terminology Services and Taxonomies to support clinic content;
Increasing clinical and productivity benefits from existing investments will create a demand for corresponding roles;
Need to broaden the skills of current clinical professionals; and
Retirement of current professionals will be a challenge.

9. New Expectations (Roles)
HIM and eHealth systems working in collaboration
Privacy:
Monitoring and auditing; enterprise-wide web-based education; support team-based breach education;
Standards:
Assisting clinicians to do a better job of documenting; expertise in taxonomies, terminology management; demonstration of adoption of standards through audit and interoperability;
Data Quality Management:
Data quality and integrity i.e. source systems, repositories, registries, etc.
Content Management

10. New Expectations (Roles)
(Cont’d)
Decision Support:
More clinical decisions at point of care i.e. synoptic coding;
Health Record Management:
Less doing and more oversight; less records and more information;
Coding, Terminology and Classifications
Shift in focus to coding activity to working with professionals to improve documentation and information. Auditing, assisting and supporting others at the point of care. Understanding of language, clinical documentation, classification & terminology frameworks by specialty.
Data Repositories and Dictionaries:
Metadata management, enterprise dictionary maintenance and management;

11. Background of HIM BT in AHS
In the fall of 2010, and refreshed in the spring of 2012, HIM developed a Strategic Roadmap, using an outcome and value based process, identifying HIM Business Transformation as a priority program with 5 strategic initiatives:
Enterprise Information Management Program
HIM Workforce Transformation
Information Capture
Service Optimization
New Services

12. Coordinated Structure of Initiatives
HIM
Business Transformation Program
Enterprise
Information Management
Workforce Transformation
Information Capture
Service Optimization
New Services
Enterprise Information Management Program
Workforce Transformation Plan
Registries
(Client, Provider, Delivery Site, & Location)
Information Stewardship Office
Enterprise Content Management
Workforce Modeling
Personal Health Portal Registry
Dictation/Speech Recognition / Transcription System Consolidation
Registration Roadmap
Terminology Services
Professional Development Program
Personal Health Record
Coded Data Quality Improvement Plan
Collaborative Toolset (SharePoint/Lync)
Document Scanning Centers

13. Major Objectives Care delivery is information enabled;
Information is managed as an asset;
Manual functions are automated to enable electronic health information management, such as:
Digitizing paper to electronic format;
Automated coding from structured clinical documentation;
Automated health record completion;
Front-end and back-end speech recognition including e-Signature of transcribed reports.
Costs are decreased (burden in managing the paper based and hybrid systems are significantly reduced).

14. Relating New Roles to HIM BTP
Business Transformation Program
Enterprise
Information Management
Enterprise Information Management:
.Data/Information Governance Specialist
Standards Analyst/Coordinator/Specialist
Information Lifecycle Management
Metadata Specialist
Data Steward
Taxonomist
Policy Analyst
Auditor
Business Intelligence Analyst
Information Management Liaison
Enterprise Information Management Program
Information/Knowledge Management:
Health Information Semantic Content Expert
Clinical Terminologies Standards Specialists
Terminologist
Code/Data Mapping Specialist
Terminology Services

15. Enterprise Information Management Organizational Structure
Executive Director
HIM Provincial Standards & Strategies
Senior Provincial Director
Health Information Management
Sample for HIM
Enterprise Information Management Organizational Structure
Director
Enterprise Information Management
Senior Advisor
IMG Business Unit
Standard Specialist
Administrative Support
Administrative Assistant
Standards
Information Management
Lead
Data Standards
HL7 Messaging
Data Architect
Standards Analyst
Clinical Documents
Standard Analyst
Registries
Reference Data Management
Information Architecture
Data Governance

16. Provincial Terminology Services Organizational Structure
Sample for HIM
Provincial Terminology Services
Organizational Structure
Executive Director
HIM Provincial Standards & Strategies
Senior Provincial Director
Health Information Management
Director
Provincial Terminology Services
Senior Advisor
Terminology Standards
Terminology Lead (Generalist)
Provincial Lead
Clinical Documentation
HIM Learning & Development
HIM Compliance
Project Manager
Terminology Services
Strategy Project
Health Informatics Consultant
Learning & Development
Communication Coordinator
Admin Assistant

