Resolution on Quality Data and Documentation in the EHR

Submitted by AHIMA's Physician Practice Council

Preamble

Whereas, the healthcare industry is in transition to electronic health records (EHRs) and EHRs need to yield quality documentation and data in order to support patient care, health information exchange, quality management, compliance and other secondary uses of data;

Whereas, EHR systems are an important tool and provide a significant opportunity to improve documentation and patient care when properly designed and used;

Whereas, EHR systems may contain design features and functions that can potentially contribute to suboptimal quality of healthcare data and documentation;

Therefore, be it

Resolved, That AHIMA advocates that organizations developing or implementing EHR systems take steps to ensure that the functionality of their EHR system supports quality care, valid documentation, and data integrity;

Resolved, That AHIMA advocates that HIM professionals, particularly those with expertise in data capture methods, compliance, and data quality management, actively participate in EHR system selection, design and development, implementation, and maintenance;

Resolved, That AHIMA advocates that organizations implementing EHR systems ensure that process analysis and improvement is performed in order to enhance documentation and avoid inaccurate, incomplete, inappropriate, or non-compliant documentation;

Resolved, That AHIMA advocates that HIM professionals collaborate with clinician users of the EHR, including training, to ensure that the best quality of data and documentation is maintained for patient care, quality management, compliance, health information exchange; and secondary use purposes; and

Resolved, That HIM professionals actively participate and contribute to organizations that develop standards for the EHR to ensure that data and documentation in the EHR meets the needs of healthcare organizations.

Approved by the 2007-08 House of Delegates, October 7, 2007, Philadelphia, Pennsylvania