Author: Glondys, Barbara; Kadlec, Lesley

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: May 2016

Editor’s Note: This update supersedes the November 2010 update, EHRs as the Business and Legal Records of Healthcare Organizations that combined information from the October 2004 Practice Brief “The Strategic Importance of Electronic Health Records Management” and the Jun....

Author: Ritter, Jennifer

Source: Journal of AHIMA - website

Publication Date: May 01, 2016

An often discussed theme in the health information management (HIM) profession as well as the 2015 AHIMA Convention is the ability for facilities to grow their own coding professionals. As coding resources continue to be scarce, having an in-house coding training program on any scale is a....

Author: Rose, Angela Dinh

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: April 28, 2016

AHIMA hosted a very engaging Twitter chat on Thursday, April 14, 2016, about the role that privacy and security plays towards launching and implementing successful information governance (IG) programs. To see Tweets from the chat and other information governance (IG) related Tweets, v....

Author: Combs, Tammy

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: April 27, 2016

If a couple were to decide they wanted to build a house, they would need to communicate regularly to complete the home and make sure it fit the needs of both of them. If one of them were to say, “We need three bedrooms,” and the other one instead said, “No, we must have four bedrooms,” the....

Author: Dooling, Julie A

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: April 21, 2016

The cleanliness, integrity, and trustworthiness of our provider data is essential to remember at all times, even as focus shifts toward other important initiatives, such as working toward a better method of matching and identifying our patients.  When it comes to managing and governin....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: April 20, 2016

In last month’s post I raised questions about what might constitute an electronic health record (EHR). Recent action of the Ohio Supreme Court has inspired me to revisit “the EHR”—in the context of what constitutes a “medical record” under Ohio law.


An Ohio statute provides t....

Author: INTERFACEWARE

Source: Journal of AHIMA - website

Publication Date: April 15, 2016

There’s no question that healthcare is in the middle of a data explosion. New sources of information like medical devices, wearables, and mobile apps are being introduced all the time.


While more information can do wonders for clinical decision making and improving operationa....

Author: Washington, Lydia

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: April 14, 2016

In the summer of 2015, AHIMA embarked on an ambitious project to recruit healthcare organizations that were embarking on the information governance (IG) Journey to serve as pilot sites that would provide greater insight into how healthcare IG organizational capabilities develop and to....

Author: Endicott, Melanie

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: April 2016

The definitions and clinical criteria of sepsis and septic shock have been revised, per an article published February 23, 2016 in the Journal of the American Medical Association (JAMA). The recommendations from the 19 physician members of the task force that wrote the new definitions were:....

Author: Saharia, Devendra

Source: Journal of AHIMA

Publication Date: April 2016

Disruptive technology can turn any industry on its head—virtually overnight. Just five years ago, summoning a taxi was an inefficient, time-consuming effort that often involved dialing up a dispatcher, who contacted a driver, who would then make their way to your location, perhaps in an h....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: April 2016

It is a dark and stormy night at a mid-sized regional trauma center when an EMS team brings in a 30-year-old man who is suffering from a prescription narcotics overdose. The patient is conscious but disoriented when he arrives on a gurney. When he wakes up, his loved ones, dutifully at his....

Author: Dill, Mark W; Lucci, Susan; Walsh, Tom

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: April 2016

As protectors of patient health records, health information management (HIM) professionals are developing a keener understanding of the broad topic of cybersecurity and are becoming actively involved in organizational cybersecurity efforts. Information technology (IT) departments typically are....

Author: Linder, Karen M

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

Publication Date: April 2016

Rochester Regional Health is an integrated health services organization serving the people of western New York and the Finger Lakes region. The system provides care from 150 locations, including five hospitals; more than 100 primary and specialty practices, rehabilitation centers, and ambu....

Author: Martin, Melissa

Source: Journal of AHIMA

Publication Date: April 2016

Privacy and security has been one of the most interesting aspects of my job. I often tell folks the role of privacy comes very easily to HIM professionals because we were the “Confidentiality Police” long before the title “Privacy Officer” was widely accepted. Prior to HIPAA, HIM professi....

Author: Lee, Christine

Source: Journal of AHIMA

Publication Date: April 2016

According to the American Medical Association (AMA), physician practices continued a slow but steady transition toward hospital ownership in 2015. In their July 2015 study, the AMA reported a decrease in physician-owned practices alongside a continual increase in physicians working direct....