17. Business Transformation Program
Relating New Roles to HIM BTP
(Cont’d)
HIM
Business Transformation Program
Information Capture
Identity Management:
.Master Data Management Specialist
Reference Data Management Specialist
Repository/Registry Management
Data Quality Analyst
Data Integrity Specialist
Identify Management Coordinator
Data Integration Specialist
Registries
(Client, Provider, Delivery Site, & Location)
Registration Roadmap
Data Capture:
Specialist In:
Clinical Data
Code Validation
Concurrent Coding
Clinical Documentation Improvement
Code/Data Mapping
Clinical Data Analyst
Data Steward
Coded Data Quality Improvement Plan

18. Organizational Structure
Sample for HIM
Registry Management
Organizational Structure
Executive Director
HIM Provincial Standards & Strategies
Senior Provincial Director
Health Information Management
Director
Registry Management
Provincial Lead
Client Registry
Provider Registry
Delivery Site Registry
Administrative Assistant

19. Business Transformation Program Medical Transcription:
Relating New Roles to HIM BTP
(Cont’d)
HIM
Business Transformation Program
Service Optimization
Legal Record of Care:
.Enterprise Content & Records Management
Content Management Expert
Compliance Officer
Process Improvement Engineer
Enterprise Content Management
Enterprise Content and Records Management – combines 2 concepts – electronic records management and enterprise content management
Medical Transcription:
Medical Text Editor
Dictation/Speech Recognition / Transcription System Consolidation

20. Business Transformation Program Information Manager Services:
Relating New Roles to HIM BTP
(Cont’d)
HIM
Business Transformation Program
Information Manager Services:
.Data/Information Steward
New Services
Information Stewardship Office
Consumer Support:
Information Broker
Registry Agent
Portal Agent
Consumer Services Agent
Information Reconciliation Officer
Registration Application Coordinator
Personal Health Portal Registry
Personal Health Record
Wait Time Measurement Program
Document Scanning Centers

21. Sample for HIM Information Stewardship Office Organizational Structure
Senior Provincial Director
Health Information Management
Director
Information Stewardship Office
Service Coordinator
Research Coordinator
Administrative Coordinator
ISO

22. So, What Are We Doing About It
Creating an organizational structure that supports the leadership for future roles i.e. EIM, Terminology Services, etc.;
Leaders mentoring staff into new roles i.e. Terminology services, Standards Specialists, etc.;
Delivering and supporting learning opportunities that identify and explain future roles i.e. Lunch and Learns, conference/webinar attendance, etc.;
Working with our staff on their career path that identifies opportunities for future roles;
Advocating professional bodies and educational institutions to develop and deliver Informatics Programs.

23. Your Opportunities Become more informed and knowledgeable such as:
Membership in your Professional Association
Read Practice Briefs and Professional Journals;
Access websites i.e. HIMAA, CHIMA, AHIMA, COACH, etc. ;
Attend Webinars;
Volunteer for Committee Participation;
Identify and work with your employer to plan your career path;
Formalize learning i.e. continuing education and advanced certifications;
Join a Standards Development Organization; and
Write an article and contribute it to your departmental newsletter or professional association.

24. “And…..that is how change happens.
In Conclusion
“Destiny is not a matter of chance; it is a matter of choice. It is not a thing to be waited for, it is a thing to be achieved.”
Quote by William Jennings Bryan
“And…..that is how change happens.
One gesture.
One person.
One moment at a time.”
Quote by Libba Bray

25. Q & A

26. Appendix

27. Future Work Skills Social Intelligence Novel and Adaptive Thinking
ability to develop solutions and responses that are beyond rote or rule based
Computational Thinking:
ability to translate vast amounts of data into abstract concepts and applying reasoning to understand
New Media Literacy:
Ability to develop content that uses new media forms
Trans-disciplinary:
Understand concepts across multiple disciplines
Virtual Collaboration