HIM and HIT Effectiveness in The Enterprise

Complementary Facilitators of the Evolving 21st Century EHR

Cecilia R. Plata, RHIA, CPHI, CHP.HIM Consultant, Interim Director and EPIC Implementation,

Harmony HealthAHIMA Approved Revenue Cycle Trainer

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LSU Sha’Carri Richardson broke the women’s 10 meter collegiate record 2 weeks ago3

OSCAR PISTORIUSFrom South AfricaOlympic Runner

400 M – London, 2012

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4.5

https://www.youtube.com/

Oscar Pistorius Wins T44 400M Final

2012 Paralympics (1:39 mins)

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Rule 1: ROBOTS are not human and

HUMANS are not robots.6

STORE

PICKUP:

Order

onl

ine

and

pick

up

At the

sto

re fo

r fre

e!

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Rule 2: Control in large Enterprises must remain HUMAN AT ALL CRITICAL POINTS AT EVERY LEVEL.

The Boeing 737 Max Disasters (385 lives lost) are blamed on a Robotic Flight Program which was NOT controllable by the Pilots

programmed because (speculation) : (a) programming error, (b)the pilots didn't know then how to take control of the plane,

(c) It was set that way as an anti-high jacking measure, or(d) A combination of (a), (b), and (c).

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Rule 3: Computer programs and Robots ultimately are a reflection of their creator’s mindset and world-view.

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Frederick T.L. Leong, PhD, professor of psychology and psychiatry, Michigan State Univ.; Consortium for Multicultural Psychology Research.

INDIVIDUALCultural Accommodation

and Negotiation

Heraclitus of Ephesus (c. 535 – c. 475 BCE)

“THE ONLY CONSTANT IN LIFE IS CHANGE”

Each Person Reacts differently to the Same Change

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A MINDSET isA set of common assumptions,

methods, or notations held by one person or groups of people.

It can be seen as a reflection of a person's world view, character or

philosophy of life.

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Growth

MINDSETFixed

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DNAANCESTRY

CULTURE

TRAINING

EXPERIENCE

GROUP THINK

Belonging Emotions

Growth

MINDSETFixed

HEALTH

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DNAANCESTRY

Education at allLevels

Religious EducationPatriotism, etc.

CULTURE

Folk Traditions, Customs,

Rituals, Values, Superstitions

TRAININGWork Experience

Work with own hands/mindEarning, Negotiation skills

Successful Product Orientation

EXPERIENCECreditable

Genes, Natural Gifts,Agility, Metabolism, etc.

GROUP THINK

Belonging Emotions

Physical, Economic,ENVIRONMENTS

Social, Political, Generational

Growth

MINDSETFixed

HEALTH

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DNAANCESTRY

Education at allLevels

Religious EducationPatriotism, etc.

CULTURE

Folk Traditions, Customs,

Rituals, Values, Superstitions

TRAININGWork Experience

Work with own hands/mindEarning, Negotiation skills

Successful Product Orientation

EXPERIENCECreditable

Genes, Natural Gifts,Agility, Metabolism, etc.

GROUP THINK

Belonging Emotions

Physical, Economic,ENVIRONMENTS

Social, Political, Generational

Growth

MINDSETFixed

HEALTH

OUTPUT15

DNAANCESTRY

Education at allLevels

Religious EducationPatriotism, etc.

CULTURE

Folk Traditions, Customs,

Rituals, Values, Superstitions

TRAININGWork Experience

Work with own hands/mindEarning, Negotiation skills

Successful Product Orientation

EXPERIENCECreditable

Genes, Natural Gifts,Agility, Metabolism, etc.

GROUP THINK

Belonging Emotions

Physical, Economic,ENVIRONMENTS

Social, Political, Generational

Growth

MINDSETFixed

HEALTH

OUTPUTDecisions, Counsel

Opinions, Conclusions,Emotional Tone, Stability 16

1. Agriculture, Food & Natural Resources2. Architecture & Construction3. Arts, A/V Technology & Communications

5. Education & Training6. Finance7. Government & Public Administration

9. Hospitality & Tourism10. Human Services

12. Law, Public Safety, Corrections & Security13. Manufacturing14. Marketing

16. Transportation, Distribution & Logistics

16 Occupational Clusters

HIT/Comp.Sci.