Author: Fernandes, Lorraine M.; Haendel, Angelika; MacDonald, Marci; Nicholson, Lorraine; Skurka, Margaret A.; Yokobori, Yukiko

Source: Journal of AHIMA

Publication Date: April 2016

The familiar phrase “think globally, act locally” urges people to consider the health of the entire planet and to take action in their own communities and cities. The rapid spread of epidemics such as Avian flu, Ebola, HIV, and the latest threat of Zika to pregnant women and th....

Author: Greene, Adam H

Source: Journal of AHIMA

Publication Date: April 2016

In 2009, CONGRESS passed the Health Information Technology for Economic and Clinical Health (HITECH) Act, which granted individuals a right to have a copy of their records sent to a third party, according to 42 U.S.C. § 17935(e) of the regulation.


Unfortunately, many attorn....

Author: Deming, Sally; Dooling, Julie A; Kadlec, Lesley; Kirby, Annessa; Munns, Megan

Source: Journal of AHIMA

Publication Date: April 2016

The 2015 Supreme Court decision requiring states to license a marriage between two people of the same sex and to recognize same sex marriage across state lines has widespread implications for health records management.1


This article will describe these implications and issu....

Author: Gordon, Lynne Thomas

Source: Journal of AHIMA

Publication Date: April 2016

Recently, the New York Times ran a provocative opinion piece that called for increased use of patient data for research purposes. “When I explain to my own patients what can be done with their medical information for the greater good in research, nobody has ever said to me ‘don....

Author: Reeves, Mary G

Source: Journal of AHIMA

Publication Date: April 2016

Editor’s Note: This article is the second in a series that provides a road map for implementing an information governance (IG) program in any organization. Each month a set of concepts will be discussed that tie to the IG Road Map Infographic developed by AHIMA. Any organization can....

Author: Hundal, Ripandeep K

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

Publication Date: April 2016

Wounds are injuries that break the skin or other body tissues. They include cuts, scrapes, scratches, and punctured skin. Wounds are typically due to accidental injury but may also result from surgery, stitches, or chronic disease processes.1


Wound care involves evaluation,....

Author: Sawatsky, Elaine; Warner, Diana

Source: Journal of AHIMA

Publication Date: April 2016

Interoperability standards and their continuing adoption by e-health programs expand the capacity of information systems to capture, use, and exchange clinical data. For exchange to occur, the majority of data processing decisions need to take place both computationally and automatically.....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: April 01, 2016

As predicted, 2016 is proving to be the year of ransomware, with multiple reported incidents making news as we approach April. As they become startlingly more common, it’s important that HIM professionals be aware of how preventable they are, says Tom Walsh, CISSP, founder and managing partner of tw-Security. Just as with other types of data breaches, ransomware attacks are the result of human intervention—that’s also where they end.

Author: Noreen, Neysa; Lusk, Katherine; Kadlec, Lesley

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: March 2016

Why is patient matching important? Why is information governance (IG) important?


And how are the two linked together?


IG starts at the creation of information and patient matching starts at the time the patient information is being created. Part of resolvin....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: March 24, 2016

The HIM Problem


Nursing staff at NorthShore University Health System were worried about protecting patient privacy when family members called for status updates during surgical procedures and inpatient stays.

The HIM Problem Solver


Terri Bunsen, R....

Author: Combs, Tammy

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: March 23, 2016

When calculating the productivity guidelines for a clinical documentation improvement (CDI) program it is important to remember both quantitative and qualitative perspectives. Sometimes it is very easy to focus solely on the quantity of reviews that are performed. If the quality of those r....

Author: Fernandes, Lorraine M.; O'Connor, Michele

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: March 18, 2016

Healthcare is transforming at a rate not previously seen. Many different levers are at work in this transformation, applied either in parallel or jointly. This transformation is occurring with the goal of advancing the IHI Triple Aim—improve care and outcomes, reduce costs, improve health.....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: March 15, 2016

My blog posts have, for the most part, focused on electronically stored information (ESI) in the context of civil litigation. In this blog I want to shift my focus slightly to raise some questions about the electronic health record and what must be produced in response to a....

Author: Berkeley Research Group

Source: Journal of AHIMA - website

Publication Date: March 2016

This article is published in sponsorship with Berkeley Research Group (BRG).


