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Guiding the Development of Health Information Technology Standards for HIM Practices

Author: Bailey-Woods, Linda; Munns, Megan; Orlova, Anna; Rhodes, Harry B.; Warner, Diana

Source: Journal of AHIMA

Publication Date: August 2015



Interoperability of health information systems will enable clinicians to communicate with their patients and each other using information and communication technology to enable safer, effective, and efficient care, and improve population health. Health information technology (HIT) standard....

Time to Get on Board with IG

Author: Birnbaum, Cassi L

Source: Journal of AHIMA

Publication Date: August 2015



Not a day goes by for HIM and healthcare industry leaders without challenges that result from a lack of trust in the data and information we encounter in our work—or in caring for our loved ones. Years ago, when I was working as the director of quality and resource management at a well kn....

Keys to Help Solve Patient Data Matching

Author: Nelson, Michael L

Source: Journal of AHIMA

Publication Date: August 2015



Accurate patient data matching is a critical patient safety issue. Overlays that comingle the medical information of two or more people may lead to disastrous adverse medical events and duplicate medical records, which may be fragmented and incomplete and can limit the effectiveness of tr....

Owning the EHR and Information Governance at Your Facility

Author: Head, Erin

Source: Journal of AHIMA

Publication Date: August 2015



For many decades, health information management (HIM) departments have been the hub for information collected within healthcare organizations. HIM has frequently been referred to as the “medical records department” due to the perceived idea that the department’s main tasks are receiving a....

Visualizing Information Governance

Author: Journal of AHIMA Staff

Source: Journal of AHIMA

Publication Date: August 2015


Information governance (IG)—like so many concepts in health IT and health information management—can be hard to understand, visualize, and articulate. Fortunately, AHIMA has developed an infographic that helps with all three. From defining IG to demonstrating how and why it works, t....

Getting Started with Information Governance. What Are You Waiting For: Taking a Simplified Approach to Information Governance

Author: Goodell, Suzanne; Kadlec, Lesley; Lawler, Karen; Prater, Valerie S

Source: Journal of AHIMA

Publication Date: August 2015



Are you drowning in data and information? Do you feel as though your organization has lost its logical approach to the management of health information? As we continue to embrace the transformation that healthcare is undergoing, we recognize that electronic health records (EHRs) and other....

Policy and Procedure Considerations for Health Information Exchange Organizations

Author: Bowen, Rita K.; Chestler, Alisa; Coomes, Donna; Dooling, Julie A; Fuller, Brenda; Grijalva, Christine; Kirby, Annessa; Kuehnast, Tanya; Stewart, Elizabeth

Source: Journal of AHIMA

Publication Date: August 2015


Policies and procedures govern the operations of health information exchange (HIE), and many factors must be taken into consideration during their development or revision. They set expectations for the workforce, delineate staff training and accountability, and must be part of an ongoing educat....

Clinical Definition Standards Case Study

Author: Lusk, Katherine

Source: Journal of AHIMA

Publication Date: July 2015



With the October 1, 2014 date for prospective payment for inpatient pediatric Medicaid discharges looming, Children’s Health System of Texas identified an organizational need to reboot and formalize its clinical documentation improvement (CDI) program. The journey began with three co....

Survey Predicts Future HIM Workforce Shifts: HIM Industry Estimates the Job Roles, Skills Needed in the Near Future

Author: Sandefer, Ryan; Marc, David; Mancilla, Desla; Hamada, Debra

Source: Journal of AHIMA

Publication Date: July 2015



The American Health Information Management Association (AHIMA) conducted a study to assess the future needs of the health information workforce. The study was intended to define the current reality of HIM within the healthcare industry, how the market is shifting to meet future needs, and....

New CDI Challenge: Adjusting to Quality, Not Quantity

Author: Murphy, Brian

Source: Journal of AHIMA

Publication Date: July 2015



It’s no secret that healthcare is undergoing a profound transformation. While fee-for-service delivery remains the current model for acute care hospital payment, the transition to paying for quality over quantity is happening before our eyes.


In January, the Centers for Me....

ONC Targets Information Blocking

Author: Downing, Kathy; Mason, Jessica

Source: Journal of AHIMA

Publication Date: July 2015



A NEW REPORT to Congress from the Office of the National Coordinator for Health IT (ONC), released in April, has put information blocking in the spotlight.1 The ONC report comes out on the heels of a recent article written by five US senators titled, “Where Is HITECH’s $35 Billion Dollar....

Closing the Loop on Quality and CDI: Refocusing Programs to Ensure an Accurate Picture of Clinical Care

Author: Gurrieri, Joseph J; Milligan, Cassie; Strafer, Paul

Source: Journal of AHIMA

Publication Date: July 2015



The ultimate goal of most CDI programs is to improve the quality of patient care through more accurate and complete clinical documentation. A potential increase in revenue is, of course, a positive byproduct of doing so—which makes sense. If organizations can demonstrate severity of illne....

Reinvigorating Your CDI Program

Author: Geissler, Kristen; Dion, Joni

Source: Journal of AHIMA

Publication Date: July 2015



Long gone are the days of “grab and go” coding, finding the CC/MCC to push reimbursement to the next level and then moving on to the next record. Today, in addition to reimbursement, clinical data drives quality initiatives, hospital and physician profiles, and medical necessit....

Clinical Documentation Improvement in the Outpatient Setting

Author: Arrowood, Danita; Johnson, Laurie M.; Wieczorek, Michelle M.

