No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Redefining the Roles of Health Information Management Professionals in Health Information Technology
... For the proper implementation and expansion of HIT in the health system, it is important to understand the definition and purpose of technology. Zeng, Reynolds, and Sharp (2009) draw on an extensive range of resources to point out that there is no agreed definition of HIT in the literature; however, there is a consensus on its purpose "as the use of devices for the management of information in order to ensure that it is available to the right person at the right time and place" (p. 1). Similarly, Agarwal et al. (2010, p. 800) note that for the proper implementation of HIT, its design is the starting point and it should be recognised that "HIT is a means and not an end". ...
... It is important to understand and clarify the meaning of success in EHR implementation, as it includes factors such as privacy and security issues, the provision of quality data, and the provision of data that is fit for purpose. As demonstrated in the literature, there is no clear definition of health sector IT (Zeng et al., 2009). Therefore, it is important, as stated by Hersh and Wright (2008), to determine which professionals play important roles in the implementation of EHR, and to clearly define their roles in order to avoid any overlap in responsibilities. ...
... Therefore, it is important, as stated by Hersh and Wright (2008), to determine which professionals play important roles in the implementation of EHR, and to clearly define their roles in order to avoid any overlap in responsibilities. In addition, it is important to understand that there is a difference between what an information system can be expected to do, and who manages it and how (Zeng et al., 2009). ...
Health Information Management (HIM) now plays a vital role in efficient healthcare delivery systems worldwide. With Oman now investing strongly in health information technology and embracing a new vision for its health services, a better understanding the role of HIM practices has become critical. This study, therefore, examines the current status of HIM in Oman, identifies the factors that influence its practice, and suggests a framework to guide future developments. To achieve these goals the following questions were addressed: (1) What is the status of HIM in Oman? (2) What are the factors that impact its current status? (3) How does this reflect on the needs of HIM professionals? (4) What could the future direction of HIM look like?
The research applied an exploratory sequential mixed-methods design through three integrated studies. Study One involved six focus groups, comprising 21 senior HIM professionals, to examine and gain a better understanding of HIM practice from the perspective of current professionals in their workplaces, as well as the participants’ opinions in regard to the roles and challenges of their professions within Oman’s Ministry of Health (MoH) institutions. These participants from the HIM field were selected purposively to provide information that is relevant for this study. Several themes emerged from the inductive thematic analysis. There was consensus in the responses regarding the ineffectiveness of current HIM practices with respect to obtaining quality health information. In addition, all participants argued that higher authorities in the health system must acknowledge the role and importance of HIM professionals’ abilities, skills and knowledge for a more effective HIM system to be developed. The findings emphasise that the current status of HIM does not lend itself to any significant role, which affects the quality of health information and the satisfaction of HIM employees.
Study Two comprised semi-structured interviews with eight executive leaders within the Oman health system to explore their understanding of HIM practices, including the current status of the health system and the needs and factors influencing future approaches. The first three interviewees were selected purposively based on their knowledge, expertise and position within the MoH and their association with the study of HIM areas. These first three participants referred the researcher to the remaining five participants in the organisation based on their position in the Ministry and their expertise in a particular area related to HIM practice (i.e. legal, planning, human resources, statistics). A number of themes and findings emerged. Interviewees from the fields of IT, Statistics and HIM showed clear knowledge of the roles and importance of HIM in the system. In contrast, interviewees from other areas lacked a coherent understanding of HIM practices, particularly the concept, role and functional structure of these practices. This results from knowledge gaps regarding HIM practice at higher management levels.
Study Three focused on cross-validating the qualitative findings and quantifying the relative impacts of various factors on the current status and future direction of HIM in Oman through an online survey completed by 201 frontline HIM staff. The results provided insight into the operation and needs of the HIM system from the perspective of HIM staff. The findings highlighted the importance of improving the roles of HIM staff, as well as enhancing collaboration and communication between overlapping fields. One hundred and forty-two respondents (70.6%) highlighted the need for a clear framework, including clear job descriptions and unified policies and procedures (68.2%). In addition, the data suggest that developing an organisational structure and determining a governing body for HIM would have a positive influence on the satisfaction of HIM staff. The need to develop the knowledge and skills of current employees and future candidates working in HIM through robust education and training was strongly supported.
The outcomes from the literature review, context analysis and the primary data collected from the above three studies were consolidated and analysed to inform the development of a framework for the future development of HIM. The Abbott Framework (Abbott, 1988) was utilised for the interpretation and discussion of the findings. This framework provides a perspective in which the evolution and interrelations of occupational groups, as well as the structuring and division of expert labour are the focus.
The findings across all studies indicate a lack of consensus regarding the HIM area, a misunderstanding of the HIM concept itself, and confusion regarding the functional structure and personnel roles in the MoH. Moreover, the results identified a need for HIM professionals to be recognised and engaged in the health system’s development in order to have an effective impact on the quality of health information gathered. Further, higher management levels play an important role in addressing the factors that can help improve the development of HIM systems and professionals. The results have important theoretical and practical implications for future HIM practices in the MoH and across the whole healthcare industry in Oman.