As a recent initiative, a growing number of healthcare organizations are turning to OpenNotes as a strategy for addressing patient engagement shortcomings in the US healthcare system. Originally pion....

Author: Rockendorf, Betty

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: March 10, 2016

Ministry Door County Medical Center (MDCMC) is a 25-bed critical access hospital in Sturgeon Bay, WI that offers many services, from inpatient and outpatient care to rehabilitation services, emergency department and urgent care, six clinics, and a skilled nursing facility. So, how doe....

Author: Endicott, Melanie

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: March 10, 2016

In the years leading up to ICD-10-CM/PCS implementation, doomsdayers chanted horror stories of expected productivity losses of up to 50 percent. Now that we are nearly six months post-implementation, I’ve yet to hear about an instance where such a prediction came true.....

Author: Neville, Deborah

Source: Journal of AHIMA - website

Publication Date: March 2016

This article is published in sponsorship with Elsevier.



While the ICD-10-CM/PCS implementation date is now behind us, the ICD-10 change management journey is far from over. Clinicians, executives, and managers must continue to support cultural alignment, collaborative co....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: March 2016

Over the past several years it’s been hard to avoid public conversations about the “childhood obesity epidemic.” One of the biggest targets for regulators like the USDA and for politicians such as former New York City Mayor Michael Bloomberg has been Americans’ addi....

Author: Haugen, Mary Beth; Richardson, Amy

Source: Journal of AHIMA

Publication Date: March 2016

Consider the following fictional, and perhaps all-too-familiar, conversation between health information management (HIM) department staff and health information technology (IT) staff:


Chief Information Officer (CIO) to HIM Director: “Were you aware that last month we implem....

Author: Meehan, Ann M.

Source: Journal of AHIMA

Publication Date: March 2016

Editor’s Note: This article is the first in a series that provides a road map for implementing an information governance (IG) program in any organization. Each month a set of concepts will be discussed that tie to the IG Road Map Infographic developed by AHIMA. Any organization can t....

Author: Dover, Kayce

Source: Journal of AHIMA

Publication Date: March 2016

Self-pay accounts receivables are on the rise. While the volumes of traditional self-pay and indigent care cases are down, the number of patients with high deductible health plans (HDHPs) and swelling patient portions are up. Self-pay used to be a segment of a provider’s population; now i....

Author: Clack, Crystal

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

Publication Date: March 2016

On October 30, 2015, the Centers for Medicare and Medicaid Services (CMS) finalized changes to the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center (ASC) payment system for calendar year (CY) 2016. The OPPS payment rates and policies impact approximately 4,000....

Author: Glondys, Barbara

Source: Journal of AHIMA

Publication Date: March 2016

AHIMA has continually recognized the importance of consumer engagement in healthcare through education and advocacy. Through its partnership with other patient advocacy organizations and investments in its own consumer-focused initiatives, AHIMA has demonstrated its commitment to helping c....

Author: Belanger, Mark

Source: Journal of AHIMA

Publication Date: March 2016

The world of health information exchange remains busy in Massachusetts as the Mass HIway, the statewide health information exchange (HIE), enters its fourth year of rolling out Direct messaging statewide. Overall, Mass HIway officials feel things are going very well, with more than 580 or....

Author: Diop, Karen

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

Publication Date: March 2016

We studied. We practiced. We prepared. We had extensions—first a year, then two. More time to practice. Then, at long last, October 1, 2015 arrived, bringing with it the much-anticipated new code sets ICD-10-CM and ICD-10-PCS. Despite much hand wringing and nay saying, the implementation....

Author: Selsky, Darren

Source: Journal of AHIMA

Publication Date: March 2016

Data integration is a costly activity, but one that is used by healthcare organizations on a daily basis to unite information from diverse sources, such as lab, pharmacy, and radiology. This data is typically centralized in electronic health records (EHRs) or other niche systems for clini....

Author: Wendicke, Annemarie

Source: Journal of AHIMA

Publication Date: March 2016

Healthcare is striving for meaningful health data—something well noted in many recent industry articles and presentations. But how will the cultivation of meaningful data be accomplished in the healthcare industry’s complex environment?


Healthcare data comes from....

Author: Journal of AHIMA Staff

Source: Journal of AHIMA

Publication Date: March 2016

The College of Healthcare Information Management Executives (CHIME) has a proposition. Come up with a solution to the following scenario, become a millionaire:


“Consider the number of John Smiths living in the same town, sometimes even under the same roof. Now think about th....

