In one sense, the future is already here for those who manage health information. The skills HIM professionals need today are not very different from those they’ll need in 10 years, according to a new survey of practitioners, recruiters, and employers conducted by AHIMA.

In addition, while the industries looking for HIM knowledge continues to diversify, the greatest concentration of employment is expected to remain within seven industries that are today’s major employers.

What will change, however, is the breadth and depth of the competencies required to do the work. The fundamental knowledge of health informatics that may serve today, for example, won’t go a long way in 10 years, according to survey respondents.

Following are the top five competencies that respondents believe are required for health information management now and in 10 years, ranked by their current importance.

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On Wednesday the Centers for Medicare and Medicaid Services (CMS) published the interim final rule for the Genetic Information Nondiscrimination Act (GINA). In it, CMS modifies the HIPAA privacy rule to explicitly include genetic information within the definition of health information. 

The rule also proposes to:

• prohibit health plans from using or disclosing protected health information that is genetic information for underwriting purposes;
• revise the provisions relating to the notice of privacy practices for health plans that perform underwriting;
• make conforming modifications to definitions and other provisions of the privacy rule; and
• make technical corrections to update the definition of “health plan.”

The interim final rule applies GINA’s prohibitions on using and disclosing protected genetic health information for underwriting to all health plans subject to the privacy rule, rather than solely to the plans GINA explicitly requires be subject to the prohibition. It also proposes applying the prohibition on using or disclosing is genetic information for underwriting purposes to all health plans that are covered entities as defined by the HIPAA privacy rule.

CMS will accept public comments for 60 days.

Signed in 2008, GINA protects individuals against discrimination in health coverage or employment based on their genetic information.

HIM professionals who go from practice to teaching (or teach part-time while practicing) bring a wealth of real-life experience to their classes. They also bring some subtler lessons they have learned about succeeding in the workplace.

Jill Burrington-Brown, who teaches in an online HIM program at Missouri Western State University, shares with her students the communication skills she has learned in a career that has covered a range of settings and roles.

Burrington-Brown, MS, RHIA, FAHIMA, has been an HIM director; managed quality improvement, medical staff, and risk management departments; taught; worked in a law firm; and for eight years, she was a professional practice manager at AHIMA. Communication skills may not be a chapter in standard HIM and health IT textbooks, but she assures her students that communicating well will fundamental to doing their jobs well. (more…)

The October 2009 cover article examines the provisions in the American Recovery and Reinvestment Act that offer exceptional opportunities for HIM programs, individuals, and the profession as a whole. Other features report on how diversity in the HIM workforce can help reduce healthcare disparirities and how integral senior-level professional practice experiences are for HIM students.

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The Department of Health and Human Services announced awards totaling $27.8 million to health center networks and large multi-site health centers to implement health IT.

The funds are part of the $2 billion allotted to HHS’s Health Resources and Services Administration (HRSA) under the American Recovery and Reinvestment Act to expand healthcare services to low-income and uninsured individuals.

The $27.8 million will be used to expand and upgrade health IT systems, including electronic health records, and are related to other ARRA efforts to promote the adoption and use of health IT throughout healthcare.

Eighteen grants totaling more than $22.6 million will support EHR implementations. Grants totaling more than $2.6 million will help four grantees implement other health IT-related projects, including creation of health information exchange networks. Another five grants totaling more than $2.5 million will help health centers use existing EHRs to improve patient health outcomes.

HRSA-supported health centers treated 17 million patients in 2008, 40 percent of whom have no health insurance, according to HHS.

A list of grant recipients is available through the above link. More on ARRA provisions for community health centers is available through the HHS.gov/Recovery site.

For healthcare providers seeking to participate in the federal government’s “meaningful use” incentive program, the barrier of entry may be lowering.

David Hunt, MD, chief medical officer at the Office of the National Coordinator for Health IT, indicated that criteria in the program’s first phase will focus on getting providers to purchase and begin using electronic health record systems. Hunt spoke at Health Data Management’s Health IT Stimulus Summit in Boston yesterday.