... Health information management in Nigeria health care delivery today has and still playing vital roles in contributing to the treatment of patients [1]. Health information management professionals play critical roles in collecting, analysing and maintaining data that physicians, nurses and other health care providers rely on to deliver quality health care to patients in the hospital [2]. As the expert in patient health data management, they work in a variety of section in the hospital including outpatients' clinics, e.g. ...
Introduction: Health information management professionals play critical roles in collecting, analyzing and maintaining data that physicians, nurses and other health care providers rely on to deliver quality health care to patients in the hospital. Aim: To assess the knowledge and perception of patients towards the roles and services rendered by health information professionals in LAUTECH teaching hospital, Osogbo, Osun State, Nigeria. Method: The study was a descriptive study design in which 144 respondents took part (42% male and 58% female) in a sample selected from patients in LAUTECH teaching hospital, Osogbo, Osun State, Nigeria; using simple random sampling to selects respondents. Data was collected with the use of a structured self-administered questionnaire with closed ended questions and was analyzed using SPSS version 21. Result: Based on the findings of this study, it was observed that patients know the importance of health information managers in health care services rendered in the hospital and also have the knowledge and perception on health records personnel function in health institutions. It can be concluded that with the various challenges faced by the patients and which was identified in this study the hospital meets up with the expectation of the patients by providing necessary equipment and resources needed (Human resources, equipment, conducive working environments and lots more) to improve health care services rendered to patients by health information professionals. Conclusion: Based on the research findings, health information professionals should be very effective in carrying out their duties. Friendly to the patient and gives calmness of mind during clinics.
... Later in 2009, "The Health Information Technology for Economic and Clinical Health-HITEC Act" was introduced. The primary focus was to trigger the adoption of electronic health and medical records coupled with supporting health information technologies within the United States [19]. ...
Health information technology systems have the capacity to improve health outcomes for the patients thus ensuring quality and efficient services. Health information systems (HIS) are important tools in guidance towards patient safety and better outcomes. However, still, morbidity and mortality attributed to medical errors remain an important issue that needs to be addressed. The objective of the present study was to assess the health information system in terms of technological, environmental, organizational and human factors affecting the adoption as well as the perceptions of stakeholders along with barriers and constraints related to successful implementation. A descriptive cross-sectional study design was used. Prospective data was collected from primary sources by self-administering the pre-validated questionnaires as well as by physical verification of the availability of equipment. After data collection, data was analyzed to assess the health information management systems. The results of the present study showed that the health information system in Pakistan is not up to the mark. The equipment was mostly unavailable at the primary healthcare facilities. The staff was also unsatisfied with the available services. Administrative, financial and human constraints were identified as the major barriers towards successful implementation and management of HIS. The present study concluded that the health information system of Pakistan needs to be revamped. Health information management system partially existed at district and sub-district offices, while was completely absent at tertiary, secondary and primary healthcare levels. The poor adoption of health information technology systems at healthcare facilities might largely be attributed to insufficient human resources with limited resources and budget allocation for health in Pakistan. Effective and timely strategies involving all important stakeholders and healthcare professionals must be designed and implemented at the National level to restructure an affordable, resilient and quality healthcare system.
... Another workforce study outlined the overlap of HIM and HIT roles, which included project management, and privacy and security 6 ; while DeAlmeida et al. used data from AHIMA membership profiles to link jobs to STEM technology job titles. 7 Marc et al. studied the U.S. and global trends in HIM job announcements using relevant HIM keywords and identified current job domains. ...
This study's objective was to identify the prevalence of the American Health Information Management Association (AHIMA) career map jobs and determine which job categories, degrees, and skills are associated with higher pay. We extracted data from SimplyHired, a major employment website, from December 2018 to December 2019. We retrieved 12,688 career posts. We found differences in average salary by career category (p-value 0.00). Most jobs were in coding and revenue cycle (CRC) and information governance (IG) categories. The highest average salaries were in data analytics (DA) and informatics (IN). Each career category had a unique set of skills associated with the highest paying jobs. Eighty-two percent of CRC, 67 percent of IG, 65 percent of IN, and 83 percent of DA jobs listed in the AHIMA career map were present in the extracted dataset. These results can help employees, academics, and industry leaders understand the health informatics and information management (HIM) workforce landscape.