Author: Martin, Melissa

Source: Journal of AHIMA

Publication Date: March 2016

MARCH IS A very busy month for AHIMA. We are kicking off our voluntary patient safety identifier campaign and preparing to showcase it at our Advocacy Symposium. Also, we will present the campaign to our legislators during Hill Day in early April.


This is the perfect time....

Author: AHIMA Work Group

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: March 2016

There is a significant amount of evidence that points to the existence of serious quality concerns for patients undergoing care transitions across multiple care settings. The 2001 Institute of Medicine (IOM) report “Crossing the Quality Chasm” famously described the US system as dec....

Author: Gordon, Lynne Thomas

Source: Journal of AHIMA

Publication Date: March 2016

Late last year, National Coordinator for Health Information Technology Karen DeSalvo challenged an audience at the Bipartisan Policy Center to commit to a future where consumers can easily and securely access their health information; where providers share health information for care with....

Author: Tremlett, Janie

Source: Journal of AHIMA - website

Publication Date: March 2016

Payment models in healthcare are transforming—which should be no surprise to health information management (HIM) professionals. What may come as a surprise though is how quickly these models are transforming.


Healthcare is rapidly moving to incorporate measures of value....

Author: Kadlec, Lesley

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: February 25, 2016

We hear a lot of conversations about information governance (IG) in healthcare, and our importance in leading these initiatives. But oftentimes the IG discussion centers on the work to be done within the four walls of the institution, and does not look at the need to engage healthcare cons....

Author: Combs, Tammy

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: February 24, 2016

Understanding clinical documentation improvement (CDI) metrics can be confusing, especially when you first start reviewing them.


Let’s dive a little deeper into the topic and take a closer look at some frequently reported CDI metrics and evaluate how these measures can reflect the....

Author: Glondys, Barbara

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: February 18, 2016

Although health information management professionals are still wrapping their heads around IG, it is critical to begin involving and training your organization’s workforce community in the principles and practices of IG sooner rather than later. The Pocket Glossary of Health Informat....

Author: Wall, Kathleen E.

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: February 17, 2016

The implementation of the ICD-10 classification system has provided an opportunity to capture data that has not been previously captured. The classification of “underdosing of drugs” can provide valuable information regarding not only the fact that a drug was underdosed, but also why. Thin....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: February 16, 2016

My prior posts have looked at AHIMA’s Information Governance Principles for HealthcareTM (IGPHC) in the litigation context. In this post I want to focus on one facet of litigation, something every healthcare provider (and every other party) wants to avoid: sanctions. Specifically, th....

Author: Goodell, Suzanne

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: February 11, 2016

I am the director of meaningful use for a health system with 6 hospitals, 400-plus employed physicians, and a regional presence in my state. I suspect my healthcare system isn’t the only one using patient registration practices better suited to a bygone era. Recently I stumbled across one....

Author: Endicott, Melanie

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: February 10, 2016

Zika virus is a mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys. There has recently been a rise in incidences of the Zika virus in Brazil. More than 13 countries in the Americas have reported sporadic Zika virus infections, indicating....

Author: Downing, Kathy

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: February 04, 2016

Every health information management (HIM) leader has their hands full these days. All of us are working hard just to keep up. Despite the ever increasing pace at which the healthcare industry—and HIM—is moving forward, through AHIMA’s information governance (IG) pilot program, we also see....

Author: Glondys, Barbara

Source: Journal of AHIMA

Publication Date: February 2016

A communication technique developed by the United States Navy and used with nuclear submarines has been endorsed by multiple healthcare organizations. That technique, known as “SBAR,” is an acronym for “Situation, Background, Assessment, Recommendation,” a technique....

Author: DeMasters, Dana; Deanna, Peterson

Source: Journal of AHIMA

Publication Date: February 2016

A police officer with a body-worn camera records video of an altercation in an emergency department involving a patient who has become violent. During the recording another patient not involved in the altercation has their image captured. The officer leaves the facility wit....

Author: Blair, Barclay T; Snyder, Ann

Source: Journal of AHIMA

Publication Date: February 2016

Though the discipline of information governance (IG) is relatively young, research from the Information Governance Initiative (IGI) shows that organizations today are spending real money on IG and taking on a variety of IG projects. Simply put, IG work is getting done.


