At the American Health Information Management Association's annual conference in Orlando, Fla., in September, there was a lot of talk about meaningful use, ICD-10, data analytics and reporting, and other information technology and process changes that will significantly challenge HIM professionals in coming years.

Ask Kim Bussie, director of revenue cycle health information services at Washington-based Howard University Hospital what is the biggest challenge HIM professionals face and she'll point out the rapid change from information management to informatics. The industry is starting to see more HIM pros going back to school to bone up on informatics, she says. But too many of their peers aren't grasping the formal education that will be required in the near future, she laments.

I fear that AHIMA leadership may not be grasping it either. New CEO Alan Dowling's speech to members was hardly a clarion call to meet the educational needs of members. "HIM is ready, willing and quite capable of doing what's necessary to enhance health information management's place in health care," he told members. But he never mentioned the education gap that many members face in their fast changing profession. Heck, the written copy of the speech didn't include the word "education" at all and "training" was mentioned once in passing.

It was a rah-rah speech that touched only the top layers of the surface on a multitude of issues. There were eight references to the "energy" of the association and its members, seven references to the "momentum" toward change and how evident and encouraging it is, and four references to the "enthusiasm" he has witnessed since taking the helm eight months earlier.

The closest Dowling came to acknowledging a knowledge gap may be growing was this: "As individual professionals, we're ready to accept the self-investment required to advance health information management in ways that allow the profession to keep pace with 21st Century health care and for each of us to progress through the profession."

Translation: You're on your own.

In Bussie's view, the educational gap could prevent HIM from taking the leadership role that many of its members believe they must take as health care moves deeper into use of information technology. "Our competitor is the I.T. department and the CIO could soon be in charge of health information," she warns. "There's a vanishing wall here and an evolution of the combination of the two."

An immediate danger of the vanishing wall between HIM and I.T. could be the CIO leading electronic records implementation and meaningful use compliance efforts without enough understanding of information flow, workflow, patient flow and how data actually is used, Bussie says.

HIM departments must have an influential presence as meaningful use and ICD-10 work is done, she believes. But HIM also has to show other parts of the organization that it can provide new, I.T.-enabled value added services.

For instance, Bussie is looking at ways to make the forms management committee virtual--doing its work via a Web portal. This would enable online forms review and decision-making, replacing a paper- and meeting-based process "and not make people wait a month for review and approval of their forms," she explains. Such Web technology could make many committees in an organization virtual and more responsive, she adds.

Danielle Berthelot, HIM director at Woman's Hospital in Baton Rouge, La., also sees new technologies coming to a department not ready for them. One of the buzzwords at AHIMA was "natural language processing," which among other uses can aid in the extraction of discrete data elements from electronic medical records for research and reporting purposes. NLP also can identify pertinent information in text--all those transcribed and digitized physician notes--and convert it to discrete data.

"HIM professionals have to start learning about natural language processing," Berthelot laments. "Otherwise, you're trusting that the vendor understands and knows what's going on. I need to understand how it works. Is the data getting where it is supposed to be?"

For Lori Jayne, HIM director at Lahey Clinic in Burlington, Mass., understanding the core objectives in meaningful use requirements is a big challenge that she and peers soon need to tackle. "HIM professionals have to have the knowledge and be aggressive in their institutions to ensure the core measures are selected so that there is a process to achieve success," she asserts. "HIM professionals also need to have an understanding of EHR modules in their facilities and to ensure they are a qualified for certification. Most eligible facilities may have a 'best of breed' approach to their EHR based upon specific business requirements. We need to understand whether all applications have to be certified or just the repositories or portals for access."

At the conference, AHIMA leaders proudly--and rightly-- crowed that the association this year passed the 60,000-member mark. But if those members were looking for new programs to help them survive the incredible changing coming now, they got cheerleading platitudes instead.

"There are a lot of different indicators out there that would suggest HIM is not just up to the hard work, but also the smart work involved in winning this evolutionary process," Dowling said in his speech.

And what did he use as an example? "One of those indicators, one that speaks loudly to me, is that a positive energy, a buzz if you will, has been building throughout AHIMA all year."

Rah rah.


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