... Since the data which is included in the patient's medical record, fall within the most sensitive personal information (main illness, history of present illness, allergies and medicines, medical history, family history, social history, occupational history, sexual history, addiction to use of drug, smoke and other substances), every aspect of their safety, confidentiality and protection must be ensured substantially [25,26]. In the last few years, the Citizen Health Record has been promoted in Europe, which corresponds more thoroughly to the contemporary vision of the globalized citizen, as far his expectations from the health services are concerned. ...
e-Health leads to the reshaping of the traditional ways of providing services by health professionals, aiming both at the rationalization of the expenses and the satisfaction of the patients-users of health services. Nevertheless, the key elements which prejudge its success are the measurable results, the guarantee of a broad consensus, as well as the leadership’s commitment to implement it. Ιn Greece, it is implemented within the European action eEurope 2005-eGovernment and the eEurope-i2010 programme. The application of e-Health in Greece is a national priority, for a number of reasons, such as the thousands of islands in the Greek archipelago which make the traditional form of medical care practically impossible. However, the economic crisis that broke out in Greece in 2009, as well as the arrival of waves of refugees in the country raised new issues in the development of the e-Health sector. This chapter analyses the institutional framework of e-Health in Greece. It also outlines the various technological, legal and organizational challenges that arise in the process of implementing e-Health in the pivots of effectiveness, efficiency, quality and equal accessibility. Finally, it develops a strategy for the future of e-Health in the Greek National Health System.
... Scholars have used the term "health information technology" to describe communication and information technologies used in healthcare (Buntin et al., 2011;Chaudhry et al., 2006 (Zeng, 2009, p.1). Health information technology is an umbrella term that denotes various healthcare-related technologies including (but not limited to) electronic health records, personal health records, e-prescribing, health information exchange, analytics/decision support, patient health tools, and mobile health technologies (Deloitte Center for Health Solutions, 2013;HealthIT, 2013;Zeng, 2009). However, among these technologies, the term health information technology has been mostly associated with electronic health records since most hospitals were initially interested in using desktop-based computers as alternative repositories of paper-based health records (Adler-Milstein et al., 2015;Haux, 2006;Hillestad et al., 2005). ...
Although there are studies that highlight how healthcare professionals use smartphones for work purposes, there is a scarcity of knowledge of this phenomenon among nurses – the largest group of healthcare professionals in a hospital. Existing studies are also theoretically and methodologically limited. To address these research gaps, this research aims to determine the factors and issues associated with nurses’ use of smartphones for work purposes in the Philippines based on a theoretical framework constructed using the Theory of Planned Behaviour, Organisational Support Theory, and IT Consumerisation Theory. First, an Exploratory Study based on in-depth interviews with 30 nurses in the Philippines was conducted. Results showed that nurses used their smartphones for communication, information seeking, and documentation purposes to facilitate clinical work. It also showed that several behavioural (i.e., instrumental and affective attitudes, injunctive and descriptive norms, perceived behavioural control, and intention) and organisational antecedents (i.e., perceived organisational support) could influence nurses’ use of smartphones for work purposes. Moreover, a relevant outcome of its use is enhanced quality of patient care. The study also uncovered some organisational issues that might affect how nurses used smartphones for work purposes. In general, results of the Exploratory Study were used to further develop Study I and Study II. Study I identified the predictors and outcome of nurses’ use of smartphones for work purposes. Hypothesis testing used structural equation modelling (SEM) of survey data from 517 staff nurses employed in 19 tertiary-level general hospitals in Metro Manila, Philippines. Exploratory and confirmatory factor analysis results showed that nurses’ use of smartphones for work purposes is operationally defined by its use for communication and information seeking purposes. Next, SEM results showed that injunctive norm and perceived behavioural control were positively associated with intention to use smartphones for work purposes. Moreover, intention was positively associated with nurses’ use of smartphones for work purposes. On the other hand, nurses’ use of smartphones for work purposes was positively associated with perceived quality of care. Results of the indirect effect analysis showed that perceived organisational support had an indirect effect on nurses’ intention to use smartphones for work purposes through injunctive norm and perceived behavioural control. Study II identified organisational issues that influence support to nurses’ use of smartphones for work purposes from the perspective of nurse administrators – one of the organisational agents where nurses derive organisational support. Nine focus groups were conducted with 43 nurse-administrators from nine randomly selected tertiary-level general hospitals that were part of Study I. The findings showed that the issues were divided on those that encouraged (i.e., problems with existing workplace technologies, absent or insufficient unit phones, insufficient unit phone credits, and unrealistic policies) or inhibited (i.e., smartphone use for non-work purposes and misinterpretation by patients) nurse administrators to support nurses’ use of smartphones for work purposes. Overall, the research findings were used to generate key recommendations on nurses’ use of smartphones in hospital settings. These recommendations can be used by hospitals to develop policies on nurses’ or healthcare professionals’ use of smartphones in hospitals.
... Moreover, eHealth solutions describe the use of information and communication technologies (ICT) to support health systems and services; this can include everything from SMS appointment reminders on a mobile phone to more complex electronic medical record systems (Kay, 2011). In particular, HIT is described as patient-centered health technology and as a key element in streamlining processes, improving quality and harnessing costs within health care in general and within HP (Zeng, Reynolds, & Sharp, 2009). Overall, the number of technologies relevant in relation to promoting the health of underprivileged citizens can be considered multiple. ...