But ho....

Author: Valyi, Catherine; Gann, Robin; Liquori, Carol; Marshall, Pamella

Source: Journal of AHIMA

Publication Date: February 2016

Today’s healthcare systems have become a hotbed of activity ripe with new trends, opportunities, and roles for HIM professionals. Centralization of HIM services is one of these megatrends that places the profession at the heart of unparalleled change. Driven by value-based payment mo....

Author: Delahoussaye, Elizabeth A

Source: Journal of AHIMA

Publication Date: February 2016

The primary objective of the House of Delegates (House), made up of delegates from AHIMA’s Component State Associations, is to look at professional issues affecting the health information management (HIM) profession both today and in the future. Essentially, this is a venue in which AHIMA....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: February 2016

Buying tomatoes at the grocery store or farmer’s market will suffice for most cooks. For others, particularly those with a green thumb, growing their own is the only way to fulfill all their salsa and marinara sauce fantasies.


These devotees understand that a garden ca....

Author: Thierry Sheridan, Patty; Watzlaf, Valerie J.M.

Source: Journal of AHIMA

Publication Date: February 2016

Information governance (IG) captures the soul of health information management (HIM), yet many HIM professionals may not engage in IG due to a lack of knowledge, inexperience, or a misunderstanding of all that IG entails. Because of this, experts in IG leadership took part in a focus group....

Author: Martin, Melissa

Source: Journal of AHIMA

Publication Date: February 2016

Have you ever taken on a special project outside of your comfort zone? My special project this year has been building an outpatient surgery center (OSC) from the ground up. Leadership, Strategic/Organizational Management, Change Management, and Project Management are all curriculum domain....

Author: Land, Daniel

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

Publication Date: February 2016

On October 1, 2015 the updates to the ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting went into effect. There were no changes to the ICD-10-CM Guidelines at that time. Fifty new ICD-10-PCS codes were added, which brings the total to 71,974 PCS codes for FY 2016. Thir....

Author: Orlova, Anna; Rhodes, Harry B.; Warner, Diana

Source: Journal of AHIMA

Publication Date: February 2016

At the 2015 AHIMA Convention and Exhibit, members of AHIMA’s Standards Task Force reported on a ground-breaking white paper they developed called “Health IT Standards for Health Information Management Practices,” a first-of-its-kind white paper that serves as a guide for....

Author: Gordon, Lynne Thomas

Source: Journal of AHIMA

Publication Date: February 2016

This month, AHIMA celebrates our fourth annual Information Governance (IG) Month. AHIMA created this event to increase awareness and understanding of IG and to help members understand IG’s importance to HIM practice. You’ll be seeing more details about IG Month in our publicati....

Author: Clack, Crystal

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

Publication Date: February 2016

When the first edition of the Current Procedural Terminology (CPT) was released in 1966, there were only 3,554 codes. In 2016, CPT, published by the American Medical Association (AMA), is celebrating its 50th birthday with 10,000 CPT codes. This year’s CPT updates include 140 codes added,....

Author: Comfort, Angie; Maimone, Carol; Rugg, Donna

Source: Journal of AHIMA

Publication Date: February 2016

Starting with services provided on or after October 1, 2015, health systems across the country transitioned to coding with the International Classification of Diseases, 10th Revision (ICD-10). Implementation of ICD-10 is intended to deliver both immediate and long-term benefits including....

Author: Combs, Tammy

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: January 27, 2016

When an architect draws up plans for a building, they pay close attention to the details of the foundation. This provides the support to the building and prevents it from crashing down at any moment. If the building later has structural damage it is easy to fix when the foundation is not i....

Author: Taylor, Nathan Patrick

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: January 25, 2016

If you are new to healthcare analytics, it can be quite expensive to get up and running with a statistical application. Between the cost of the software itself and the instructional courses—not to mention your investment of time—just getting started could run several thousand dollars. Than....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: January 2016

The HIM Problem


As providers and business associates bring themselves into compliance with the HITECH-HIPAA Final Rule, encrypting data in transmission and at rest can pose a challenge. Two ROI experts discuss encryption and the use of standards in privacy and security.....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: January 20, 2016

Telemedicine is, to say the least, “exploding”—both as a source of electronic health information and a business model. As of December 2015, “29 states and Washington D.C. have enacted legislation ensuring that private insurers offer reimbursement for telemedicine at equival....

