By Lorraine Fernandes, RHIA; Kerryn Butler Henderson, PhD; Carol Lewis, MPH, RHIA; Marci MacDonald, CHIM; Margaret Skurka, MS, RHIA, CCS, FAHIMA; Hussein AlBishi; and Kylie Axford
Healthcare, like manY other segments of society and the economy, has become truly global.
The impact of healthcare on national economies is evident in the 2018 Organization for Economic Cooperation and Development (OECD) study, which revealed the average amount spent on healthcare across OEDC nations is six percent of the Gross Domestic Product (GDP), with healthcare in the US accounting for as much as 18 percent of GDP.1 In addition to its financial impact, healthcare is increasingly being built into our lives and our livelihoods via mobile technology that allows quick access to vital health information. Thus, health information and its management couldn’t be more important than it is today.
Healthcare is also a big international industry fueled by medical tourism, expatriation of businesses and their workers, and an imperative to have quality healthcare on the “home front” by advanced societies. Large healthcare organizations, including the Hospital for Sick Kids (Toronto), Cleveland Clinic, and Mayo Clinic, operate facilities or conduct global research not only in cities around the US and Canada, but also in countries around the world.
Healthcare is also an increasingly high-tech industry where health information management (HIM) plays a crucial role in the governance and the safe sharing of health records and patient information. This is why the International Federation of Health Information Management Associations (IFHIMA), which will hold its 19th Congress in Dubai, United Arab Emirates from November 17 to November 21, sees its role in the globalization of the healthcare industry as so very important.
IFHIMA, a non-profit organization affiliated with the World Health Organization (WHO) as a non-governmental organization (NGO), is acutely aware of how rapidly healthcare delivery and policy is changing. Accordingly, the organization works with its members to ensure the HIM workforce is trained to manage the privacy and security of paper and digital data in any country. The challenge of this work is evident, given that healthcare data is predicted to double every 73 days by the year 2020.2
IFHIMA has an executive board that is made up of elected officials, the president, the president-elect, and six regional directors representing Europe, the Americas, South East Asia, Western Pacific, Eastern Mediterranean, and Africa. Attendees from various IFHIMA regions will converge in Dubai in November to attend educational sessions, hear speakers discuss globally relevant HIM topics, and network with other HIM professionals.
IFHIMA’s Revised Mission, Vision, Values
In addressing the changing healthcare ecosystem, the 2018 IFHIMA Board revised its mission, vision, and values to reflect the rapidly evolving global healthcare environment and the challenges HIM professionals face.
- IFHIMA represents and advances the global health information management profession
- A healthy world enabled by quality health information
- Leadership: in quality health information management
- Integrity: principled, honest, and ethical
- Mutual Respect: embrace diversity and treat all with dignity and respect
- Collaboration: engage and maintain global partnerships
IFHIMA Congress Celebrates Its Golden Jubilee
Last year marked IFHIMA’s Golden Jubilee Celebration—50 years since the organization was founded in 1968 as an opportunity for the global exchange of HIM-related information, education, and networking.
In a series of articles posted on the IFHIMA.org website, members shared their reflections about what 50 years of the international association has meant to them. Sue Walker from Australia wrote in her article, “What a wonderful organization IFHIMA is—seeking to unite health information professionals from across the world, helping us to understand that many of the issues and problems we think are unique to our own experiences are actually common, working together to promote best practices.” Dr. G.W. Mogli from India wrote, “IFHIMA has transformed the HIM profession excellently with limited resources.”
Since the IFHIMA Congress is held every three years in one of the 23 IFHIMA member countries, this year’s 19th Congress will mark the first chance for the organization to celebrate the golden jubilee milestone in person. Themed “Empowering HIM Professionals Through a Global Voice,” the 19th Congress will convene HIM colleagues from around the world to explore how the HIM global voice is changing and how IFHIMA is advancing core practice areas. Dr. Robert Jacob, director of standards, terminology, and classification at the World Health Organization, will be a keynote speaker at the event and address the release of ICD-11. Dr. AbdulElah M. Alhasawi, director general of the Saudi Patient Safety Institute, is also slated to discuss key elements to improving patient safety, including HIM and clinical documentation, in his keynote address.
The 19th Congress Scientific Program will reflect the diverse practice areas for HIM including clinical coding/classifications, health informatics, healthcare finance/value-based health reimbursement, healthcare transformation, workforce developments, education for the future, research and studies, and HIM practice. Pre-Congress educational training and certification preparation workshops will be held on November 17, 2019. Abstract submittals for the 19th Congress are open through May 1. More information is available at https://ifhima2019.com/abstract-submission.php.