In this doctoral thesis, I address the problem of inequality in health by focusing on
how underprivileged citizens experience and manage health-related problems in
their everyday lives. Particularly, I focus on the citizen’s use of technology for
engaging in health-related occupation. The field of research for the thesis is
occupational science (OS), while Deweyan pragmatism is called upon as a
theoretical frame.
The overall aim of this thesis is to develop conceptual knowledge on how to support
underprivileged citizens’ engagement in health-related occupation, with attention to
these citizens’ everyday health management using technology. To achieve this aim,
three consecutive studies were conducted.
Study I: A state-of-the-art literature study to contribute knowledge of how relevant
areas of concern have been described and conceptualized within contemporary
occupational science and therapy literature from 2004 to 2014. The study revealed
an assumed relation in the literature between occupation and inequality in health. A
transactional perspective on occupation was identified and introduced as a possible
theoretical perspective on the relation between occupation and inequality in health.
From a transactional perspective on occupation, inequality in health may be
regarded as a situation that can be experienced by individuals or groups of people
due to unequal and limited possibilities for choosing and participating in occupation.
Study II: An empirical study to contribute empirical knowledge about
underprivileged citizens’ use of technology for engaging in health-related
occupation. John Dewey’s theory of transaction was applied as a conceptual
framework for analyzing the citizens´ use of technology for managing everyday
health. The study showed that citizens’ use of technology for engaging in healthrelated
occupation is influenced by the technology’s support of the merging of the
complex interplay of personal and contextual conditions and its supporting of the
citizens in their “inquiry to action” strategies concerning everyday health
management.
Study III: A theoretical study of John Dewey’s theory of inquiry to contribute
theoretical understanding of engagement in occupation from a situated perspective.
In the study, it was found that inherent in occupation is an inquiring process that
provides occupation with a transformative capacity. By engaging in occupation,
humans situate themselves into ever changeable situations through the explorative
and practical acting of inquiry. However, this enacted situated inquiry depends on a
context rich enough to provide cues for knowledge strategies on how to engage in
the next experimental and transformational doing in everyday life.
Overall, this thesis contributes by conceptualizing underprivileged citizens’
engagement in health-related occupation as a situationally dependent transactional
experience, characterized by the practical acting of inquiry on health-related matters.
Derived from this conceptualization, underprivileged citizens’ problems in engaging
in health-related occupations can be viewed as difficulties with acting inquiringly on
health-related indeterminacy in their everyday lives. Based on this perception of
engagement in health-related occupation, underprivileged citizens’ use of
technology for everyday health management can be described as dependent on
whether or not the technology takes account of and supports the merging of the
necessary and complex interplay of personal and contextual conditions as well as
supporting the citizens in their “inquiry to action” strategies concerning in-depth
practical concerns about everyday health management.
... According to the World Health Organization (WHO) Health Management Information System (HMIS) is absolutely important and fundamental in improving health care delivery and addressing the health challenges in developing countries (1). Moreover, it is essential in health promotion, health management and planning (2) as well as storage of health data (2,3). HMIS is not only meant as a system for data collection and generating quality information, but use of that information to influence policy for decision making, individual and community health outcomes, and studies as well as implementation of programs (4,5,6). ...
According to the World Health Organization (WHO) Health Management Information System (HMIS) is absolutely important and fundamental in improving health care delivery and addressing the health challenges in developing countries.
This systematic review on HMIS is intended to highlight the current situation of integrating HMIS in the health care services of low and middle income countries (LMICs) aimed to identify the factors that emphasize the importance of HMIS in improving the health system performance and the challenges that impede the efficiency of HMIS services in health and medical practice in developing countries in order to recommend methods that help overcoming these challenges in selected developing countries.
The main findings:
• HMIS is essential for strengthening of health system, improving healthcare delivery and addressing the health challenges especially in low and middle income countries.
• Application of HMIS in developing countries has similarities and differences. However, variations can be attributed to differences in the social-political entities of health systems. These include, but are not limited to, differences in power structures and different capacities of professionals.
• The main challenges of electronic-Health in developing countries are: lack of familiarity with the technology for users, lack of cultural appropriateness, lack of computer skills among the clinicians therefore need to conduct Information and communications technology (ICT) training and time consuming for those with lack the ICT skills.
Recommendation:
• Building capacities of health care worker force and training in HMIS especially in public health sectors
• Improve leaderships awareness regarding the value of HMIS and its major role in improve healthcare services and health status of population.
... aggregate clinical data [2]. Adopting healthcare technology offers the possibility to improve the delivery of care in ways that can provide exceptional quality, promptness, performance and availability [3]. ...
... [54] As the data custodians, HIMs will implement and manage the control systems related to the integrity, security, and privacy of health data. [53,55] The knowledge and skill set of staff HIMs will manage will shift from operational management of clerical staff to strategic and operational management of information knowledge workers. The different qualifications, competencies, and skills of this workforce will require advanced qualifications in more senior management positions. ...