HIM

Caregivers

Administration

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GENETICS L E G A C Y L E G A C Y L E G A C Y

C U L T U R E C U L T U R E C U L T U R ET R A I N I N G T R A I N I N G T R A I N I N G

Professional ANCESTRY (Documents & Oral History)

Business, Mgmt. Administration Computer Sciences

Caregivers, Agriculture, NaturalResources, Environment, Arts,

Finance, Accounting, Public Admins,

Government, EntrepreneurshipScience, Architecture,

Construction,Audio-Visual Technology &

CommunicationsLaw, Public Admin., Public

Safety, Information TechnologyEducation & Training, Health

Sciences, Hospitality & Tourism, Human Services

Manufacturing, Marketing Sales, Services, Transport & Logistics Scientific Research

Religious Occupations.Engineering, Electrical

Chemistry, etc.

MEDICINE & HEALTH SCIENCE PROFESSIONS

HIM

HEALTH INFORMATIONTECHNOLOGY

CAREGIVERS / ARTISTS / AGRICULTURE

BUSINESS, INVESTMENTS & LAW

SCIENTISTS/ENGINEERS/CHEM./MATHEMATICS

ADMINISTRATIONSUPERVISION

GENETICS GENETICS

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UGrowth

MINDSETFixed

12

INTELLECTUAL ANCESTRYTRAINING /EDUCATION

Who trained you?What did you Learn?

Where did you learn it?

NATURAL TALENTS & GENESWhat comes easy?

What do you enjoy?

EXPERIENCEHealthcare, Teaching,

Commerce, Law/SecurityProduction and Sales,

Other.

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DNAANCESTRY

Education at allLevels

Religious EducationPatriotism, etc.

CULTURE

Folk Traditions, Customs,

Rituals, Values, Superstitions

TRAININGWork Experience

Work with own hands/mindEarning, Negotiation skills

Successful Product Orientation

EXPERIENCECreditable

Genes, Natural Gifts,Agility, Metabolism, etc.

GROUP THINK

Belonging Emotions

Physical, Economic,ENVIRONMENTS

Social, Political, Generational

Growth

MINDSETFixed

HEALTH

OUTPUTDecisions, Counsel

Opinions, Conclusions,Emotional Tone, Stability 16

U

Boss

FriendOutside

OfWork

Work WithOr

Supervise

CollaboratorIn Another

DepartmentMe

B

F

W

C

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“MAY THE FORCE BE WITH YOU AND YOUR TEAM”Star Wars

“To him who knows how to do right, butdoes it not, to him it is sin.”

New Testament

INFORMATION SCIENCE ELECTRICAL ENGINEERINGArchitecture, Organization, COMPUTER ENGINEERINGManagement , Access, COMPUTER SCIENCE

Retrieval INFORMATION ENGINEERING[MEDICAL RECORD] INFORMATION SYSTEMS

INFORMATION TECHNOLOGY

MEDICAL

I N F O R M A T I C SELECTRONIC MEDICAL RECORD

E-MR

[MEANS TO END]

END (Purpose): TO IMPROVE PATIENT CARE

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1. Agriculture, Food & Natural Resources2. Architecture & Construction3. Arts, A/V Technology & Communications

5. Education & Training6. Finance7. Government & Public Administration

9. Hospitality & Tourism10. Human Services

12. Law, Public Safety, Corrections & Security13. Manufacturing14. Marketing

16. Transportation, Distribution & Logistics

16 Occupational ClustersGENETICSLEGACYCULTURETRAINING

UBossFriendWork WithCollaborator

22

CollaboratorIn Another

Department[Health Information Technology]

HIM

XGENETICS

LEGACY

CULTURE

EDUCATION/TRAINING

C

1, 2,

1, 2,

11, 15,

3, 11, 15,

3, 5,

3, 5, 8,

3, 5, 8, 11,

3, 8, 11

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Boss

FriendOutside

OfWork

Work WithOr

Supervise

CollaboratorIn Another

DepartmentMe

B

F

W

C

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SUPPLEMENTARY SLIDES

HIM and HIT: EFFECTIVENESSIN THE ENTERPRISE

Cecilia R. Plata, RHIA, CPHI, CHPAHIMA Convention, June 23-25, 2019903 452 2930 or platac@hotmail.com