Author: Godbey-Miller, Barbara

Source: Journal of AHIMA - website

Publication Date: January 2016

This article is published in sponsorship with Berkeley Research Group (BRG).


The year preceding the ICD-10 compliance date was filled with a myriad of challenges for health information management professionals, from department heads to coders, regarding ICD-10 implementation.....

Author: Crabb, Stephanie

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: January 14, 2016

How are football and IG related? Anyone who knows me knows that I am a sports fanatic and football is my favorite professional team sport. So, as we stand on the precipice of the playoff season, I have football on my mind. With IG ALWAYS on my mind, I found myself thinking about how to ans....

Author: Endicott, Melanie

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: January 13, 2016

I am so excited that ICD-10 is finally here—now we can stop wondering when it’s actually going to be implemented and roll up our sleeves to get to work! Now that it’s officially here and everyone is using it, we can really start to dig into the details and take advantage....

Author: Dooling, Julie A; Fernandes, Lorraine M.; Kirby, Annessa; Landsbach, Grant; Lusk, Katherine; Munns, Megan; Noreen, Neysa; O'Connor, Michele; Patten, Melinda

Source: Journal of AHIMA - website

Publication Date: January 06, 2016

A recent survey with AHIMA members revealed that over half of HIM professionals routinely work on mitigating possible patient record duplicates at their facility, and of those 72 percent work on mitigating duplicate records weekly. Contributing to the issue, less than half (47 percent) of....

Author: Hefti, Erik ; Blanco, Javier G

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

Publication Date: January 2016

The “personalized medicine” paradigm is at the forefront of discussions about the future of healthcare, and a wealth of new data concerning how human genetic variation contributes to drug response has the potential to change the practice of medicine. The promise of treating pat....

Author: Saponaro, Charlie

Source: Journal of AHIMA

Publication Date: January 2016

Often viewed as the backbone of a facility’s revenue cycle, health information management (HIM) outsource vendors have seen an explosion in demand as the healthcare industry has transitioned to ICD-10-CM/PCS. Many HIM service companies have seen an increase in volume and client reque....

Author: Rhodes, Harry B.

Source: Journal of AHIMA

Publication Date: January 2016

All of the current excitement about the potential of mobile technologies and patient engagement opportunities comes at a time when many providers are frustrated about their electronic health record (EHR) systems. Struggling against poor EHR system usability, a lack of interoperability, and....

Author: Gordon, Lynne Thomas

Source: Journal of AHIMA

Publication Date: January 2016

As I write this, the industry is finally beginning to shift its gaze from the first few weeks of the brave new world of ICD-10-CM/PCS. In October, with each passing day, we breathed a collective sigh of relief as implementation went smoothly. At the end the month, the Centers for Medicare....

Author: Eramo, Lisa A

Source: Journal of AHIMA

Publication Date: January 2016

John Quincy Adams once said, “If your actions inspire others to dream more, learn more, do more, and become more, you are a leader.”


Had HIM been as important in Adams’ time as it is today, the former president would have surely included HIM professionals in the category o....

Author: Sims, Kimberly F

Source: Journal of AHIMA

Publication Date: January 2016

More than 60 million American adults experience heartburn at least once a month, and more than 15 million adults suffer daily from heartburn.1 Gastroesophageal reflux disease (GERD) occurs when the lower esophageal sphincter (LES) is weak or relaxes inappropriately, allowing the stomach’s....

Author: Journal of AHIMA Staff

Source: Journal of AHIMA

Publication Date: January 2016

The best part about a professional new year’s resolution is that it can be much easier to stick to than a personal resolution—there is more motivation (i.e., your boss, personal ambition) and less temptation to slack (i.e., co-worker accountability).


To get a sense of what 2016....

Author: Martin, Melissa

Source: Journal of AHIMA

Publication Date: January 2016

In Back to the Future Part II, Marty McFly traveled from 1985 to 2015, and while there he used videoconferencing to communicate with his coworker Needles. Although the real 2015 might not be exactly the world that Marty McFly found in the movie, teleconferencing with a doctor and other te....

Author: Brinda, Danika

Source: Journal of AHIMA

Publication Date: January 2016

Stories about workforce members inappropriately accessing health information continue to plague the Department of Health and Human Services’ Data Breach Portal—which lists US provider data breaches that affect more than 500 individuals. Recently two data breaches reported on th....

