New Challenges and Opportunities for HIM by Shahid N. Shah

Part III in the Big Picture Predictions and Perspectives Blog Series

If you've been a health information manager (HIM) for a while, you were probably in charge of retrospective paper records. Over the past decade or two, many paper records have been converted to digital records but the quantity of paper remains high because we're right in the middle of transitioning into an era of digital native records. What's obvious is that the next 10 years will see an acceleration of the digital native transition and increased responsibilities of data stewardship; what's not so obvious is that the HIM role of the future will not be overseeing retrospective paper records primarily used for creating bills and getting paid. Instead, we're going to be seeing digital native clinical histories, labs, microbiology, radiology, pathology, transcribed notes, ADTs, report summaries, genomics, proteomics, and other pan- omics data used primarily for prospective, population driven, predictive, and coordinated clinical care.

Successful HIM professionals of the future will be responsible for understanding these major aspects of digital records (data) that are quite different from paper:

Governance. Everyone talks about this but very few organizations give HIM resources the time they need to put together a good story. A great new resource, Demystifying Healthcare Data Governance, is available from HealthCatalyst. Instead of speaking in generalities about the goodness of governance, this white paper provides actionable advice and specific guidance.

Provenance and Metadata. When paper was king, medical records provenance was easy - the letterhead, the envelope, or the folder it was contained in had the source and signature of who created the record or at least who sent it. Once something is digital it can be easily copied, moved, separated, and segregated without maintaining provenance. Maintaining the source of where digital data came from, whether data was converted, split, or merged is going to be a huge challenge. You'll need to expand your expertise in metadata management and master data management (MDM) to help with both data governance and data provenance.

Networking and Transport. Except for large (detailed) 3D images, digital data is pretty easy to transport because our network pipes are getting larger and faster. However, personalized medicine and its need for genomics, proteomics, and other pan omics make even our largest image files look small. While data transport and networking tech seems like a problem for the IT team, they may not realize what's in store, so HIM experts need to jump in and help with network planning based on personalized medicine requirements.

Storage. Most of our networks and data storage plans were created at a time when imaging, not personalized medicine, was the major consumer of disk space. However, just like transport of data is going to get harder due to genomics, so will storage. Because storage is getting cheaper, IT teams want to buy more local storage, but you'll want to see if it's better to store larger files that will be shared across HIPAA-compliant, cloud-based, elastic storage facilities.

Compute. Until genomics and other pan-omics needs become paramount, server farms will remain reasonably small. However, as soon as omics and other personalized medicine requirements grow, you'll need almost 10 to 100 times more computing power to help analyze and use all the data you'll be asked to transport and store. More importantly, you'll want to make sure that computing resources are as geographically close to the storage as possible, otherwise you'll spend a lot of money on transporting data back and forth.

Leakage. When you have so much data that it's hard to count or track, yet it still needs to be shared for good clinical or business reasons, it's more likely that data leakage can occur. A simple email with a CCD or PDF attached sent outside to a vendor without BAA could cause breach concerns. You'll want to be sure to learn about and invest in data loss prevention software. While this seems like something that should be taken care of by your IT team, there are tools to help make sure data loss is preventable rather than just auditable.

As you can see, there are many more significant topics that HIM leaders need to be aware of as they migrate to a digital native environment, but it's nothing to fear - it's all tangible opportunities for you to become even more valuable to your clinical and operational colleagues.

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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