First Congress in the Middle East
The 19th Congress marks the first time the IFHIMA event is being held in the Middle East. Dubai was selected as the host city since it is becoming an international destination for architecture (featuring the world’s tallest building), shopping, historic culture, and world-class healthcare—specifically through its Dubai Healthcare City, a health and wellness campus covering over four million square feet and featuring over 150 healthcare facilities. According to its website, Dubai Healthcare City “has worked towards its vision to become an internationally recognized location of choice for quality healthcare and an integrated center of excellence for clinical and wellness services, medical education, and research.”
The IFHIMA 19th Congress organizing committee is working to create an event that will provide the best in diverse learning and networking, along with opportunities to experience Dubai through social events and organized tours.
Board Activities Advancing IFHIMA
IFHIMA Board members regularly promote topics expanding global HIM perspectives at association conferences around the world. Here are some of the most recent board activities:
- September 2018 AHIMA Convention, Miami, FL. Lorraine Fernandes presented “Information Governance: New Perspectives and Global Experiences”
- September 2018 CHIMA Convention, Niagara Falls, Ontario, Canada. Marci MacDonald presented “International Perspectives in HIM”
- October 2018 KlasifiKon, Prague, Czech Republic. Angelika Haendel presented “IFHIMA, DVMD, Clinical Documentation and Coding in Germany”
- April 2018 Medical Informatics Europe MIE 2018 Convention, Gothenburg, Sweden. Angelika Haendel with Angela Kennedy, Grace Kennedy, Mervat Abdelhak, Marion Ball, and Ursula Huebner presented “Ask the Patient! What can TIGER, AHIMA/IFHIMA and CAHIIM do to ensure patient safety through better health informatics/health information education?”
- November 2018 HIMAA Convention, Hobart, Tasmania. Vera Dimitropoulos presented “Transition to Implementation of ICD-11—What do we need to consider?”
Advancing Collaboration and Knowledge in Developing Nations
The 18th IFHIMA Congress held in 2016 in Tokyo, Japan had unprecedented attendance from developing nations, thanks to the generosity of the Japan Hospital Association. To sustain this momentum and keep advancing HIM practice in developing nations, the Japan Hospital Association has graciously endowed a new IFHIMA Japan Scholarship. Additionally, the IFHIMA Ulli Hoffman Scholarship—Hoffman was IFHIMA President from 1992-1996—endowed by Hoffman’s friends and family will also be given for the 19th Congress. Scholarship applications and details can be found on the 19th IFHIMA Congress website, IFHIMA2019.com. Scholarship recipients for the 19th Congress will be determined in mid-2019 by the IFHIMA Board.
IFHIMA in Action
At the core of every IFHIMA Board discussion is a commitment to its mission, vision, and values and member nations. “Looking back over the long period I have followed IFHIMA, I find great pleasure in seeing how IFHIMA has developed and now embraces all WHO Regions,” says Darley Peterson from Denmark, a 30-year IFHIMA member. Developing nations are routinely highlighted since the IFHIMA Board believes raising a tide for all is critical to improving health and wellness around the globe. Some of IFHIMA’s activities over the past year include:
IFHIMA recently updated nine Learning Modules designed as educational resources to assist in communicating core healthcare and HIM-specific practices between people working in the field of health records/information management around the world. The modules are not formal curriculum or training guides; rather, they are resources to assist practitioners in communicating core principles and practices.
Change in the healthcare ecosystem will be coming in the next decade in the form of ICD-11. While the US may feel that they’ve just caught their breath after ICD-10 was implemented in 2015, much of the world implemented ICD-10 one or two decades ago. Thus, WHO has been working for over a decade on the International Classification of Diseases, Eleventh Revision, which will be officially adopted by the WHO for implementation in May 2019. ICD-11’s new structure reflects a diversity of data needs given the vast use of health data, new information technologies, and the advancements in medicine. IFHIMA, through US member Margaret Skurka, MS, RHIA, CCS, FAHIMA, has an official voice and vote on the WHO Education and Implementation Committee, with fellow HIM professionals including Yukiko Yokobori (Japan), Vera Dimitropoulos (Western Pacific), and Sue Walker (Australia). Carol Lewis, MPH, RHIA (US), and Joon Hong (Republic of Korea) are also managing many aspects of this work. Much work remains to be done to build training, further testing, and advance language translations and computer assistance for the workforces that will assign or review the new codes. The practical reality is that actual implementation by some countries will likely not happen until 2022-2025 or later.