Author: Campbell, Susan E

Source: Journal of AHIMA

Publication Date: January 2016

Information for general health information managers about the standards development framework and process—with a focus on mobile health For Patient and Self Care

Author: Cange, John R

Source: Journal of AHIMA

Publication Date: January 2016

To prevent a problem, however, requires that you understand the potential causes of the problem—and this understanding requires data. A complete understanding requires a complete dataset. In the case of HAIs, the ideal dataset would contain data concerning every type of HAI from ever....

Author: Stearns, Michael

Source: Journal of AHIMA

Publication Date: January 2016

President Obama signed into law the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 on April 16, 2015. This legislation repealed the sustainable growth rate (SGR) but also introduced a number of provisions designed to compensate physicians and other healthcare professionals ba....

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: January 2016

By Mary Butler


As the old canard goes, "if all you have is a hammer then everything looks like a nail." Which is to say that specialists in a given area tend to only consider their specialty and miss the big picture. To personally disprove the idiom, one ideally has multiple too....

Author: Archer, Anita; Campbell, Angela; D'Amato, Cheryl; McLeod, Melissa; Rugg, Donna

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2016

Editor's Note: This Practice Brief supersedes the May 2013 and March 2010 Practice Briefs titled "Putting the ICD-10-CM/PCS GEMs into Practice."


Mappings between ICD-9-CM and ICD-10-CM/PCS will play a critical role in the successful utilization of ICD-10-CM/PCS. The Centers for Me....

Author: Hebert, Laurie

Source: Journal of AHIMA - website

Publication Date: January 2016

Patient-centered care has emerged as an imperative for the healthcare industry. It drives patient satisfaction, quality of care, patient safety, better outcomes, and reduced costs. With these goals in mind, the Commission on Cancer’s (CoC) Cancer Program Standards: Ensuring Patient-Ce....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: December 2015

Obtaining access to one’s written or electronic medical records in a timely manner is one of the guarantees listed in AHIMA’s “Consumer Health Information Bill of Rights.” Yet, for one consumer, Amanda Michelle Jones, MS, AM, being on a first-name basis with medical records depa....

Author: Washington, Lydia

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: December 28, 2015

I hear this question all the time from new as well as veteran HIM professionals. Especially now that the implementation of ICD-10-CM has come and gone (mostly with nothing more than a whimper, I might add, largely due to the exceptional planning and organization skills of great HIM profess....

Author:

Source: Journal of AHIMA - website

Publication Date: December 2015

In order for health information management (HIM) professionals to be successful in their organizations—from starting an information governance program to getting ICD-10-CM/PCS implemented on time—support from the C-suite is crucial. As HIM departments undertake increasingly expa....

Author: Fee, James P

Source: Journal of AHIMA - website

Publication Date: December 2015

Editor’s Note: Read this article’s companion piece “Fighting CDI Fires in ICD-10: Three Burning Questions Every Organization Must Answer” in the December 2015 edition of ICD-TEN, available here.



For most clinical documentation improvement (CDI) sp....

Author: Kadlec, Lesley

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: December 18, 2015

If you are reading this blog post, you have probably already figured out that data analytics is complex. Understanding data analytics is like the proverbial peeling back of the onion skin, the more layers you take off, the more layers you find underneath.


In today’s healthcar....

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: December 18, 2015

This is the last Legal e-Speaking post of 2015. I thought I would use it to predict what 2016 might bring in litigation and beyond. When looking ahead to the next year, there are many possible things that HIM professionals should keep an eye out for, but five stand out to m....

Author: Washington, Lydia

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: December 10, 2015

If there was one central theme that ran through AHIMA’s 2015 IG Summit, it was “just get started.” With the disruptive changes currently emerging in healthcare, there is no time to waste. We can no longer tolerate the “one-off’s” and silos that engulf the creation of our information and it....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: December 09, 2015

For two AHIMA credential holders—one with a registered health information administrator (RHIA) and one with a registered health information technician (RHIT) credential—the extra work required to earn them have paid dividends. Both Karen Linder, BS, RHIT, CCS, CCS-P, and....

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: November 2015

The HIM Problem


Completing regular privacy risk assessments is one of the most proactive ways of preventing healthcare privacy breaches. However, finding helpful tools for these assessments is hard to come by.


The HIM Problem Solver: Sharon Lewis, MBA, RHIA, CHPS, CP....