Views of the Real World and the Future

Coverage of AHIMA’s 83rd Convention and Exhibit in Salt Lake City continues in AHIMA Today.

AHIMA leaders and industry experts took listeners on a journey from HIM’s current real-world challenges to the potential successes of the future during Tuesday morning’s general session.

‘Dream Big’

Incoming AHIMA President Patty Thierry Sheridan, MBA, RHIA, FAHIMA, called on her audience to “dream big” and noted that the HIM profession is in the midst of a cycle of creative business destruction, in which existing technologies and processes are being replaced by new ones.

“The future of HIM rests in our collective hands,” Sheridan said, “and our successful future depends on our ability to experiment, innovate, adapt, collaborate, and clearly define updated and new HIM roles. This will require all of us to educate our employers and stakeholders on how HIM roles are changing, and how updated and new roles can help to contain healthcare costs, while improving the quality of data.”

Sheridan cited emerging HIM roles in data standards, privacy, information exchange, clinical documentation improvement, and data management as jobs to “dream big” about. And, to make an impact in response to the country’s healthcare crisis, “teaching consumers to manage their health information is the responsibility of the health information management profession,” she said.

“It’s time to go out into the community and be recognized as a trusted source,” Sheridan said.

Putting the Patient at the Center

Dr. Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality (AHRQ), gave an overview of the agency’s work to achieve better quality, access, and patient-centered care. HIM is an “indispensable” partner to remake the healthcare system in this effort, Clancy said.

One important part of the picture is supporting patient-centered outcomes research, which contributes to the goal of evidence-based care. “Because of the way our data is organized, it’s hard to know what happens [to patients] over time,” Clancy said.

While the role of health IT in patient-centered outcomes research is still being determined, Clancy said the HIM role is vital in the three elements she believes are needed to remake healthcare: “information, incentives, and infrastructure.” These elements are visible in the projects AHRQ funds, such as demonstration projects in health information exchange and research on transforming quality through the use of health IT.

Ready for ICD-11?

“If we don’t take appropriate actions today, tomorrow we will end up in an electronic Tower of Babel,” said Dr. T. Bedirhan Üstün, MD, PhD, team coordinator of classification, terminologies, and standards in the department of health statistics at the World Health Organization. Üstün said the country has been procrastinating over ICD-10, and decisions need to be made.

But HIM professionals should take heart. “Your biggest assets are your knowledge, your association, and your potential,” Üstün told the audience. “You have not only a great tradition, but a great future. Your biggest power is in the mind of a coder,” he said, referring to the winning video in a 2010 AHIMA contest.

Üstün noted that classification systems have been around since the 1660s, when parish clerks in London posted the first bills of mortality, which recorded deaths and causes of death. He then traced the evolution of the ICD system, including ICD-10, developed in 1990.

With US implementation set for 2013, “you have been 23 years late, but you cannot afford to be later for the future,” he said. And ICD is moving forward; Üstün, who is working on the development of the ICD-11 system, says that it will be ready in 2015.

A draft version of ICD-11 is available on the WHO website. Üstün said in future, he envisions a more modern construction and revision process: online, year-round, Wiki-enabled, peer reviewed, and in multiple languages. “It is you who is going to build ICD by social computing,” he said.

‘You Are Not Alone’

New AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, FACHE, is an optimist, she told the audience, but she is also a realist. While the market for HIM jobs is rapidly growing, those in the profession face significant challenges, Thomas Gordon, who took office September 29, told the audience.

One of those challenges is the countdown to ICD-10 (“727 days, 15 hours, and 12 minutes…but who’s counting?” Thomas Gordon said). But there are others: healthcare reform, value-based purchasing, accountable care organizations, and meaningful use, to name a few. “We will have to adapt, change, and learn, and we have to be quick about it,” Thomas Gordon said.

“And while I bring forth these challenges with a sincere sense of urgency and a clarion call for immediate action, I also come to you today with a vision for what AHIMA can and will do to support your success beyond these very challenges,” Thomas Gordon said.

Members can expect the association’s full support on “anything and everything,” with tools for education, certification, and thought leadership, she said.

“You are not alone.”

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