A Call for HIM Action

The stimulus bill includes provisions for education, outreach, and training around healthcare IT. Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSS, offers a look at the significant career development and employment opportunities this offers HIM professionals. Cassidy is a strategic leader for the Certification Commission for Healthcare Information Technology and a past-director of the AHIMA Board of Directors.

Title XIII of the American Recovery and Reinvestment Act, or ARRA, includes $19.2 billion in provisions for healthcare information technology and information management. Much of the money is dedicated to health IT adoption, but a significant amount goes toward training, education, and knowledge-sharing.

This article focuses on the education, outreach, and training opportunities that reside within the section “Incentives for the Use of Health Information Technology.” The provisions recognize that the successful adoption, implementation, and use of health IT require a newly trained work force.

Section 3011. “Immediate Funding to Strengthen the Health Information Technology Infrastructure”

Highlights for HIM: Immediate funds are available to support training on and the dissemination of information on integrating health IT, including electronic health records, into a provider’s delivery of care, consistent with best practices learned from new health IT research centers (see below). Also supported are tools for the promotion of telemedicine; promotion of the interoperability of clinical data repositories or registries; promotion of technologies and best practices; and improvement and expansion of the use of health IT by public health departments.

Opportunities for HIM: HIM professionals are encouraged to share information management best practices and their HIM expertise regarding electronic health record (EHR) implementation and training.

HIM professionals can lead the knowledge transfer efforts and have a positive impact on the training of the work force in workflow redesign for EHR system implementations, project management techniques for successfully integrating EHRs into the provider setting, promoting the use of standards for EHR content and interoperability, understanding the requirements of a certified EHR product, and managing compliance of data integrity and privacy.

Each year, AHIMA appoints short-term groups to work on focused HIM projects. Participating as a volunteer member in one of these work groups provides an excellent opportunity to share knowledge, including EHR best practices, current issues, challenges and legal implications of a hybrid record, clinical content management, and clinical documentation improvement techniques.

Section 3012. “Health Information Technology Implementation Assistance,” Development of a Health IT Research Center

Highlights for HIM: Health IT extension programs will be developed to assist healthcare providers adopt, implement, and effectively use certified EHR technology that allows for the electronic exchange and use of health information. The Office of the National Coordinator for Health Information Technology (ONC) will establish an extension program to provide health IT assistance services to be carried out through the Department of Health and Human Services (HHS).

Opportunities for HIM: The HIM work force is ideally suited to assist ONC in creating and running the research center for both HIM and non-HIM healthcare professionals to share best implementation practices and training, covering everything from workflow to operating policies to employee training.

Section 3013. “State Grants to Promote Health Information Technology”

Highlights for HIM: ARRA calls for a new program to facilitate and expand the electronic movement and use of health information among organizations according to nationally recognized standards.

Opportunities for HIM: As trusted guardians of health information, HIM professionals have the opportunity to step up and actively participate in the development of health IT standards and promote safe and secure health information exchange. Funding exists for promoting the use of EHRs for quality improvement, including through quality measures reporting.

Section 3014. “Competitive Grants to States and Indian Tribes for the Development of Loan Programs to Facilitate the Widespread Adoption of Certified EHR Technology”

Highlights for HIM: The head of ONC can award competitive grants to “eligible entities” to establish loan programs for facilitating the purchase of EHR technology, enhance utilization, training, and improving secure electronic exchange.

Opportunities for HIM: Grants and loans will be available for healthcare providers to facilitate not only the purchase of certified EHRs, but to promote implementation, training, and usability of interoperable EHRs.

Section 3015. “Demonstration Program to Integrate Information Technology into Clinical Education”

Highlights for HIM: The HHS secretary may award grants to carry out demonstration projects to develop academic curricula integrating certified EHR technology in the clinical education of health professionals.

Opportunities for HIM: Of particular interest here are the HIM professionals working or consulting in academic medical centers. This creates a new frontier of weaving health information management training into the clinical education process of our providers of tomorrow.

Section 3016. “Information Technology Professionals in Health Care”

Highlights for HIM: The HHS secretary, in consultation with the director of the National Science Foundation, will provide assistance to higher education institutions to expand or establish medical health informatics education programs, including certification, undergraduate, and master’s degree programs for both healthcare and information technology students.

Opportunities for HIM: This provision sounds very similar to AHIMA’s Vision 2016, which means now it is Vision 2010! AHIMA’s Assembly on Education and Commission on Accreditation for Health Informatics and Information Management Education are the experts in the development of HIM curricula, advising on student recruitment and retention, developing HIM education materials (both books and AHIMA’s Virtual Lab), and enhancing bridge programs in health informatics programs in existing health IT and HIM programs in community colleges and universities.

Several other provisions hit the HIM sweet spot. These relate to the wiring of rural areas with broadband appropriations for the Department of Agriculture; appropriations via the National Science Foundation for research and to the Indian Health Services for the development of health IT adoption; and funding to support the training and retraining of new and dislocated workers.

HIM Assistance Needed

The industry is faced with a major challenge—not enough HIM and other healthcare professionals to help implement and manage health IT. Columnists writing in the Huffington Post recently noted, “A recent analysis of the U.S. workforce estimates that almost 40% more healthcare IT staff and professionals are needed at U.S. hospitals for broad adoption of healthcare IT.” Radical change is required to transform a primarily paper-based system to a totally electronic, interoperable healthcare industry.

This change calls on HIM professionals to demonstrate that they are the trusted leaders in defining the skill sets, experience, knowledge, certifications, and credentials necessary for this emerging health IT work force.

Promoting EHR adoption requires a work force capable of using health IT. Most healthcare providers will need technical assistance and training. Internal staff and external consultants specializing in HIM are needed now to:

  • Collaborate with vendors in designing systems that meet the needs and requirements of the standards
  • Work with the providers to design requirements and select systems that meet the unique needs of a practice or hospital
  • Redesign workflow to align with the new software
  • Achieve the expected benefits of improving efficiency and quality
  • Train providers and staff on all aspects of health information management
  • Educate the future work force and conduct research on future of HIM

Health IT must enable providers to achieve quality and efficiency in and of the services they provide. The HIM profession has the opportunity right now to make the rubber meet the road. We must demonstrate that we are the profession that enables “quality healthcare through quality information.”

3 Comments

  1. Thanks for the good information.

    EMR will take a while to be implemented properly. It will take us many years of struggle and maybe many failures along the way. However, there are always things to be learned and we hope that move us closer each time we fails.

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  2. Bonnie’s article is right on target. I think most HIM professionals have not yet internalized the staggering implications that the ARRA Privacy and Data Exchange provisons, not to mention EHR adoption, will foster. Many healthcare stakeholders continue to beleive that HIM’s role is lessening as prov iders move away from the traditonal paper records. Quite the converse is true, in order to facilitate the Privacy and Data Exhange provisions a 40% increase in HIT professionals is the minuimum estimate. Now is the time for all HIM professionals to get familiar with ARRA and to work towards leadership roles within their own organziations to insure positioning of processes, applications and record management polices that are as efficient as possible and that provde the highest level of safeguards for the electronic health information.

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