American Health Information Management Association. Position statement. Issue: clinical practice guidelines and critical paths--roles of HIM professionals

With the advent of managed care and healthcare reform, clinical practice guidelines and critical paths have become important tools in the delivery of high-quality, cost-effective healthcare. Their use results in better communication and collaboration among caregivers, more efficient use of resources, and more consistent patient care. Health information management (HIM) professionals support these efforts through the provision of information needed to develop sound, workable critical paths that incorporate recommendations from clinical practice guidelines. With their expertise in health information systems and quality management, HIM professionals should serve as key members of the multidisciplinary teams that develop, implement, and refine these tools.     

The application of knowledge management principles to compliant coding activities

This article applies the concepts of knowledge management to diagnostic and procedural coding performed by health care providers. The process of diagnostic and procedural coding is both an art and a science. In particular, the information stored away in the minds of individuals performing the coding function is ripe for the basis of an effective knowledge Health Information Management (HIM) coding management system. In this article, we explore the issues and processes that HIM professionals can take advantage of in standardizing the coding function.     

The technological reengineering of health information management departments: myth or reality?

Data from this study indicate that health information professionals are poised to take on greater responsibility in the design, evaluation, and application of information systems within healthcare. Whether or not health information management will move into these areas and begin to control future technological reengineering, however, remains unanswered from findings in this study. Future studies on healthcare administrator attitudes toward HIM professionals, curricular emphasis on information system design and analysis, and health information professionals in nonacute care settings are necessary to understand the direction of the HIM profession and its role in information systems.     

The medical records professionals' view of the electronic medical record

The migration of Kaiser-Permanente (KP), a large managed care organization, to the management of health care information in a paperless environment is presented from the viewpoint of Health Information Management (HIM) professionals. The author conducted an informal survey of these professionals and presents a synopsis of their recommendations in the context of KP's efforts to develop an enterprise Electronic Medical Record. Their consensus is that physicians are primarily information managers and that successful health care organizations will be those who most effectively manage their information.     

Addressing HIPAA across the continuum

HIPAA is an issue in hospitals across the nation, but what about other kinds of facilities--such as long-term care, behavioral health, or home care organizations? They, too, need to address HIPAA. We asked three HIM professionals who work in these settings to briefly address how HIPAA is changing the way they work.     

Knowledge management: white knight or white elephant?

Knowledge management (KM) is a new management theory embraced by hundreds of writers in multiple countries and industries. Although a single fixed methodology does not exist, several methodological elements are common to most KM writtings. KM has a number of similarities to and differences from quality improvement and reengineering. It can be applied to at least two universes in health care organizations. Applying KM to a case study in health information management (HIM) departments yielded much useful information but also proved unable ultimately to resolve the problem being studied. HIM professionals can embrace elements about KM that are good and useful, while ignoring elements that do not work.     

Does gender make a difference? Factors that influence salary level in health information management

The article examines factors that influence salary level among health information management professionals. Specifically, it addresses questions related to whether gender makes a difference in salary level or whether factors such as education and size of the organization are important. Findings suggest that education and size of the organization are the most important factors influencing salary level. The one notable exception is among newly credentialed registered record administrators. Here, men earn more than women when education and size of the organization are controlled variables.     

Can you manage managed care?

HIM professionals' data management skills make them a hot property in many settings, but none more so than managed care. In this second installment of the Journal of AHIMA's special series on managed care, the author describes the ways managed care organizations use data and how HIM professionals can contribute.     

