by Chris Dimick
The path to meaningful use runs through the HIM department. Meeting the requirements of the federal EHR incentive program requires the contributions of HIM professionals to redesign documentation workflow, implement new health IT systems, and capture quality measures.
For that reason, regional extension centers (RECs) routinely work with HIM departments when they consult with providers on how to meet the meaningful use program requirements.
HIM staff help is critical to a provider’s success, says Sarah Cottington, MHA, RHIT, CPHQ, the quality improvement advisor at the Telligen Health Information Technology Regional Extension Center, based in Iowa.
When Cottington enters a healthcare facility for REC work, she always checks to see if an HIM representative is on the steering committee or involved in the meaningful use effort. If one is not, she explains how privacy and security, documentation workflow, and several stage-1 measures like electronic reporting of health information all require HIM input.
“Even though a hospital may not think the HIM professional is needed or required—that it’s all IT—I try to make it very clear from the beginning that the HIM professional needs to be involved,” she says.
As an RHIT and CPHQ with extensive quality work in hospital HIM departments, Cottington knows the value of having HIM involved in the planning. Take for example, she says, the stage-1 requirement to provide patients with electronic copies of their information within three days. HIM staff are necessary to help write the policies and procedures, design workflow, and train staff on operations.
RECs routinely help hospitals develop problem lists, another stage-1 measure. The Telligen HITREC always includes coding professionals in developing the list and its processes, “because it’s all based off the current codes of the patient,” Cottington says.
An HIM Role at Buena Vista Regional Medical Center
When Iowa’s Telligen HITREC worked with Buena Vista Regional Medical Center, a 25-bed critical access hospital based in Storm Lake, Iowa, the HIM department played a key role in the process.
Fresh off an EHR implementation, Buena Vista had the REC conduct an analysis of its electronic processes to show any gaps in meeting stage 1 meaningful use, says Lori Cherrier, RHIA, director of HIM at Buena Vista.
The Buena Vista HIM department mainly worked with the REC at the “administrative strategic level” and not at the coding or record analysis level.
REC staff educated the facility on the details of the meaningful use criteria, numerators and dominators needed to measure the criteria, and assessed how close the facility was to meeting stage 1. The REC also benchmarked Buena Vista’s stage 1 readiness versus other facilities in the state. A section of that evaluation focused on maintaining privacy and security requirements while taking part in the program, requiring HIM staff input.
The release of information processes needed to be reworked in order to give patients copies of their discharge instructions and other medical records within three business days, a stage 1 measurement.
HIM staff also worked on adapting the EHR to collect information for the quality measure reporting aspects of the program. This has been a problem for many providers since most EHRs don’t inherently have the functionality to meet the measure, Cherrier says. HIM was key to solving the problem.
“The REC was helpful in helping us identify other organizations around the state that are in the same situation as us so we can hopefully try to work together and find a process that works,” Cherrier says.
Due to the RECs help, Buena Vista is on track to attest to stage 1 meaningful use next year.
HIM involvement with the REC planning helps ensure the health record remains sound and secure during meaningful use focused redesigns.
“We’re the ending point for all the patient information,” Cherrier says. “We do all the reporting, the release of information, maintaining the record. Even though we’re on the back end of the process, we need to be very involved in the front end so it’s not a mess on the back end.”
For more on the REC program, see “RECs on a Mission” in this month’s issue.