Understanding the HIE Landscape. Appendix C: Talking Points for HIM Professionals

HIM professionals are uniquely qualified to participate in HIE development and operations. However, those involved with developing and running many HIEs often times do not realize the value that HIM professionals bring to the table.

If HIM professionals are not involved in your local HIE, reach out to the HIE and ask for the opportunity to meet with them. When meeting with HIE staff, convey who AHIMA is, the HIM professional knowledge and skill set, and how HIM professionals can assist in developing and implementing information management practices. Relate how each of these values allows HIM professionals to contribute to the structure, governance, and operations models of the HIE. The following talking points may assist CSA leadership and HIM professionals in discussing information exchange and management.

AHIMA Facts: AHIMA is the premier association of HIM professionals. AHIMA's more than 59,000 members are dedicated to the effective management of personal health information required to deliver quality healthcare to the public. Founded in 1928 to improve the quality of medical records, AHIMA is committed to advancing the HIM profession in an increasingly electronic and global environment through leadership in advocacy, education, certification, and lifelong learning.

Quality Healthcare through Quality Information: Quality information is essential to all aspects of today's healthcare system. HIM is the body of knowledge and practice that ensures the availability of health information to facilitate real-time healthcare delivery and critical health-related decision making for multiple purposes across diverse organizations, settings, and disciplines.

Leader in the Management of Health Information: Founded in 1928 to improve health record quality, AHIMA has played a leadership role in the effective management of health data and medical records needed to deliver quality to the public. Historically, medical records have been a paper-based business. However, with the advent of e-HIM practices, HIM professionals are working to advance the implementation of electronic health records by participating and leading industry initiatives such as HIPAA privacy and security rule implementation efforts, e-MPI management, and developing the future workforce. HIM skills and knowledge are transferrable from paper to electronic practices.

Partner in the Delivery of Quality Healthcare: HIM professionals work in 40 different settings under 125 different job titles. They often serve in bridge roles, connecting clinical, operational, and administrative functions. In short, they affect the quality of patient information and patient care at every touchpoint in the healthcare delivery cycle. Having skilled HIM professionals on staff ensures an organization, or HIE, has the right information when and where it is needed while maintaining the highest standards of data integrity, confidentiality, and security.

Advocate for Healthcare Policy: With national focus on health information, EHRs, ARRA, HITECH, and information exchange across the country, AHIMA is qualified to shape the national agenda. Change is happening on four fronts:

• Privacy and security
• Standards for data interchange and system interoperability
• The EHR
• The overall national health information infrastructure

With HIM's overriding goal in mind-ensuring the availability of health information to facilitate real-time healthcare delivery-AHIMA is involved in initiatives advancing the role of HIM in informing clinical practice, developing standards to improve data quality and facilitate information exchange, and helping healthcare organizations migrate to the EHR.

Valuable Professional Resources: AHIMA keeps HIM professionals posted on the healthcare industry through multiple resources. The award-winning Journal of AHIMA delivers news and expert guidance. AHIMA textbooks are recognized for their excellence and authority. Members can also receive electronic newsletters that deliver up-to-the-minute industry updates and advice.

Questions to Ask:

1. What vendor has the HIE chosen? If no vendor has been chosen, provide a copy of AHIMA's RFP practice brief "The RFP Process for EHR Systems."
2. Will state Medicaid (or other federal payers such as prisoners, workers' compensation, Indian Health Services, or veterans) recipients be automatically enrolled in the HIE?
3. Will the HIE sign a business associate agreement (BAA) with each covered entity? Does the BAA address how breaches will be handled? Is the BAA compliant with state-specific notification requirements? Provide the HIE with copies of AHIMA's HITECH- revised BAA.
4. How will the HIE address patient identity management? Provide the HIE with a copy of AHIMA's practice brief "Reconciling and Managing EMPIs."
5. How will the HIE address release of information functions? Provide the HIE with a copy of AHIMA's practice brief "Management Practices for the Release of Information."
6. Will the HIE have a structured HIM department?
7. What types of tools and resources will the HIE provide to patients to assist in managing the bidirectional exchange of information?
8. What is the governance structure of the HIE? Is the HIE opt in/opt out?
9. Does the HIE have an HIM professional representative either on the board, subcommittee, or workgroup?
10. Who will have access to the data and under what conditions (e.g., law enforcement, attorneys)?
11. What specific data elements will be shared by each participant?
12. Does the HIE have specific standards or formatting requirements for the data or other technical requirements (e.g., HL7 sending and receiving formats)?
13. Will participants have the option to audit the HIE for privacy and security reasons?
14. How will the HIE address requests for restrictions, accounting of disclosures, and other privacy issues?
15. What is the process for a participant who withdraws or terminates data sharing with the HIE? Can a participant be expelled from the HIE?
16. Are there any associated fees required for participation?
17. Who will provide training and support to consumers?
18. Is there a comprehensive list of responsibilities that includes individual responsibilities of the HIE, organization, and provider?
19. How will the HIE address accounting of disclosures and data breaches?

HIM professionals should provide the HIE with the link to AHIMA's HIE Web page and AHIMA's ARRA Web page [web pages no longer available].

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