Moving HIM into the FutureHow will that look?

By Wyntis Hall, RHIT

Change is scary

Have you ever just woke up and said “Hey I want to change” ????

Who really likes change…..unless it jingles!

Change is inevitable, especially in HIM with the introduction of the electronic health record that has taken our profession by storm.

So many people in our department could not ride the wave of change...what do you do?

With the evolution of the EHR you have a “new generation of employees” (another change).

Remember the Old Days

● In-house coding

● Paper charts

● Loose sheets

● Walking charts to the floor

● Doctors signing off on patients charts MANUALLY

● In-house transcription

● Having to come onsite to retrieve records - calls for records

● Filing records by TERMINAL DIGIT ORDER

Skills needed to meet future HIM job demands• Auditing• Business development• Clinical documentation improvement• Cybersecurity• Data management, visualization, and analytics• Financial analysis• Informatics• Information governance• Management of remote workers• Process improvement• Project management• Revenue cycle management, including knowledge of new and emerging

payment models such as risk adjustment, BPCI, CPC+, PCMH, and others

What can we do to change?● HIM Professionals will need to become adept at navigating

electronic databases and systems to enable organizations to take advantage of the wealth of information available for analysis

● Clinical and non-clinical participants strongly support the idea of standardizing electronic health record systems and health information technology for data sharing.

● Staying relevant in HIM is all about thinking ahead…not having the mindset “this is how it has always been done”

The Electronic Health Record forced change● By now you should have or be on your way to converting to an Electronic

Health Record.● Epic, Cerner, Allscripts, eClinicalWorks and many more…● I have watched our Medical Records department of over 100 people in

1999 transform into Health Information Services and now a staff of 20.● The need for a file clerk position has become obsolete. Clerks have

become analysts, ROI clerks, scanners and super-users to the companies EHR system to stay relevant.

● Scanning and the way we store and retain our PHI

The EHR forced change, cont.● Where as the paper chart could only be handled by one person at a time,

the chart in the EHR can be viewed by many, at different

times...eliminating the need to retrieve paper records and take them to a

floor or to a physician.

● HIMSS stages will help mold your organization and your way of thinking.

● Patient portals have made it possible to receive medical results without

even leaving the house.○ Our verification skills on the ROI team in medical records we became the access

point for signing patients up for Epic’s MyChart. *new role*

Computer Assisted Coding

● Our Coding team at HMC is a part of the Revenue Cycle Service

Line

● Professionals expect that future coding will be automated and pulled

directly from charts.

● Some systems now are able to detect words and other pertinent

documentation that have already made manual coding in hospitals

unnecessary and will only become better over time.

Transcriptionists Transforming

We had in-house MT at our medical center which became too costly

We had Dolby for over 25 years and converted to MModal

Your MT background can be used in several different ways

● Real time Scribing

● Auditing & editing EHR documentation

● Documentation Specialists

Analysts into Auditors

● With different systems I can tell you how we changed at Hurley.

● Our analysts had to embrace different roles…○ Front-end dictation auditors

○ Copy and Paste Auditors

○ Chart Correction Specialists

● Scanners

Expand your way of thinking● There are so many other different places our RHIT/RHIA can take us…

○ Hospitals, physician offices, nursing homes○ Consulting firms○ EHR companies○ Insurance companies○ Educators○ Patient Advocates: helping patients understand the information in their record○ MPI specialists

■ Merging records - cleaning up the MPI

○ Quality managers○ Privacy and security auditors

Obtain additional credentials

● CDIP - Certified Documentation Improvement Practitioner

● CHDA - Certified Health Data Analyst

● CHPS - Certified in Healthcare Privacy and Security

● CHTS - Certified Healthcare Technology Specialist

● CPHI - Certified Professional in Health Informatics

● EHR vendor - specific certifications○ At Hurley Medical Center we have Epic and if you become a member of an

Epic “team” you are sent for certification in that area ie: HIM

Conclusion…● HIM will evolve from a department in the hospital--to have a seat at the table on various

committees: privacy, security, information governance

● Prepare yourself

● Keep up with technology, read, ask questions, and network

● Vendors are our friends…they really are!

● Additional education is key○ Technology based classes…taking on a more technical role

● IT and HIM will become partners○ IT will need HIM’s input on designing new policies and procedures

● Remember it’s not the strongest but the one most responsive to change that survives.

Let’s talk about it

Thank You!

Questions?