Professional advancement of women in health care management: a conceptual model

Ragins and Sundstrom suggest three major conclusions based on power and gender differences within organizations. The first is that power develops or detracts as individuals progress along their career track. HIM professionals who accept the challenges that changing roles bring can also develop a new sensitivity to the value of power as a tool. They can use their negotiating skills to avoid being placed in work roles that result in a decrease in power. The second difference between men and women within organizations is that obstacles often impede women's career paths more than men's. Perceptions by women and men of a woman as homemaker and mother create serious conflicts when jobs are demanding and time intensive. Lastly, Ragins and Sundstrom suggest that career progression is influenced by both intrinsic factors (personal and professional) and extrinsic factors (organizational and interpersonal). The interaction between these factors is often driven by gender differences allowing men to progress and succeed, whereas women remain beneath the glass ceiling. HIM professionals, like other women health professionals, are graduating from advanced programs in health care and business administration at a greater rate than ever before in the history of this country. Not all these graduates will be able to acquire top-level administrative positions in the traditional health care institutions (e.g., hospitals). Therefore, if they wish to advance, they may have to move to nontraditional work settings. This is especially true for HIM professionals. The expanding computerized environment in traditional and nontraditional health care settings presents great potential for the development of new roles and responsibilities that have not been identified as male roles. HIM professionals and women in other health care professions who aspire to advance to upper administrative positions in traditional and nontraditional settings must be willing to take the risks inherent in assuming these changing roles and responsibilities. Successful women leaders in upper administrative positions recognize and take opportunities when they are offered and are not reluctant to assume more responsibilities and power in an organization. Lastly, if women are to move through the glass ceiling, health care institutions must become sensitized to the factors that prevent women's advancement and facilitate entry-level opportunities for women in administration. Continuing education and opportunities for mentoring and networking, combined with flexibility in work structures, will promote the integration of women at high administrative levels in health care, not only within their own professions, but in corporate health care as well.     

Graduate education bridges the gap between the electronic health record and clinical need

Recent reports, including several from the Bureau of Labor Statistics, emphasize an increased marketplace demand for health information management (HIM) professionals who can demonstrate competencies appropriate to an electronic information management environment. In support of this marketplace demand and increased technology development, several academic programs in HIM have developed masters level programs embracing and expanding on the discipline of applied health informatics, yet focused on the fundamental competencies of managing vast and complex health information resources. Individuals dedicated to the management of daily functions within an electronic healthcare environment can better assure the continued viability of the healthcare system through better management of health information, acting as the bridge between the technical development of the electronic health record and the clinicians who will rely on it-thus ultimately supporting better patient care.     

Sickness Presence among Disabled Workers at the University Medical Centre Ljubljana

Objectives

The aim of the article is to investigate the differences in sickness present and non-sickness present in the group of disabled health care professionals.

Methods

Data were gathered from all disabled health care professionals suffering from invalidity of category II or III who were identified in the research among all health care professionals at the University Medical Centre Ljubljana and who were employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of three standardized international questionnaires.

Results

There were 248 disabled workers of the II. and III. category of invalidity among the participants. Disabled sickness present reported to have more chronic diseases than disabled non-sickness present (OR = 57.0; 95% CI = 24.4–133.2), lower salary when on sick leave (OR = 13.1; 95% CI = 5.7–30.2) and poor self-rated health (OR = 5.8; 95% CI = 2.7–12.3).

Conclusions

The prerequisite for sickness presence among disabled workers is their chronic bad health. It is also formally recognized with the degree of disability. Economic factors are among the most important to direct disabled workers towards sickness presence. The results indicate that workplaces are not adapted to disabled workers in regard to their limitations.     

The emerging need for transformational leadership in health information management

The prospect of national healthcare reform, new clinical and information technologies, and the need to cut the cost of health care delivery are contributing factors in the restructuring of the health care system. In light of these rapid changes and great uncertainties, health information management (HIM) leadership must radically change its style. The appropriate new styles will move the HIM practitioner from the specialized medical records department to a larger, more professional role. The successful transformational leader will help HIM emerge as a central function in the new health care industries.     

Career trends in health information management: a look toward 2006, Part I

The transformation taking place in health information management is causing a shift in the role of HIM professionals. This article examines the influence this shift has had on current trends in the workforce and what it means to HIM professionals.     