The Health Information Management profession has a long history in Australia dating over 70 years. Traditionally, the profession has been associated with the two functions of paper-based medical records management and clinical coding. Now, a time of digital transformation and ongoing health reform requires the profession to strategically position itself from information technicians to information strategists, and demonstrate its ongoing important contribution to improving patient care and outcomes, and the effective management of health care.
The purpose of this report is to identify the major future challenges facing Health Information Management practitioners and academics. Three major questions to be examined are:
1. What are the forecast health reform and technological transformations that will impact on the Health Information Management profession?
2. What are the future responsibilities, skills, and knowledgebase requirements of the Health Information Management profession to contribute to high quality, safe patient care, and efficient organisational functioning?
3. What educational reform is necessary to prepare Health Information Management Practitioners for the future health and human service sectors, and to create sustainable faculties?
To examine each of these, an environmental scan of the literature on the future of health care, digital health, and education was undertaken. This environmental scan provides the support for the considerations raised in this report.
... For instance, the federal government can create guidance for genomic databases and standard quality improvement metrics for genetic tests, provide information to the general public about the benefits and risks of genetic tests, establish regulations to control the price of patented genomic tests or treatment approaches, and develop policies and procedures to handle genetic discrimination cases. 88 With the availability of these government rules and regulations, people would have confidence to take advantage of genomics-based personalized medicine. ...
In recent years, the term personalized medicine has received more and more attention in the field of healthcare. The increasing use of this term is closely related to the astonishing advancement in DNA sequencing technologies and other high-throughput biotechnologies. A large amount of personal genomic data can be generated by these technologies in a short time. Consequently, the needs for managing, analyzing, and interpreting these personal genomic data to facilitate personalized care are escalated. In this article, we discuss the challenges for implementing genomics-based personalized medicine in healthcare, current solutions to these challenges, and the roles of health information management (HIM) professionals in genomics-based personalized medicine.
... Combining the development of leadership skills with job redesign is particularly timely because experts have predicted approximately 25 new roles for health information professionals. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Thus, leaders can act synergistically and efficiently by conducting job redesign for these new roles and concomitantly developing leadership capacity. ...
Leaders have the responsibility to develop leadership in their departmental members. Leadership capacity is needed so that health information professionals will be able to successfully respond to the constant changes in the healthcare environment. This article demonstrates how leadership can be modeled and developed through the redesign of jobs in departments of health information services.
... The extended role of HIM professionals requires an enriched curriculum and a well-organized educational campaign. 6 After reviewing the challenges and drawbacks of HIM curriculum for the Master's degree, this article uncovers the future avenues of health information by virtue of the national health information infrastructure (NHII) model through which HIM professionals should augment their knowledge and skills at the Master's and Ph.D. levels. ...
Challenges and drawbacks of the health information management (HIM) curriculum at the Master's degree were examined, including lack of well-established computing sciences and inadequacy to give rise to specific competencies. Information management was condensed to the hospital setting to intensify the indispensability of a well-organized educational campaign. The healthcare information dimensions of a national health information infrastructure (NHII) model present novel requirements for HIM education.
Articles related to challenges and barriers to adoption of the personal health record (PHR), the core component of personal health dimension of an NHII, were searched through sources including Science Direct, ProQuest, and PubMed. Through a literature review, concerns about the PHR that are associated with HIM functions and responsibilities were extracted. In the community/public health dimension of the NHII the main components have been specified, and the targeted information was gathered through literature review, e-mail, and navigation of international and national organizations. Again, topics related to HIM were evoked.
Using an information system (decision support system, artificial neural network, etc.) to support PHR media and content, patient education, patient-HIM communication skills, consumer health information, conducting a surveillance system in other areas of healthcare such as a risk factor surveillance system, occupational health, using an information system to analyze aggregated data including a geographic information system, data mining, online analytical processing, public health vocabulary and classification system, and emerging automated coding systems pose major knowledge gaps in HIM education.
Combining all required skills and expertise to handle personal and public dimensions of healthcare information in a single curriculum is simply impractical. Role expansion and role extension for HIM professionals should be defined based on the essence of HIM roles and responsibilities. Forming a curriculum development team consisting of various professional profiles brings divergent views regarding the HIM curriculum and paves the way for HIM to branch out at the Master's and Ph.D. levels based on advanced information technology.
There are roughly 4000 AYUSH hospitals spread out across India under various councils and hospitals run by the Indian government. Today’s atmosphere makes it more challenging than ever to locate a suitable AYUSH facility for the treatment. The AYUSH Ministry provides India’s top option for healthcare delivery. The government is examining strategies to lower expenditures while enhancing patient care. We are proposing the ground-breaking idea of e-healthcare which involves various novel features like suggesting various tools to the patients those need to communicate with the healthcare professionals as per their convenience remotely. This research suggests an interactive system using Android in line with this trend. By integrating different bio-medical data sources that contain information pertinent to the hospital demographics, their inpatient procedure rates, Outpatient department, etc., we proposed a system that surveys on the various AYUSH hospitals to find. This system uses the Google Map API for tracking and highlighting the location to the nearby AYUSH hospitals with opening and closing timings. Additionally, the proposed system plays a crucial role in emergency scenarios by supporting the user in performing the necessary first aid techniques. Using this strategy, the entire system demonstrates that this research provides a superior method for making decisions than past studies.
