Preparing for the Looming ICD-10 Transition Deadline: HIT, Meet HIM

Yes. So that would be top of my list. The second on my list would be the need for analysis of a breach. If you can prove, for example, that there’s minimal harm, using four factors, you wouldn’t have to report a breach to a patient. The four: you have to prove that minimal information has been breached; you have to specify what’s in that information (you have to go through the 19 items considered protected health information);  and was it acquired and viewed, or just acquired? For example, if you mailed something to the wrong address and it was sent back to you unopened, then there was no harm; but if it was opened, that raises it to a different level of risk. And the other component… You have to look at all of those. Risk of harm takes you over the threshold.

What kinds of collaboration will needed between HIT and HIM people?

It all boils down to one simple thing: enterprise information data governance. It can no longer be IT governance, with HIM off to the side. Because the biggest risk is the ability to flag. And that has not happened; many organizations have not done the needed organizational workflows. Some organizations have begun to do flowing; if they have a true CMIO and a really strong CIO, for example. But if the CIO is really a CTO… In my opinion, there are too many CIOs who really should be CTOs, and they don’t understand; that’s where the collaboration needs to come in.

What will HIM people be bringing to this process?

The hidden gem or resource in the organization will be the HIM professionals.

And there are so many HIM professionals waiting to invited to the table. Now, I’m encouraging them to stop waiting, and to just sit down at the table and start eating! But not everybody is comfortable with that. This is a body of knowledge… And there’s about a 10-percent error rate in terms of the integrity of information.

And because one error in documentation in a patient’s EHR raises the stakes, right?

Yes, and that 10-percent error rate covers many different types of things—for example, a patient care organization registered me as Rita Bowen one time and as Rita Smith Bowen another time; or there might be two Rita Bowens. And if a care provider copies information from a patient’s EHR that’s incorrect, the chances could multiply. So there’s got to be a focus on health information integrity; and that’s when the HIM manager comes in. Because who actually reads the entire chart? Usually, it’s the HIM coder.