Informatics in managed care: HIM adds value to data

The third installment of the Journal of AHIMA's special series on managed care focuses on informatics--methods that add value to data, turning it into useful information. How do informatics and managed care fit together and what is HIM's role in this picture? The HIM professional's knowledge is critical to the health team responsible for the interpretation and use of statically valid information. For example, HIM professionals are well positioned in their understanding of the construct and application of coding classification systems (ICD-9-CM, CPT, etc.), and groupers (DRGs, APCs, ETGs, etc.). Their unique training positions them to understand the associated rules, principles, guidelines, and nuances associated with correct coding and grouping. And when codes or groupers change, HIM professionals work closely with the health team to ensure parity, validity and reliability of the appropriate data or data sets. Managed care organizations use value-added data, as you will see in this article, to evaluate contract pricing, develop contracts, evaluate existing services or detail benefit plans, process and in some instances pay claims, and report results to a number of interested parties. The previous article in this series ("Can You Manage Managed Care?" July/August 2001) focused on effective management of data, including data acquisition. This article takes us to the next level, where informatics creates value-added information, and discusses some important uses of this information within managed care. These articles build on two of the functional areas that form the HIM process within managed care organizations. Author Scott Stratton studied under the creators of DRGs and was involved in the development of their nursing home counterpart, RUGs. He also has worked with the creators of ETGs. As a result, he can present the perspective and context within which these systems were created and intended. and how they form the foundation for informatics as a functional area within managed care.     

The leadership role of the health information management professional in research

Research and its role in the health information management (HIM) field are discussed in the context of the priorities and research needs of the Health Security Act of 1993 and Healthy People 2000. Research needs from Healthy People 2000 specific to the HIM field are outlined. Questions to ask when the research proposal, study designs, methodologies, and examples specific to HIM are formulated are explained and discussed so that HIM professionals can become leaders in the field of HIM research.     

The converging roads of HIM and managed care.

The authors explore the definition of managed care and how the health information manager's skills apply to a managed care setting. In addition, HIM professionals who have made the transition to the managed care setting share their experiences.     

Work activity analysis of Finnish occupational health professionals

BACKGROUND: Some Finnish studies have dealt with how occupational health nurses divide their working hours but other occupational health professionals have not been evaluated. AIMS: This study describes how occupational health professionals allocate their working hours between main tasks. METHODS: Questionnaires were sent to 250 occupational health professionals, of whom 176 (70%) returned the completed forms. The data were analysed by using frequencies, means and one-way analysis of variance test. RESULTS: Employee-oriented tasks accounted for roughly 50% of working hours from all occupational health professionals. The remaining working hours were shared between workplace visits, co-operation with partners, other occupational health care responsibilities and tasks in other health care fields, especially in the health care centres. These working hours varied greatly between the different occupational health professional groups. All units employed full-time occupational health nurses, but the services of physicians, physiotherapists and psychologists were usually provided part-time or even restricted to a few hours each week because these services were difficult to obtain. Occupational health nurses working in the municipal health care centres spent more time on workplace visits than other nurses. Employee-oriented tasks were emphasized more in physicians', physiotherapists' and psychologists' work, especially in private medical health care units and in the jointly owned health care units. CONCLUSIONS: The amount of time occupational health professionals are able to spend on workplace activities appears to be determined by the type of their employer.     

Aspects of data quality in the new millennium

A major topic of concern for the health information management (HIM) professional today is the quality of health care data. Although the coding professional within the HIM department has responsibility for assigning accurate clinical codes, often there are discrepancies or areas that need improvement. What ways are in place now to ensure quality clinical data? Quality programs and projects that can lead us into the next millennium are important to the HIM profession, administrators, health care payers, and state agencies. The challenges that we face are not without solutions. Sharing information and solutions is important for the individual and the profession as a whole. The article discusses four current but different ways in which data quality is looked at and addressed.