Rapid economic growth resulting from the ascendancy of Saudi Arabia as an international oil producer, and the recognition by the government of the right of all citizens and most expatriate workers to free healthcare facilitated the development of a three-tier health system ranked 26th in the world by the World Health Organisation in 2000. Concurrently, the increasing financial burden of interwoven demographic and socioeconomic factors such as unprecedented population growth, increased life expectancy, and the rise of noncommunicable diseases, necessitated the diversification of health funding in the form of mandatory healthcare insurance. The coding of the clinical documentation of diagnoses and interventions of patient health episodes by clinical coders has become the international standard for submitting health insurance claims and in 2013, a contract was negotiated with the Australian government to adopt the complete ICD-10-AM package.
A mixed methods approach was selected to determine the factors impacting on the ICD-10-AM implementation in seven public hospitals, which had not previously submitted claims or employed clinical coders. Data were obtained from a quantitative Likert scale questionnaire completed by a random sample of 283 respondents and a qualitative semi-structured interview was conducted with seven purposively selected experts while only one physician indicated a desire to be interviewed. Instrument design and content were based on factors drawn from ICD-10 implementation literature representing developed and developing nations. The reviewed Saudi literature covered healthcare management, staffing conditions, inadequate technology and interoperability, and the failure to follow through with previous reform attempts.
Derived factors were categorised as organisational (planning, staffing, training, and technology); Health information (purpose, benefits, practice, and a knowledge of anatomy, pathology, and interventions); National (implementation support, funding, maintenance, upgrading, and the unified system). SPSS computation of the 5-point Likert scale (1 = strongly agree; 5 = strongly disagree) yielded an overall mean of 4.01 for the 23 items, foreshadowed by a strong negative response to three demographic items querying prior clinical coding certification or ICD-10 training, and implementation status. A 9% minority of highly qualified professionals differed from the majority. Three years after the original implementation date, factors deemed essential, particularly organisational awareness, training, and adequate staff specialists were still being ignored.
Most respondents had been excluded from job-specific training, showed little understanding of the relevance of ICD-10 and clinical coding in health information management, or a vision of their hospital as a component of a national system. In the only hospital practicing clinical coding it was tasked to the physicians, continuing a Saudi pattern of mediocre reform attempts symptomatic of a fragmented health system lacking leadership.
Background
In Saudi Arabia, Health Information Management (HIM) programs are established in universities and colleges that offer studies at the Bachelor's and Master's level.
Purpose
The main objective of this study was to assess the different HIM programs available in Saudi Arabian universities and colleges, in terms of the names of the programs, year of establishment, and other specific differences between them. Another objective was to have input for the establishment of future HIM degrees across Saudi Arabia.
Methods
A descriptive cross-sectional study was conducted to investigate the number, date of establishment, and location of HIM programs available in Saudi Arabian universities and colleges. In this retrospective study, information was collected from the Ministry of Education and updated online websites of universities and colleges.
Results
A total of 81 universities and colleges across Saudi Arabia were reviewed for the availability of Health Information Management (HIM) programs. Out of the 81 reviewed institutions, 16 had at least one HIM program available. 6 programs were established in private colleges and 10 were in public universities. In terms of the level of education, all of the 16 institutes were offering Bachelor’s degree programs; and, 5 of them were offering a Master’s degree program.
Conclusions
HIM undergraduate programs in Saudi Arabia are better established than postgraduate programs. The adequacy of HIM programs in Saudi Arabia can only be judged by a careful analysis of the HIM alumni job placement and workforce needs. The results of this research can be useful to predict the workforce needs to ensure an adequate supply of highly skilled HIM professionals in Saudi Arabia. In this regard, it would be important to systematically monitor trends in healthcare technology and the healthcare industry to identify the level and types of skills required by these professionals.
Background:
Paper-based routine health information systems often require repetitive data entry. In the West Bank, the primary health care system for maternal and child health was entirely paper-based, with care providers spending considerable amounts of time maintaining multiple files and client registers. As part of the phased national implementation of an electronic health information system, some of the primary health care clinics are now using an electronic registry (eRegistry) for maternal and child health. The eRegistry consists of client-level data entered by care providers at the point-of-care and supports several digital health interventions that are triggered by the documented clinical data, including guideline-based clinical decision support and automated public health reports.
Objective:
The aim of the eRegTime study is to investigate whether the use of the eRegistry leads to changes in time-efficiency in health information management by the care providers, compared with the paper-based systems.