5 HISTORICAL LEGACY SLIDES1 POTENTIAL ACTIVITIES

P E R C E N T O F R E C O R D S O N P A P E R

100 TARGET: 0 %90 1 RECORD = 1 VIEWER

80

70

60

50

40

30

20

10

0

1950 1960 1970 1980 1990 2000 2010 2020

TRANSITION FROM PAPER RECORD TO ELECTRONIC PATIENT RECORD IN US

One e-Medical Record = Many Simultaneous Viewers in Real Time

2025

CAREGIVERS / ARTISTS / AGRICULTURE

Healing - Biology - Art - Nursing - Public Health

Education: Liberal Arts, Education, Social Sciences

AIM: To heal and promote growth

Degrees: MD, Ph.D., BS, MS, RN, RT, Licenses

YEAR

1750 Coding for cause of Death

1920 Medical records showed improvements In health care

1940 Advances in Surgery Techniques

1941

1950 Coding for cause of Illness

1960

HEALTH INFORMATION MANAGEMENT Definition, Organization & Responsibility for Patient Medical Record

1962 AHIMA was formalized: Training and Medical Record Standards

1970

1971 Computer-Assisted Medical Transcription

1977 ICD SystemCoding Classification of Diseases – Computer-Assisted Coding

1979 CERNER & EPIC Systems Progressive Development the integrated eMR

1981 Installations of Integrated eMR in Med. Centers

2000

2008

2020 ICD-10 Coding Version Classification of Diseases

OWN HISTORY

SCIENTISTS/ ENGINEERS/ CHEMISTS/ MATHEMATICSInvent, Research, Discover, Apply Technology Education: Science, Technol., Engineering & MathematicsAIM: Invent machines/chemicals to do WORKDegrees: Mech-., Electr.-, Chem.- Engineers, Comp. Sciences

YEAR

1750 Start of the "Industrial Revolution"19201940

1941 Era of Antibiotics began with Penicillin1950 Computer Programs for expanded Databases1960 HEALTH INFORMATION TECHNOLOGY

Integration of multiple databases & adaptation to generalized multi-user patient health care records

1962 HIMSS formalized, Training, Standards, Yearly Mtg.1970 Development of the INTERNET1971 Start of the "Information Age"19771979 Functional Record Scanning integration1981 Advanced Programming Developed & Standardized2000 Informatics Science developed in specialty areas2008

2020 Integration of all patient history in one single eMR

OWN HISTORY

BUSINESS, INVESTMENTS & LAWCommerce - The art to Buy, Sell, Invest and Profit

OWNHISTORY

Education: Business and EconomicsAIM: To obtain most return for a dollarDegrees: BBA, MBA, Account, Law,

YEAR1750 Early Manual Accounting1920 Cost Accounting Refined in hospital health care194019411950 Medical care standards by various Societies

1960Computers Generalized as a Business Tool

1962 Coding and standards linked to Pay-for-Service1970 Computerized patient billing197119771979 Institutional Transitions from pMR to eMR1981 Increase efficiency of MR to real time2000 Early integration of Databases across Enterprise2008 Integrated eMR for system hospitals and clinics2020 Fully Integrated eMR across communities

POTENTIAL ACTIVITIES TO IMPROVE COLLABORATION AND WORKFLOW

1. TRAINING, TRAINING AND TRAINING! TO then set minimal certified competencies applicable to Data Quality, Analysis and Workflow.

2. Focus on identifying and resolving workflow “bottlenecks.”

3. Learn the other department/culture, language, value system and standards.

4. Generalize two foundation courses in each collaborating cluster (e.g., HIM and HIT).

5. Establish cross-internships between collaborating areas.

6. As often as possible, use a team approach to “problem resolution” always including both technology and practice workers.

7. Set defined departmental continuous improvement goals and objectives that are related to those defined for the enterprise.

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