by Kevin Heubusch
Organizations undertaking EHR system design, planning, and implementation can become so focused on getting the clinical details right that they forget to put sufficient attention to the legal implications of maintaining the information over time.
Turning an organization’s focus to legal issues can require leadership—the ability to raise awareness, and even urgency, within the planning team or executive leadership. A leadership model from AHIMA helps HIM professionals identify, develop, and contribute technical leadership skills on the legal EHR.
Width and Breadth of View
Legal EHR leaders have the subject expertise to raise issues and recommend solutions. For example, they identify and communicate the risks in failing to address the legal and business aspects of EHRs. They identify and engage champions and stakeholders to establish the organization’s positions.
Legal EHR leaders have a wide view as well as a long one. They see the tracking and maintenance of data for legal reasons relating on a broader plane with overall enterprise content and records management—an integrated set of strategies, standards, best practices, and technologies for managing an organization’s complete information.1 By seeing where data management is heading, they make more informed decisions in the present.
HIM professionals are charged with ensuring that organizations develop and apply information management standards that maintain the integrity necessary for health records to meet the organization’s business and legal needs. As experts in these requirements, they are natural candidates for technical leaders on creating and maintaining a legally sound EHR.
A Focus on Goals, Behaviors, Activities
The terms leader and manager are sometimes used interchangeably, but although they overlap, the two terms describe different roles.
Managers are responsible for ensuring operations run smoothly; leaders strive to help organizations adapt to change.2 AHIMA’s model focuses on technical leadership: leadership based on technical expertise rather than general leadership skills (though these skills are also necessary). It helps HIM professionals visualize, initiate, and lead legal EHR initiatives at institutional, regional, and even national levels.
The model is action-centered; that is, it identifies goals and the behaviors and types of activities that support them. It seeks to advance the user’s understanding of technical HIM concepts and precepts, regardless of the user’s current role within the organization. It seeks to help HIM professionals apply theory and technical knowledge using leadership techniques to drive change within their institutions and the industry.
The model adapts concepts from Vinay Dabholkar’s “3 I’s of Technical Leadership.”3 According to Dabholkar, a business and technology consultant, technical leaders exhibit the following three key characteristics and behaviors:
- Independence: make and communicate sound decisions and take responsibility for the decisions they make.
- Initiative: assess situations, propose solutions, obtain sponsorship, and negotiate and execute decisions.
- Influence: affect the decisions made by others and the creation and delivery of solutions.
Designed for Adaptation
The leadership model is a matrix containing four categories of information. Nine leadership goals provide a description of outcomes associated with effective legal EHR leadership. Leadership characteristics/behaviors describe key “soft skills” required to effectively achieve each goal. Sample management activities support individuals and organizations in achieving the goals. Finally, a list of tools and resources identifies AHIMA articles, books, and courses that provide guidance and education in support of the goals, behaviors, and sample activities.
Individuals have differing levels of legal EHR expertise, and their organizations will be at various stages in the transition to electronic health information management. The leadership model is intended to serve as a guide, and it should be customized to meet personal goals and organizational strategies. For this reason, it is available for download in both PDF and MS Word formats.
The model is not a static document. Feedback from users, industry changes, and new resources will cause it to evolve over time.
The legal EHR model is available without charge from the AHIMA Web site [...]. AHIMA also offers a leadership model on data content standards, and additional models are forthcoming.
The Leadership Model: Excerpt
The leadership model is a matrix containing four categories of information. Leadership goals provide a description of outcomes associated with effective legal EHR leadership. Leadership characteristics/behaviors describe key “soft skills” required to effectively achieve each goal. Sample management activities support individuals and organizations in achieving the goals.
Not shown here is a column recommending AHIMA articles, books, and courses that provide guidance and education related to the goals, behaviors, and sample activities.
The model includes nine goals. The first two are shown in this excerpt.
Sample Management Activities
Source: AHIMA. “Legal EHR Leadership Model.” December 2008.
- AHIMA. “Enterprise Content and Record Management for Healthcare.” Journal of AHIMA 79, no. 10 (Oct. 2008): 91–98.
- Swenson, David X. “Leadership Theory and Change Management.” In Health Information Management: Concepts, Principles, and Practice, edited by K.M. LaTour and S. Eichenwald Maki. Chicago, IL: AHIMA, 2006.
- Dobholkar, Vinay. “3 I’s of Technical Leadership.” April 26, 2008. Available online at http://cataligninnovation.blogspot.com/2008/04/3is-of-technical-leadership.html.
Kevin Heubusch (firstname.lastname@example.org) is editor-in-chief at the Journal of AHIMA .
"Leading on the Legal EHR: New Model Identifies Goals, Behaviors, Activities, and Resources"
Journal of AHIMA