Methods:
This is a substudy in a cluster randomized controlled trial (the eRegQual study) and uses the time-motion observational study design. The primary outcome is the time spent on health information management for antenatal care, informed and defined by workflow mapping in the clinics. We performed sample size estimations to enable the detection of a 25% change in time-efficiency with a 90% power using an intracluster correlation coefficient of 0.1 and an alpha of .05. We observed care providers for full workdays in 24 randomly selected primary health care clinics-12 using the eRegistry and 12 still using paper. Linear mixed effects models will be used to compare the time spent on health information management per client per care provider.
Results:
Although the objective of the eRegQual study is to assess the effectiveness of the eRegistry in improving quality of antenatal care, the results of the eRegTime study will contribute to process evaluation, supplementing the findings of the larger trial.
Conclusions:
Electronic health tools are expected to reduce workload for the care providers and thus improve efficiency of clinical work. To achieve these benefits, the implementation of such systems requires both integration with existing workflows and the creation of new workflows. Studies assessing the time-efficiency of electronic health information systems can inform policy decisions for implementations in resource-limited low- and middle-income settings.
International registered report identifier (irrid):
DERR1-10.2196/13653.
Background:
Health information technology (IT) solutions can aid healthcare reform efforts, but without proper information management, these efforts are futile. In this study, we used Kuwait as an example of a high per-capita gross domestic product country that faces information management challenges to draw insights that can be generalised to other developed countries.
Objective:
(i) to uncover the status quo of information management practices in public hospitals and (ii) to offer recommendations to improve them.
Method:
This study analysed qualitative and quantitative accreditation-related data pertaining to the compliance with the information management standard at all secondary care public hospitals over two accreditation cycles.
Results:
Overall, public hospitals had made positive progress in their compliance with the information management standard. However, issues still existed with (i) developing and implementing an information management plan, (ii) involving the appropriate stakeholders in selecting health IT solutions and (iii) access to the Internet by staff and patients.
Conclusion:
Evidence underscored the importance of proper information management driven by clear centralised strategic plans.
Implications:
With the rapid adoption of digital health systems, the role of health information management leaders should not be undervalued. Embracing health IT solutions with strong information management practices can aid healthcare reform efforts.
Mit der zunehmenden Digitalisierung des Gesundheitswesens und dem dadurch steigenden Einsatz von Verfahren wie maschinellem Lernen und künstlicher Intelligenz gehen komplexe Herausforderungen in sämtlichen Bereichen des Informationsmanagements und damit verbundener Applikationen einher, die von der initialen Datenakquise bis zur interaktiven Visualisierung reichen: Wie lassen sich heterogene und verteilt vorliegende Datensätze automatisiert in einen konsolidierenden Datenbestand überführen und für Lernverfahren nutzbar zu machen? Wie müssen Entscheidungsunterstützungssysteme gestaltet sein, um einen echten Mehrwert für Nutzer in Diagnose und Therapie zu generieren? Welche Algorithmen ermöglichen eine hohe Transparenz für medizinisches Fachpersonal, damit Prädiktionen nicht aus einer „Black Box“ kommen und die Nachvollziehbarkeit gewährleistet ist? Der Informationsmanagementzyklus (IMZ) adressiert obige Herausforderungen bzw. Fragestellungen und stellt dabei stets den (medizinischen) Informationsnutzer (z. B. Patient, Arzt, Therapeut) und ein zu generierendes Informationsprodukt in das Zentrum der Betrachtung. Er ist in vier zyklisch miteinander verbundene und überlappende Phasen unterteilt: Bedarfserhebung, Integration, Aufbereitung und Bereitstellung. In diesem Kapitel diskutieren wir sowohl das Informationsmanagement als auch den IMZ anhand eines praktischen Beispiels aus der medizinischen Diagnostik und stellen dabei sowohl Lösungsansätze und Herausforderungen als auch Fallstricke in der tatsächlichen Implementierung vor.
With the recent rapid adoption of electronic medical records (EMRs), studies reporting results based on EMR data have become increasingly common. While analyzing data extracted from our EMR for a retrospective study, we identified various types of erroneous data entries. This report investigates the root causes of the incompleteness, inconsistency, and inaccuracy of the medical records analyzed in our study. While experienced health information management professionals are well aware of the many shortcomings with EMR data, the aims of this case study are to highlight the significance of the negative impact of erroneous EMR data, to provide fundamental principles for managing EMRs, and to provide recommendations to help facilitate the successful use of electronic health data, whether to inform clinical decisions or for clinical research.
With information and communications technology as its backbone, the electronic health information system has become an increasingly important component of telerehabilitation (TR) service delivery. The purpose of this chapter is to examine ethical responsibility for resolution of issues emerging within the intersection of the fields of rehabilitation and health information management (HIM). These issues involve areas of clinical competencies and user accessibility that might further inform the development of codes of ethics and other guidance for HIM and TR practice. Case studies anchor the narrative in actual problem-solving situations. Bioethics and practice documents are used to illustrate existing guidance. Conclusions and recommendations present interdisciplinary examples of research problems and best-practice initiatives, and also touch upon the ethical dilemma of the ethical vacuum when no human agent can be identified due to the complexity of the information environment.
