Word from Washington
cessing. These changes will add new responsibilities for the
HIM department as data using different protocols and languages from disparate sources must be analyzed. Concerns
about data integrity and privacy protections will require HIM
expertise.
Population Health
In addition to changing reimbursement requirements, the
HIM profession is also faced with consumers and an indus-
try that are demanding more oversight and use of data to
improve population health. AHIMA has advocated for years
that administrative and clinical data not be modified to ad-
dress various external and internal data requirements. HIM’s
motto has been “collect once, use many times.”
However, the call to improve population health means that
HIM professionals must be involved in ensuring that data
taken from EHR and administrative systems are accurately
and appropriately reported for secondary data uses.
will decrease HIM staff, in reality the nonclerical aspects of
HIM will continue to grow as the industry takes better care
of its health information and uses it for a variety of functions
that will improve both individual and population health while
cutting healthcare costs.
Privacy and Security
Since HIPAA was implemented, HIM professionals have taken on the role of privacy and security officers, and there are
significant privacy and security challenges ahead related to
HITECH, changing technology, and patient accessibility.
In May the industry received a proposed rule on accounting for disclosures and access. The rule, which would give
patients the right to a report of anyone who accessed select
information in their records, would require covered entities
make changes to their systems at a time when they already
are responding to many other government and industry initiatives. Further changes to the accounting of access portion
of the rule could be coming in future years.
The Office for Civil Rights, author of the disclosure and access rule, also plans to release a significant privacy rule this
fall that will cover most of the other HITECH changes. Some
of the provisions will overlap with other system changes and
patient access issues.
The meaningful use program and HITECH privacy changes
add new requirements related to patient access that HIM
must analyze and implement. Most current EHR systems and
expanded designated records sets or systems cannot report
data in a way that is useful to the patient.
The industry is slowly finalizing various discharge reports
and transmissions that will meet individual needs, but translating clinical data into a meaningful language for the average
patient is a challenge.
The new disclosure and access rule likely will raise considerable anxiety among consumers who for the first time will
see the number of accesses to a record that occur in larger
facilities. Consumers concerned with, or confused by, the reports will require explanation and education.
Increasingly, consumer health literacy will become an HIM
function, as it is usually the HIM department where this information is sought.
All of these changes require the expertise provided by HIM
experience and training. The tasks must be taken on by new
and existing HIM professionals and those educators who are
preparing the workforce.
HIM professionals have always been stewards of health
information. Meeting their obligations to preserve the in-tergrity, privacy, and accessibility of data while adapting
to many new reguations and initiatives is a challenge. But
it is also an opportunity to demonstrate why the profession is so necessary to our healthcare delivery system. ¢
Dan Rode ( dan.rode@ahima.org) is AHIMA’s vice president of policy and
government relations.