Mortality Examination and Certification
The World Health Organization Family of International Classifications (WHO-FIC) Education and Implementation Committee conducts examinations for underlying cause of death coders, and IFHIMA awards a certificate to those who achieve a score of 80 percent or better. The first mortality exams were conducted in 2007. In 2018, following a survey of recertification practice in IFHIMA member countries, a recertification examination was developed and conducted in the Republic of Korea. A recertification cycle of five years is now established. An examination for morbidity coders has been developed and conducted but, given that morbidity coding rules vary among countries, no certificate is awarded.
Implementing Membership Expansion
IFHIMA membership has traditionally been open to individuals, nations, and corporations. As of the 2016 Congress, IFHIMA added a new membership category, Educational Institutions. IFHIMA anticipates the new institutional members will engage in better collaboration to serve students and educators around the globe.
Global Workforce Challenges of the Future
As HIM has evolved over the decades, IFHIMA members are mindful that the profession must continue to address workforce challenges and changing regulations. The rapid development of new technologies and the impetus for data-driven decision-making has carried health information out of the shadows and to the forefront of supporting the safe delivery of care. But with this comes a shift in challenges for the HIM professional.
The profession will need to transform or risk becoming obsolete along with the paper health record. The need for high-level operational management within a paper or hybrid system is now reduced in a digital environment. A 2013 Oxford white paper reported that the role of medical records and health information technicians are 91 percent susceptible to automation.3 Yet, this will increase the need for data quality audits, clinical documentation improvement, and data analytics. As such, the role of the health information manager should evolve from operational managers to information strategists. And with exciting emerging roles accompanying innovations such as artificial intelligence, automation, and data strategy, the transformation of the profession seen globally places HIM central to digital health. That said, workforce development is slated to be a key topic and an important track at the 19th Congress.
In the words of past IFHIMA President, honorary member, and Australian leader in HIM, Professor Phyllis Watson, AM, “Over the years changes, and at times incredible challenges, have dominated our history and been an important part of the work of the medical record/health information professional, and we should not expect it to be different in the future.”4
Change is once again upon the HIM profession and workforce. This will require a system approach, including peak bodies advocating for the profession, educators preparing graduates for future capabilities, and practitioners joining the journey associated with workforce transformation.
These are topics that will be explored at the 2019 Congress in Dubai as IFHIMA works to advance the HIM profession and celebrate 50 years of global collaboration in support of a healthy world enabled by quality health information.
- Organization for Economic Co-operation and Development. “Spending on Health: Latest Trends.” June 2018. www.oecd.org/health/health-systems/Health-Spending-Latest-Trends-Brief.pdf.
- Corish, Breda. “Medical knowledge doubles every few months; how can clinicians keep up?” Elsevier. April 23, 2018. www.elsevier.com/connect/medical-knowledge-doubles-every-few-months-how-can-clinicians-keep-up.
- Frey, Carl and Michael Osborne. “The Future of Employment. How susceptible are jobs to computerization?” Oxford: Oxford Martin School. September 17, 2013. www.oxfordmartin.ox.ac.uk/downloads/academic/The_Future_of_Employment.pdf.
- Watson, PJ. “The first fifty years 1949–1999. Medical Record Librarians to Health Information Managers. A history of the Medial Record/Health Information Management profession in Australia.” Health Information Management Association of Australia. 2013.
Gibson, Candace J., Kelly Abrams, and Gail Crook. “Health Information Management Workforce Transformation: New Roles, New Skills and Experiences in Canada.” Perspectives in Health Information Management (International issue, May 2015). http://library.ahima.org/doc?oid=301180.
Lorraine Fernandes (firstname.lastname@example.org) is IFHIMA President-Elect, US. Kerryn Butler Henderson is senior lecturer, School of Business and Economics, at the University of Tasmania, Australia. Carol Lewis is IFHIMA Past President, US. Marci MacDonald is IFHIMA President, Canada. Margaret Skurka is IFHIMA Past President, IFHIMA representative to WHO-FIC EIC. Hussein AlBishi is IFHIMA regional director, Eastern Mediterranean. Kylie Axford is coordinator of the IFHIMA 19th Congress.
Fernandes, Lorraine. “IFHIMA Prepares for 19th Congress as Health Information Goes Global and Digital .” Journal of AHIMA 90, no. 3 (March 2019): 20–23.