EHR Challenges?
HIM Professionals Are Poised
To Ease The Pain
(ARRA) The American Recovery and Reinvestment Act gave adoption of electronic health records (EHRs) momentum. It also gave many healthcare providers an array of new regulations to navigate. HIM professionals have the skill set and expertise to aid their organizations with some of these new changes.
AHIMA wants to give you the information you need so you can:
Feel empowered that your HIM skills are urgently needed in this new electronic world.
Speak up when you see factors that could compromise data integrity.
Improve your understanding of the implications of the proposed ARRA "meaningful use" rules that were recently issued by the federal government.
Seize opportunities to take on new roles in your organization and profession.
Positive Attitude
While you may feel overwhelmed keeping up with your workload and all the new changes, stay focused on the positive outcomes of the EHR and all the opportunities it offers. And frequently remind yourself that you have the knowledge and skills to aid this transition.
Whether your facility or office is still working on paper, balancing a hybrid record, or in a full-out sprint to EHR implementation, you have an important role to play, said Diane Larson, RHIA, CHPS, director of HIM at St. Luke's Hospital in Duluth, MN. Their EHR system is well developed; at least 90 percent of all hospital and clinic records reside electronically."Having been in healthcare for 35 years, I can see that the EHR is a wonderful new technology" Larson said. "However, it has to be implemented correctly. In some organizations the IT department is taking so much responsibility that some HIM people stand back and let them go for it. But, HIM needs to be a part of the transition. If we see that something is not going to work right or negatively impact data integrity, we need to identify those problems as technology implementation showstoppers"
When patient health records can be shared with the click of the mouse, HIM expertise is acutely needed. The EHR will change the way HIM professionals execute core processes (such as privacy, security, coding processes, and record retention) and staff competencies (like abstracting and release of information), but it will not erase their importance.
Protect Data Integrity
The EHR has exacerbated some old problems, such as ensuring data integrity. This is an area where HIM professionals can exert their expertise and leadership.
"Data integrity needs more attention now than ever before;' Larson said. ''An electronic system is less forgiving than paper. If data integrity is not paid attention to, it can create nightmares. People don't think it's important, but data integrity is the foundation of the EHR:' We've all heard examples of EHRs gone wrong: Otherwise healthy patients are arriving at their provider's offices to hear that they have diabetes, sleep apnea, or high blood pressure. When in actuality, doctors are reading the wrong records because master patient indexes were compromised.
HIM has an important role in ensuring data integrity. Unfortunately, HIM processes are not always addressed very well by EHR vendors. This is all the more reason to be involved when your organization is purchasing or modifying EHR systems.
Getting Ahead of The Curve with ARRA
ARRA contains new regulations and incentives for supporting providers who serve Medicare and Medicaid patients in their transition to the EHR. HIM professionals may be affected by ARRA unlike anything we've ever seen before.
In particular, the "meaningful use" financial incentive program is having a huge impact, both in the changes it requires today, and in the uncertainties of what the final rules will eventually look like. Here are a few meaningful use basics:
To qualify for incentives, providers must meet certain criteria to show that they are using their EHR systems to achieve certain goals for increasing patient care, quality, and safety, and for increasing the efficiency of the healthcare delivery system.The first stage of the meaningful use program was announced in a notice of proposed rule making (NPRM) on January 13,2010.
The Centers for Medicare and Medicaid (CMS) is still determining more rigorous criteria for two additional stages.
After 2015, providers may be financially
penalized if they don't meet requirements.
"There's no question about it: The meaningful use rule has changed the strategic direction of our organization;' said Elaine O'Bleness, MBA, RHlA, CHP, CPHQ, director of health information services/ HIPAA contact for Banner Health Western Region in Greeley, CO. With 22 facilities in seven states, Banner Health is the fourth largest secular, not-for-profit healthcare system in the US. "We have full project plans with an eye towards all the requirements of meaningful use, and have changed our time line to accommodate the new deadlines;' O'Bleness said.
Meaningful use ties into two other regulations.
1. The "Health Information Technology:
Initial Set of Standards, Implementation Specifications, and Certification Criteria for EHR Technology" interim final rule details the standards and criteria that must be used in reporting functional measures to demonstrate meaningful use of an EHR system.
2. Another NPRM, "Establishment of Certification Programs for Health Information Technology;' which defines the certification process for EHR vendors, was posted on March 2.
A big challenge is charting a strategic implementation schedule without having all necessary information from the federal government. Providers must also keep track of which rules are proposed, interim and final, and monitor all the implemen-
tation deadlines, such as for providing electronic access to medical records and updating business associate agreements.
By keeping current on ongoing ARRA rules and regulations, you can assist your organization as it moves to meet the objectives and measures. To help you, AHIMA has created a central resource center on leading edge information, opportunities, and requirements related to ARRA at www.ahima.org/arra. There, you'll find:A series of nine ARRA white papers that summarize the meaningful use rule
Breaking industry news related to ARRA
An overview of Title XIII of ARRA, called "Health Information Technology for Economic and Clinical Health Act" (HITECH)
A calendar of ARRA-HITECH due dates