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: July 2015



Clinical documentation improvement (CDI) programs have proven their worth with over a decade of success and continued role expansion in the inpatient setting. As the healthcare industry prepares for new initiatives such as value-based purchasing, electronic health records (EHRs), and ICD-1....

Watson vs. Big Data

Author: AHIMA Staff

Source: Journal of AHIMA

Publication Date: July 2015


It is the matchup of the century—the towering hulk of healthcare’s Big Data versus the super computer known as Watson. Will Watson be able to take on this lumbering, untamed mass of information and whip it into submission?


One year ago, the Journal of AHIMA reported on the IBM su....

ESI Meets Court Order

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: June 11, 2015



I’ve written for AHIMA on various subjects, including preservation and spoliation of electronically stored information (ESI). This month, I want to ask you to think about both.


To start, consider this premise: The parties to a civil action agreed to an order “on D....

Injection and Infusion Coding Offers High Stakes: Outpatient Coders Must Play Their Cards Right

Author: Flewelling, Charles

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: June 2015



With the consistently rising value of highly skilled outpatient coders, numerous HIM departments are moving to a staffing model that employs coding professionals who are well versed in coding both inpatient and outpatient encounters. Coders in the profession today should possess a mastery....

Voices from the ICD-10 Zeitgeist

Author: Journal of AHIMA Staff

Source: Journal of AHIMA

Publication Date: June 2015


As it starts to appear likely that ICD-10-CM/PCS will finally be implemented this year, prominent advocates for the transition are striking a more optimistic tune in public statements. Overall, the ICD-10 zeitgeist has steadily swung toward an implementation date of October 1, 2015 after years....

Remediating ICD-10 Knowledge Loss: After Delays Push Back Implementation, How Unprepared Will Your Coders Be to Use the New Code Set?

Author: Black, Michelle A

Source: Journal of AHIMA

Publication Date: June 2015



If you don't use it, you lose it. This is true for much of what we learn in life, and it’s particularly true when it comes to ICD-10-CM/PCS. Although most organizations initiated ICD-10 coder training in 2013, many decided to cease training and dual coding practice after the second ICD-10....

Answering the Tough ICD-10 Questions: Coding Experts Offer Tips on How to Make it to October 1, 2015 and Beyond

Author: Hinkle-Azzara, Barbara; Carr, Kimberly J

Source: Journal of AHIMA

Publication Date: June 2015



At a US House of Representatives subcommittee hearing on February 11, lawmakers and stakeholders agreed that the implementation of the ICD-10-CM/PCS code sets should not be further delayed. Moreover, in March the House passed legislation that provides a permanent replacement to the Sustain....

Evolving Role of the Privacy and Security Officer

Author: Bowen, Rita K.

Source: Journal of AHIMA

Publication Date: June 2015



Fifteen years ago, many individuals accepted the role of the privacy officer with a perception that it would be a role involving the education and training of individuals on HIPAA rules and regulations, developing policy, and responding to reported incidents. The security officer was focu....

Final Push to ICD-10 Implementation

Author: Birnbaum, Cassi L

Source: Journal of AHIMA

Publication Date: June 2015



Chills run up and down my spine as I write this article, knowing how hard we have worked as a profession, association, and industry to get to this red letter date for ICD-10-CM/PCS.


Just before I wrote this column, I was on the edge of my seat along with the rest of indust....

Evaluating the Information Governance Principles for Healthcare: Compliance and Availability

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia; Washington, Lydia

Source: Journal of AHIMA

Publication Date: June 2015



Editor’s Note: This is the third in a series of four articles that discuss the eight Information Governance Principles for Healthcare.


AHIMA’s new Information Governance Principles for Healthcare (IGPHC) provide a framework for healthcare organizations to leverage informati....

Privacy Holes in the 'Hidden Healthcare System': Students' PHI-laden Education Records that are Stored and Shared Electronically Don’t Have the Same Safeguards as most EHRs

Author: DuBravec, Daniel A; Daigle, Matt

Source: Journal of AHIMA

Publication Date: June 2015



With student safety and privacy an increasing parental concern, school administrators nationwide are sitting on a powder keg of potential backlash because of a gray area of student privacy protections that Julia Lear, senior advisor for the Center of Health and Health Care in Schools at G....

Achieving Health Information Systems Interoperability

Author: Orlova, Anna

Source: Journal of AHIMA

Publication Date: June 2015



With the growing adoption of health information technology (HIT), interoperability—or the sharing of data between systems—has become a topic that everybody in healthcare is talking about. Interoperability impacts every stakeholder in healthcare with each individual party involv....

Paving the Final Steps to ICD-10

Author: Gordon, Lynne Thomas

Source: Journal of AHIMA

Publication Date: June 2015



What a difference a year makes.


A year ago, the HIM industry was reeling from an unexpected delay to the implementation of ICD-10. The change was brought on at the last minute, slipped into legislation and passed within a couple of days. The result was a one-year delay of ICD....

Beware the Dark Side of the Web

Author: Journal of AHIMA Staff

Source: Journal of AHIMA

Publication Date: May 2015


Unless they know exactly what to look for, most Internet users wouldn’t know that a “Dark Web” exists or what it is—let alone the potential for harm that can be done with it.


But the dark side of the web is out there, and its proprietors want your medical information.

....

Evolving Practice of Health Informatics

Author: Birnbaum, Cassi L

Source: Journal of AHIMA

Publication Date: May 2015



WHEN I DECIDED to pursue my graduate education in health information management (HIM) and informatics seven years ago, adoption rates for advanced electronic health record (EHR) systems were evolving, data was siloed, and interoperability was far from reality. Organizations were up to the....

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