“You have to be able to send data, and [the Centers for Medicare and Medicaid Services] has to be able to receive it,” Hunt said, quoted in Health Data Management. “The big thing for 2011 is that you actually acquire this equipment and start using it.”

Hunt did not comment directly on what this meant for the criteria proposed by the Health IT Policy Committee this past summer. He noted that officials are collecting a “‘tremendous amount’ of information from many sources.”

The “meaningful use” program will provide Medicare or Medicaid bonuses to hospitals and physicians that become “meaningful” users of EHRs. Payments begin in 2011, leading many in the industry to question how ambitious the initial set of criteria can afford to be, given the low use of EHRs currently.

The program, specified in the HITECH section of the American Recovery and Reinvestment Act, leaves the details up to the Department of Health and Human Services. The Office of the National Coordinator, part of HHS, has been facilitating the process.

A proposed rule on the program is expected in December. The notice will include 60 days for public comment.

Medicare expects its fee-for-service systems will be tested and fully operational on the X12 5010 standard by January 1, 2011. That’s bad news for health plans that may have been hoping the big payer would run late and create an industry-wide delay.

The upgrade to the HIPAA transaction 5010 standard was announced in tandem with the January 2009 final rule mandating the upgrade to ICD-10-CM and -PCS. The 5010 standard is necessary to support ICD-10.

According to a timeline published in the final rule, by the end of 2010 covered entities should have completed internal testing and can send and receive compliant transactions (”level 1″ testing). In January 2011 they begin testing with trading partners and move into production (level 2). The compliance date for all covered entities is January 2012, one year in advance of the ICD-10 deadline.

Read more in the current issue of AHIMA ICD-TEN newsletter.

In the September print issue, Lou Ann Schraffenberger, MBA, RHIA, CCS, CCS-P, FAHIMA, reviewed the ICD-9-CM diagnosis code changes for FY 2010. She offers an extended version of the article “New ICD-9-CM Diagnosis Codes for FY 2010” in the AHIMA Body of Knowledge. She also highlights ICD-9-CM procedure code changes in a special, Web-only article.

Revisions to both code sets go into effect October 1. The 2009 addenda with all the changes to the ICD-9-CM tabular and alphabetic index (volumes 1 and 2) are located on the National Center for Health Statistics Web site. The 2009 addenda with all changes to the ICD-9-CM procedure tabular and alphabetic index (volume 3) are located on the Centers for Medicare and Medicaid Services Web site.

Strike when the ink is wet. 

That is the motto of the clinical documentation improvement specialists (CDSs) at Shands Hospital, based in Jacksonville, FL. They routinely “shadow” physicians as part of their clinical documentation improvement program (CDIP), seeking clarification in real-time and making recommendations for how physicians can fine-tune documentation to enable more accurate coding.

CDIPs are popular in healthcare facilities looking to capture better documentation. Physicians know the documentation they need for treatment and continuity of care, but CDSs are anticipating additional detail that will later produce more complete and accurate coding. A more thorough description can enhance reimbursement and more correctly reflect the facility’s quality of care indicators.

Officials at Shands and other facilities using this technique say they get more out of their CDIPs when documentation specialists are present with physicians in real-time, not querying later via e-mail or paper forms left in the chart. But some challenges, like time management and physician buy-in, also come with the successes. (more…)

“No” is a common word heard by PPE coordinators.

Getting busy HIM professionals to host an HIM student for a professional practice experience can be a challenge. As important as the internships are in giving students real-world experience, PPE coordinators say it takes a mix of professionalism, emotion, and incentives to place students in today’s hectic work world.

Securing sites has become increasingly harder as more HIM departments face major health IT installations and reduced staffing, says Kathy Cliggett, MA, RHIA, an assistant professor and PPE coordinator at Gwynedd-Mercy College in Pennsylvania. HIM directors often feel stretched too thin to host a student, she says.

Other HIM professionals may be hesitant because they don’t know enough about the programs and responsibilities, says Stephanie Donovan, MBA, RHIA, assistant professor of HIM at Gwynedd-Mercy. “I think communicating realistic expectations to our clinical sites is one of the key components of them accepting students,” she says. (more…)