This monthly blog highlights and discuss emerging trends and challenges related to healthcare data and its ever changing life cycle.
By Jeannine Cain, MSHI, RHIA, CPHI
In this blog post, I’m going to continue the discussion I began in a LinkedIn post earlier this year on the importance of health information management (HIM) professionals playing a role in guiding user experience design. Healthcare technology is our future for capturing, storing and transporting health information from one point to another. The use of health information technology to capture data in order to improve healthcare delivery and operations is rapidly increasing. However, it still remains inefficient when it comes to accomplishing the very thing it was intended to improve. Consistently, I either hear about or witness firsthand extended implementations and readjusted workflows that were needed to accommodate a system limitation. I have even heard about solutions rolled back because even though it functioned as designed, it did not meet expectations or needs. This is an increased expense for both the company providing the solution as well as the organization seeking the solution because it consumes a lot of resources. Since the 1920s, HIM has been a profession centered around medical records, and through the years has evolved to adapt to the various environments and technologies that are used to capture, store, and maintain health information. With a profession rich in history and centered around medical records for almost 100 years, it stands to reason that HIM professionals should be present in the development of these health information technology systems.
The first step in any development process is to understand not what the person is asking for, but why they are seeking a solution. An HIM professional understands healthcare at its most granular piece of information: medical codes. At the medical code level, a person has to understand the documentation required to support that code. On top of understanding the content within a medical record, an HIM professional is required to understand how this information is used and where it is used. This includes protecting the documentation created to support the use of medical codes. Protection includes privacy, security, and destruction of health information. When you think about all of what an HIM professional knows, it is clear that it would be beneficial to have an HIM professional involved in development. Increasingly, HIM professionals are being called on to analyze not only coded data, but the various systems that collect, store, and transmit data in healthcare organizations. Since the HIM professional knows and understands the data and the flow of information throughout healthcare, it makes sense that they would understand why the individual is asking for a solution.
Development is not an easy concept to learn, but to have a person with existing knowledge to execute the right solution would be a step in the right direction for healthcare. User experience (UX) has been a buzz word for a while, but to truly understand its purpose is another dilemma. UX is not just about creating a workflow for certain users and implementing it. UX is a process that identifies all users and then works to develop an understanding of how each user would interact with the system in a given workflow. The depth of knowledge that HIM professionals possess can help document a workflow appropriately, and that same knowledge can help to identify where the variations or potential problems in that workflow can occur. All too often, you have limited health information technology solutions because someone fulfilled “the ask” but has not truly identified the problem. This leads to additional development or it requires an alternate workflow to be created by the end users to accommodate the limitations of the system. Either way, the cost has increased and the probability for additional frustrations will happen because it will never solve the problem. These frustrations and attempts to find a solution within the existing infrastructure creates new problems for organizations and end users.
The problems of bad design do not stop at increased cost. It adds to the problem of bad data. The data created and stored from using health technology is only as good as the solution provided to the end user. This is where understanding the end user, the workflows, and how the user interacts with existing systems is beneficial. An HIM professional understands more than just the data elements. They understand the users who interact with a system, the workflow of each user, and the components acting on that workflow which can impact the end result. Many HIM professionals understand the challenges associated with system designs because they have had to interact with so many of them as the hub of health information. In order to improve quality in healthcare, we need accurate data. Systems that do not follow UX principles leave room for errors—preventing the collection of quality data.
As regulations move toward a data-rich environment, and the need for interoperability increases, new health information technology is developed. As the concept is developed and new technology is created, we need to ensure that HIM professionals are included in this process. Healthcare is not one-dimensional or linear. It is a complex system that is intertwined. An HIM professional not only understands the basics of health information, but they understand how each piece of the puzzle fits together, and can help with navigating through the complexities of healthcare. Embracing the knowledge and expertise of an HIM professional can help achieve long-term viable solutions that are efficient and can help improve the quality of healthcare. We need more organizations embracing the unique, skilled, and vast knowledge of the HIM professional. For more information on the competencies of an HIM professional, visit www.ahima.org or click here to see a breakdown of the AHIMA certification knowledge domains.
Jeannine Cain is the President-Elect and the Chair of the Advocacy Committee for the Alabama Association of Health Information Management.