IT trans­form­ers

AHIMA at­ten­dees told that their lead­er­ship is key

Modern Healthcare - - INFORMATION EDGE - Joseph Conn

Asense of mis­sion and ur­gency were the twin themes of the Amer­i­can Health In­for­ma­tion Man­age­ment As­so­ci­a­tion’s 83rd an­nual con­ven­tion in Salt Lake City last week. The 63,000 health in­for­ma­tion pro­fes­sion­als who are AHIMA mem­bers—like their col­leagues through­out the U.S. health­care in­dus­try—are fac­ing rapid and pro­found changes.

Those in­clude help­ing pre­pare their or­ga­ni­za­tions for mean­ing­ful use of elec­tronic health records, fac­ing the chal­lenges to pri­vacy and se­cu­rity that in­creased EHR adop­tion en­tails, and ready­ing them for what has been deemed the big­gest lift in the his­tory of the health in­for­ma­tion tech­nol­ogy in­dus­try, con­vert­ing to the In­ter­na­tional Clas­si­fi­ca­tion of Dis­eases, 10th Re­vi­sion, fam­ily of di­ag­nos­tic and pro­ce­dural codes, or ICD-10, by Oct. 1, 2013 (Oct. 3, p. 24).

AHIMA also had some or­ga­ni­za­tional chal­lenges of its own.

Lynne Thomas Gor­don had been on the job less than a week be­fore she gave her first key­note speech as CEO of the as­so­ci­a­tion. Thomas Gor­don, a past state AHIMA pres­i­dent from Ge­or­gia and a former AHIMA national del­e­gate, started Sept. 29.

Health in­for­ma­tion man­age­ment pro­fes­sion­als will be in the midst of con­ver­sion to ICD-10 codes in Oc­to­ber 2013, or in “727 days, 15 hours and 12 min­utes,” Thomas Gor­don said dur­ing her talk. “The peo­ple right here in this room can­not pro­cras­ti­nate. That’s be­cause we must be the lead­ers to get this mas­sive project done and done on time.”

AHIMA board Pres­i­dent Bon­nie Cas­sidy ex­plained to del­e­gates why the or­ga­ni­za­tion re­struc­tured it­self—for the fu­ture as well as to deal with an ex­ec­u­tive-level shake-up. Former CEO Alan Dowl­ing and Chief Op­er­at­ing Of­fi­cer San­dra Fuller left their jobs abruptly in June.

Out­go­ing in­terim CEO Rose Dunn, in­tro­duced by Cas­sidy, was greeted with two stand­ing ova­tions. Dunn had stepped up to served as in­terim CEO, re­plac­ing Dowl­ing.

“Af­ter 16 weeks, I now know the mean­ing of re­lief, and it’s not Alka-Seltzer,” Dunn quipped.

Cas­sidy also in­tro­duced her suc­ces­sor, come Jan­uary, in­com­ing AHIMA Pres­i­dent Patty Thierry Sheridan.

Cas­sidy said that dur­ing the re­cent “tur­bu­lent time” the AHIMA board “was called upon over and over” to make smart, crit­i­cal de­ci­sions and did so with “courage and ef­fec­tive stew­ard­ship.” Cas­sidy also ral­lied the troops.

“We are in the midst of the great­est trans­for­ma­tion in the his­tory of our health­care sys­tem,” she said. “We see no rea­son to be­lieve it will be done suc­cess­fully un­less we pro­vide strong HIM lead­er­ship.”

Key­note speaker Dr. T. Bedirhan Us­tun joked that AHIMA mem­bers might want to tar and feather him for say­ing it, but they should be­gin plan­ning now for con­ver­sion to the ICD-11 codes sets, al­ready un­der de­vel­op­ment and ex­pected to be re­leased in 2015.

Us­tun is team co­or­di­na­tor of clas­si­fi­ca­tion, ter­mi­nolo­gies and stan­dards with the World Health Or­ga­ni­za­tion’s depart­ment of health sta­tis­tics and in­for­mat­ics. The WHO is the de­vel­oper of the in­ter­na­tional ver­sions of the ICD codes.

“It is writ­ten on the wall, and we can’t take it back that ICD-11 is com­ing,” Us­tun said.

He pre­dicted, “There will be suf­fer­ing” with the ICD-10 con­ver­sion, but he asked, “What can be made out of that suf­fer­ing?”

Us­tun said ICD-9, which is still in cur­rent use in the U.S., was re­leased in 1975 and adopted by the U.S. af­ter an “ac­cept­able” de­lay in 1979. But ICD-10 was com­pleted in 1990, so even if the U.S. tran­si­tion from ICD-9 to ICD-10 goes off on sched­ule in 2013, the adop­tion gap will be 23 years.

The use of in­for­ma­tion tech­nol­ogy from the start of the de­vel­op­ment of ICD-11 could make the next tran­si­tion much smoother, he said.

“I would like you as the AHIMA com­mu­nity to look at this and help us,” Us­tun said.

In ad­di­tion to the press of change, present-day oper­a­tional chal­lenges af­fect­ing AHIMA mem­bers were on the con­ven­tion agenda at dozens of its ed­u­ca­tional ses­sions. The con­ven­tion drew more than 4,000 at­ten­dees, in­clud­ing ex­hibitors.

Ses­sion speaker Suzanne Layne, di­rec­tor of health in­for­ma­tion man­age­ment sys­tems at Main Line Health in sub­ur­ban Philadel­phia, said per­for­mance in han­dling med­i­cal records at the five-hos­pi­tal sys­tem had varied from medi­ocre to poor be­fore re­vamp­ing its health IT op­er­a­tions to base them on func­tions rather than fa­cil­i­ties.

In­stead of hav­ing med­i­cal coders, pro­ces­sors who scan records and qual­i­ty­con­trol em­ploy­ees who re­view their work at each hos­pi­tal, the coders were al­lowed to work mostly from home, and pro­cess­ing and qual­ity con­trol be­came cen­tral­ized func­tions, Layne said. Man­age­ment also was cen­tral­ized, she added.

Un­der the old sys­tem, back­logs ranged from five days to 23 days to re­turn records to physi­cians for re­view, Layne said. Now, 98% of records are scanned and pro­cessed the day af­ter dis­charge.

Devore Culver, ex­ec­u­tive di­rec­tor and CEO of HealthIn­foNet, the statewide health in­for­ma­tion ex­change based in Port­land, Maine, told at­ten­dees at his ses­sion that trust was the es­sen­tial el­e­ment that en­abled 31 par­tic­i­pat­ing hos­pi­tals and 60 group prac­tices thus far to con­sent to hav­ing the med­i­cal records of their pa­tients stored in one cen­tral data repos­i­tory.

To ad­dress pri­vacy con­cerns, Maine adopted the opt-out model, where the de­fault mode is that pa­tient records from providers flow to and re­main in the ex­change un­less pa­tients choose not to par­tic­i­pate. The con­sent man­age­ment di­rec­tive is cre­ated and stored by the ex­change, not the providers, ac­cord­ing to Culver. So far, 6,751 pa­tients, or less than 1%, have opted out.


Dr. T. Bedirhan Us­tun told health IT lead­ers that they should al­ready be look­ing be­yond ICD-10.

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