Transcript Business Associates

By Katherine Downing, MA, RHIA, CHPS, PMP
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2014
2014
Objectives
• What is health information management (HIM)?
• Examine current drivers to change and how HIM is
contributing to the overall healthcare strategy
– Define the driving forces behind changing
healthcare documentation
– Discuss market needs and how they are
guiding change
• HIM—Transforming Healthcare with Information
– Discuss how technology is changing our work
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Topics
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Overview of HIM
ICD-10
Meaningful Use
Health Information Exchanges (HIE)
Accountable Care Organizations (ACO)
Electronic Health Records (EHRs)
Privacy and Security
HIM
An allied health profession that is responsible for
ensuring the availability, accuracy, and protection
of the clinical information needed to provide healthcarerelated decisions
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What Is the Health Record?
• The anchor that guides the continuity of
a consumer’s care.
• Serves as part of the record of business
as defined by a healthcare organization.
• Exists in a paper, hybrid, or electronic
environment.
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Six Functional Areas of HIM
• Data Capture, Validation, Maintenance
• Data/Information Analysis, Transformation,
and Decision Support
• Information Dissemination and Liaison
• Health Information Resource Management
and Innovation
• Information Governance and Stewardship
• Patient Health Information Protection
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A Day in the Life…
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Health Information Management
Settings of Practice
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Healthcare Provider Organizations
Healthcare Data Organizations
Healthcare Payer Organizations
Healthcare Supplier Organizations
Planning Organizations, Regulators,
and Industry Support
Educational Institutions
Research Institutions
Consumer Organizations
Third Party Compliance Organizations
Multiple Initiatives for HIM in
2014 with Overlapping Timelines…
2013
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2014
2015
2016
ICD-10 Push Continues
for HIM Professionals
• Timeline to meet October 1, 2014
will intensify this year
– Vendor Readiness
– Training
– Computer-Assisted Coding (CAC)
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ICD-10 Focus
Modifications to
Work Process
Assessing and
preparing for
coder staff
competency and
training
ICD-10-CM/PCS
Strategy for
Immediate
Transition Period
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Reimbursement
Impact
ARRA/HITECH Framework Meaningful Use at Its Core
Regional Extension Centers
Workforce Training
Medicare and Medicaid
Incentives and Penalties
State HIE Program
Standards and Certification
Privacy and Security
ADOPTION
MEANINGFUL USE
EXCHANGE
Health IT Practice Research
Office of the National Coordinator, February 20, 2011
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Improve Health
Outcomes and
Efficiency
EHR and Meaningful Use
• Compliance Date(s):
– October 1, 2013, for hospitals
– January 1, 2014, for physician practices
and other providers
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Meaningful Use
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Anticipated Changes and Challenges
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Meaningful Use Measures
Measuring Clinical Quality
HIE
EHR Safety
Privacy and Security
Consumer Empowerment
New models of care
Emerging Areas
Meaningful Use
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HIM’s Contribution to
Health Information
Exchange (HIE)
• Increased need for accurate
and available health information
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HIE Defined
• Refers to the process of reliable and
interoperable electronic health-related
information sharing conducted in a manner
that protects the confidentiality, privacy, and
security of the information.
– Verb: The electronic sharing of health-related
information among organizations
– Noun: An organization that provides
services to enable the electronic sharing
of health-related information
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HIE Drivers to Change
Payment Reform Model Examples
– Bundled Payment Options
• Need for more data
– Accountable Care Organizations (ACOs)
• Need for more data
– Patient-Centered Medical Homes (PCMH)
• Need for more data
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HIE Challenges
• The ability to accurately link (match) multiple,
disparate records relating to a single individual.
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HIM Is a Key Contributor to
the Implementation of EHRs
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Implementation leaders
Dealing with the legal records issues
Master Patient Index Maintenance
Data Conversion
Workflow analysis and redesign
Privacy and Security
HIM Professionals Are Industry
Leaders for Privacy and Security
FINAL HITECH PRIVACY RULE IS HERE!
Compliance Date: September 23, 2013
1. HIPAA Privacy, Security, and Enforcement
2. HIPAA Enforcement Rule—
Increased Tiered Penalties
3. Breach Notification
4. Genetic Information Nondiscrimination Act (GINA)
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HIM Addresses the Final
HITECH Privacy Rule
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Business Associates
Marketing
Fundraising
Disclosure and Sale of Health Information
Electronic Access
Requested Restrictions
Notice of Privacy Practice
Childhood Immunizations
Deceased Individuals
Minimum Necessary/Limited Data Set
Research
2014–Year of Data for
HIM Professionals
• “It’s All About t
he Data”
– Creating Data
– Managing Data
– Using Data
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Future Roles
• To advance technologies that collect and maintain
patient data accurately and securely
• To adopt classification systems to increase the
quality of data in clinical documentation
• To encourage the use of electronic health records
is the primary source for monitoring quality of care.
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Future State
• Data capture, validation, and maintenance
• Data and information analytics, transformation,
and decision support
• Information dissemination and liaison
• Health information resource management
and innovation
• Information governance and stewardship
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Questions
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References
• Health Information Career Pathfinder
ahima.org/careers
• Health Information Management Concepts,
Principles, and Practice, Fourth Edition
• Bureau of Labor Statistics
http://www.bls.gov/oco/cg/cgs035.htm
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