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Metamorphosis in the HIM Department


By Bill Briggs, Senior Editor October 2006
Information technology is morphing medical records departments into new shapes and sizes as it becomes an agent of change across health care organizations.

Some might view the multi-dimensional changes as unsettling, with health information management departments adrift in the ether of rapid information technology advances. But in the eyes of many, the steady march of I.T. progress means that health information management professionals have greater opportunities to improve health care. It can lead to career growth as well.

Many new and improved technologies affect the HIM department. But the advent of electronic medical records is largely behind increasing collaboration between health information management and I.T. departments, observers say. Top executives at provider organizations are taking note of that success, and the HIM director is becoming part of the inner circle.

"In the last 10 years, as more information technology was introduced into patient care, health information management has made a transition from the basement to the boardroom," says Belinda Wiegand, senior director of EMR services at PHNS, a Dallas-based I.T. services and consulting firm.

"It has a lot to do with electronic medical records and other changes in technology. The foundation of patient care has always been there, but to automate information and make it readily available in patient care makes health information management a much more critical process."

EMR systems in particular are shaping the new medical records department into what could become a completely new function, observers say.

Many HIM directors and their staff live in a hybrid environment these days, with one foot in the paper record world and one in the electronic. Their goal is to virtually eliminate paper, though many acknowledge they are unlikely ever to reach that point.

But that goal becomes more attainable as electronic medical records systems become the conduit for all patient data, be it financial, administrative or clinical. As a result, HIM increasingly is viewed as the logical overseer of data that flows into and out of the EMR.

Such conditions have helped HIM directors see what they do in a different light. Following are a few examples.

"Information technology changes it all," says Rita K. Bowen, privacy officer and HIM director at Erlanger Health System, a Chattanooga, Tenn.-based delivery system with an 800-bed hospital at its core. "It has required rethinking and retooling our health information management department. And myself."

To that end, Erlanger executives agreed to fund onsite education through a two-year registered health information technician program administered by Chattanooga State Technical Community College.

Bowen envisions a time when health information management is part of a provider organization's lifeblood. "I see information management positioned at the enterprise level, not so much as a department itself. Our people would be embedded in the patient care process, and health information management would be involved with the whole patient flow."

Karen Proffitt, health information management director at The Children's Hospital in Denver, believes the HIM department's role is changing from "surveillance to more proactively engineering workflows and finding better ways to automate."

Changes underway at the 253-bed hospital can be applied across health care, Proffitt believes, as HIM directors take on new responsibility. "We can help serve as liaisons between clinical and technology functions. We can bridge the gaps because we understand a lot of areas, such as legal requirements, and can bring different departments together."

While many HIM directors and CIOs talk about the need for health information management and I.T. departments to work hand-in-hand, Denver Health has gone a step further, says Mary Beth Haugen, director of health information management and information services. About a year ago, Denver Health merged its medical records and I.T. departments.

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