Health information system forms an integral part of the any healthcare system. Its works with an objective to provide reliable, relevant, up-to-date, adequate, timely, and reasonably complete information to healthcare professionals as well as health mangers at all level of healthcare system. This article describes the perceptions of 279 health sciences interns towards health information system where a prospective study was conducted. The selected samples were questioned by using a validated and pre-tested questionnaire and their responses were marked and evaluated using the 5-point Likert scale ranging from 'strongly agree' to 'strongly disagree'. The results showed that respondents, with good knowledge, had positively perceived the benefits of health information system, whereas many with lack of knowledge about the subject perceived otherwise. The study has also been able to identify an emergent need for educating and training the health science interns about health information system, its need, and its importance for better acceptability.
To examine five areas that we will be central to informatics research in the years to come: changing provider behavior and improving outcomes, secondary uses of clinical data, using health information technology to improve patient safety, personal health records, and clinical data exchange.
Potential articles were identified through Medline and Internet searches and were selected for inclusion in this review by the authors.
We review highlights from the literature in these areas over the past year, drawing attention to key points and opportunities for future work.
Informatics may be a key tool for helping to improve patient care quality, safety, and efficiency. However, questions remain about how best to use existing technologies, deploy new ones, and to evaluate the effects. A great deal of research has been done on changing provider behavior, but most work to date has shown that process benefits are easier to achieve than outcomes benefits, especially for chronic diseases. Use of secondary data (data warehouses and disease registries) has enormous potential, though published research is scarce. It is now clear in most nations that one of the key tools for improving patient safety will be information technology--many more studies of different approaches are needed in this area. Finally, both personal health records and clinical data exchange appear to be potentially transformative developments, but much of the published research to date on these topics appears to be taking place in the U.S.--more research from other nations is needed.
One of the biggest obstacles to expanding the use of information technology (IT) in health care may be the current narrow focus on how to stimulate its adoption. The challenge of thinking of IT as a tool to improve quality requires serious attention to transforming the U.S. health care system as a whole, rather than simply computerizing the current setup. Proponents of health IT must resist "magical thinking," such as the notion that technology will transform our broken system, absent integrated work on policy or incentives. The alternative route to transforming the system sets all of its sights on the destination.
We fully agree with Carol Diamond and Clay Shirky that deployment of health information technology (IT) is necessary but not sufficient for transforming U.S. health care. However, the recent work to advance health IT is far from an exercise in "magical thinking." It has been strategic thinking. To illustrate this, we highlight recent initiatives and progress under four focus areas: adoption, governance, privacy and security, and interoperability. In addition, solutions exist for health IT to advance rapidly without adversely affecting future policy choices. A broad national consensus is emerging in support of advancing health IT to enable the transformation of health and care.
By distributing costs and benefits among providers and payers, a regional physician association is creating a data exchange network with an ambitious goal: interoperable EHR systems in every physician's office.
Health IT has been a hot topic in the two years since AHIMA published "A Vision of the e-HIM Future." Members of the original task force take a look back.
Across the country, new RHIOs are being formed every day. The 21 RHIOs studied by the work group illustrate the variety of purposes, funding, and record linking methods RHIOs may adopt. As this trend continues to evolve and improve, RHIOs may prove to be a valuable stepping stone on the road to a national system in which a patient's medical data will be available anywhere, anytime. Accurate patient identification and linking are the foundation of health technology that is implemented in a RHIO or any similar network that shares patient information. Without accurate patient identification, patient safety and quality of care are compromised. When high percentages of duplication or overlaying of records occurs in electronic health record databases, physician trust in the system is lost. As HIM professionals, we must be involved in addressing the security and confidentiality of RHIO databases and in defining the record linking method appropriate to the RHIO. As professionals skilled in patient identification methods and possessing significant organizational skills and personnel management experience, HIM professionals should become involved in this process at the earliest opportunity in the RHIO formation. HIM professionals can participate in long-term planning, business plan development, and organizational structure definition. Future articles will address how HIM professionals can become involved, what particular attributes and skills they can bring to the table, and job descriptions appropriate to HIM professionals in the healthcare information sharing industry. The work group urges all HIM professionals to become involved personally in this exciting new field.
Fledgling RHIOs get a head start with new model policies and technical guidelines from Connecting for Health.
A Blueprint for Quality Education in Health Information Management Chicago: AHIMA
- Ahima Vision
AHIMA. Vision 2016: A Blueprint for Quality Education in Health Information Management. Chicago: AHIMA, 2007. Accessed December 23, 2008, at http://www.ahima.org/emerging_issues/Vision2016BlueprintforEduc.pdf. rRedefining the Roles of Health Information Management Professionals in Health Information Technology 11