Leading With Purpose: Driving Change in a Fractured Healthcare Environment

Recently, a story made the news about bad actors in Arizona fraudulently billing Medicaid, exploiting vulnerable Native American populations in the process. Illegitimate providers targeted these patients with the promise of behavioral health assistance, which they never provided.

Accurate documentation and reliable data are critical in detecting fraudulent billing practices and holding providers accountable. By implementing effective data management systems, authorities can protect vulnerable communities, recover misappropriated funds, and prevent future instances of fraud.

The Arizona case is a tragic example of why health information and data management matters. It also underscores the relevance of your work as members of AHIMA.

Your ability to promote accurate documentation, prevent billing fraud, and educate others helps to keep vulnerable populations safe. You also play a pivotal role in ensuring vital health information is used, shared, and exchanged, with the current state of electronic health information as problematic.

Lack of connectivity among health IT systems, public health systems, and community-based organizations make it difficult to make clinical decisions at the individual and population level. For example, how can we ensure individuals facing housing insecurity or transportation needs are properly referred to community-based services when their health information doesn’t follow them along their care journey?

Lack of seamless, timely, and electronic access to our data also keeps us from sharing our medical history with other care partners and inhibits us from managing and understanding our health and healthcare.

The pandemic made this issue impossible to ignore. Without standardized data collection and interoperable health IT systems, electronic capture of public health data and exchange of lab and vaccination information was limited, and often based in paper. The lack of real-time data further impeded accurate and timely insights on infection rates, distribution patterns, and potential disparities.

But your knowledge can help change our current state of health information access, exchange, and use.

Your operational expertise can help to build a shared understanding and streamline communication between payers and providers, overcoming tech barriers and promoting smooth data flow. Your in-depth knowledge of data quality, semantic interoperability, privacy and security and compliance, among other skills, is invaluable in helping information to move, regardless of technical barriers.

The team here at AHIMA is alongside you, advocating for a healthcare ecosystem that is technically, functionally, and semantically interoperable to enable patients, caregivers, and providers to make more informed care decisions. We have a clear purpose: Empowering people to impact health®. This starts with health information because it is the most powerful currency for change in the healthcare ecosystem.

Together, we will continue to fight for a future where health information is accurate, timely, complete — a future where it can be exchanged seamlessly and electronically to drive better outcomes and care.

I am deeply proud to lead AHIMA as the catalyst for this change.

Amy Mosser, MBA, is interim CEO of AHIMA.