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Continuing New Challenges and Opportunities for HIM by Shahid N. Shah

15/01/2015

Part IV in the Big Picture Predictions and Perspectives Blog Series

In my last post I covered a number of very important subjects that successful HIM leaders will need to master on their transition from paper to digital native medical records. Once records have been digitized, though, HIM leaders see their responsibilities grow to include:

Preventive care based on predictive analytics. With the right digital data, advanced scoring and predictive analytics can be used to encourage early screening based on more than a patient's gender or age alone. When even more data is available, analytics can show how to care for patients based on co-morbidities and other scoring capabilities as patients arrive for care. For example, if someone arrives for care in an emergency setting and has been flagged as a CHF patient, then that patient can be scored for special types of care and specific workflows can be generated that would relate to the known diagnosis.

Population health outcomes improvement. PopHealth is something that has been talked about for decades but real population health only becomes possible as digital native data is available longitudinally across time and in depth with different kinds of phenotypic, genotypic, imaging, diagnostics, and other information that can be automatically processed without human oversight. Without longitudinal data on large enough cohorts and cross sections of populations, we HIM leaders cannot yield predictive and preventive recommendations.

Care coordination and care gaps elimination. Many thousands of patients die each year because of gaps in care, errors, and improper coordination of care. To eliminate gaps and improve coordination, interoperable data must be available across the care continuum quickly enough to be useful to patients as they move from one care facility to another. Until medical records are detailed enough and managed natively, the long term goal of saving lives through proper immunization, improving medication adherence, automatically flagging co-morbidities, analyzing imaging data, and seeing trends remains difficult.

Patient engagement. For many years the industry has been working to design a patient and family centric healthcare system by engaging patients. But, we've been trying to succeed in the 21st century with 20th century technology, like phones. With digital native records, engagement becomes easier through telemedical visits, SMS, e-mail, mobile apps, and remote diagnostics. When interoperable patient registries, digital histories, medication lists, and family outreach become routine real engagement will happen without actually having to do anything special. Patient engagement, when accomplished digitally, is an emergent property of the healthcare system and not a feature or function of a system.

As a HIM leader, once you see how your responsibilities will change, you can start mastering these aspects of digital records (data) to help achieve the initiatives listed above:

Confidential information handling and privacy rules. The more digital our records get, the easier it is to send them around, and the more likely it is that data that was once private might become public. As a HIM professional you should become the biggest advocate for patient privacy rights and help ensure that records stay closed to prying eyes.

Business rules and alerts. Consider putting in BPM (business process management), BAM (business activity monitoring), and rules engines on top of digital records to help generate alerts and improve workflow without requiring human intervention. If computer system can review digital records and only emit minimal data such as reports and alerts, privacy and security are both improved.

Data sharing and reciprocal arrangements. This is probably one of the thorniest issues that HIM professionals will have to deal with in the coming months and years. Who owns the source data? Who owns enriched data? Which organizational divisions inside the enterprise can see certain aspects of data? Which partner organizations outside the enterprise can share data? These are just some of the simpler questions around data sharing and reciprocal agreements that need to be considered and established as quickly as possible. If you go digital native and the wrong agreements are in place, then you may not have access to very important parts of data.

Archiving, backups, and business continuity. Once paper records are gone, how will you operate in environments when the digital environment is performing slowly or is gone altogether? The HIM professional will be responsible for having backup plans, establishing archiving rules, and allowing for the continuity of business when systems are down.

Successful HIM professionals of the future will look very different from their historical counterparts. The transition from paper digital native is not going to be simple, but it will allow for much more effective care and improved patient outcomes.

Join our Twitter Chat: Healthcare IG Predictions & Perspectives

On January 28th at 12:00 pm Eastern, @IronMtnHealth is hosting a Twitter chat using #InfoTalk to further the dialog. If you have been involved in governance-related projects, we'd love to have you join. What IG initiatives have shown success for you? How have you overcome any obstacles? What do you see as the future of IG? Keep the conversation going during our Healthcare IG Predictions & Perspectives #InfoTalk at 12pm Eastern on January 28th.

Hear more voices from the thought leaders of the healthcare industry by reading the rest of the blogs in this series: Big Picture Predictions and Perspectives.
LINK: http://blogs.ironmountain.com/2015/industry/healthcare-information-man...
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