Project #97848 - Healthcare Delivery Systems


due 24 hours, $ 15 MAX



Case Study: Chapter 11 e-HIM - Due Thursday Nov 5th, noon.


Chapter 11

Healthcare Delivery Systems

Donald Kellogg, PhD, RHIA

 Real-World Case


1.  Read the below noted Real World Case as it relates to e-HIM evolution, AHIMA's vision, career opportunities, roles resources and competencies in e-HIM for the HIM professional.


2.  Access the "Real World Case Discussion Questions" found at the end of the case study.

3.  Answer questions 1-4 and submit via direct input into this assignment module.  Submit on or prior to the due date noted.


Points:   8



In order to receive all 8 points, learner must:

- Answer each of the 4 questions

- Answers will be well-thought out and developed with supporting documentation noted or cited to support learner response.

- Example Poor Response to Question 1:  No, the HIM profession will not be eliminated with the advent ot e-HIM.

- Example Good Response to Question 1:

I do not believe that the HIM profession will be eliminated with the advent to e-HIM.  My presonal readings and research, in my opinion, reveals that the HIM professional will actually of increased responsibilies and opportunites to be a change master with vision for the future of HIM.  An example of the increased responsibilites is  _______________________.   AHIMA task force developed the vision ________________________________________

-- Continue on with this type of supporting information and reference(s) until you have covered the points you articulated in your answer.



Overview of e-HIM 

  • Evolution from e-Health Task Force to e-HIM Task Force 
  • e-HIM definitions and descriptions 
  • AHIMA's Vision of e-Health and e-HIM 
  • Career opportunities for e-HIM professionals 
  • Roles, resources, and competencies in e-HIM 
  • Future of eHIM and where you might work 


Evolution from e-Health Task Force to e-HIM Task Force 

Over the past decade, the Internet and its derived technologies have revolutionized the way business is conducted. In healthcare, the following examples illustrate this transformation: 

  • Increasing numbers of consumers access the Internet for information about healthcare providers, treatment options, and their own personal health information
  • Health websites provide consumers with tools to develop and maintain their own online health records
  • Consumers and health providers correspond via e-mail
  • Businesses and consumers purchase supplies and equipment over the Internet
  • Health information management (HIM) business processes, such as transcription and coding, use the Internet for off-site transaction processing

The Internet and its derived technologies create a plethora of opportunities for HIM professionals. HIM professionals who understand and embrace this technology will harness and direct it to improve health information and the efficacy of healthcare for consumers, providers, vendors, payers, and all of those in the healthcare supply chain. Those who fail to understand and embrace this technology will be left behind, and their opportunities will be forfeited to faster-moving, better-focused professionals.

The work of the AHIMA e-Health Task Force (2001) resulted in the following vision statement: 

Vision for e-Health Information Management

E-health presents a new frontier for managing health information. HIM professionals will reinvent traditional HIM functions for a health record model in which the patient is part of the documentation team. In this model, the health record will be designed and/or maintained by a trusted third party organization or by the patient. Individually identifiable data will be transmitted and accessed via the Internet. 

HIM professionals will clearly define the mission-critical role of a "cyber-health record practitioner." They will develop standards of practice that support the implementation of AHIMA's tenets that its e-Health Task Force developed in 2000 and addressed the security, privacy, and quality standards for personal health information on the Internet. 

In early 2003, AHIMA appointed a task force of experts to develop a vision of the e-HIM future. 

The task force developed the following vision of the future of health information: "The future state of health information is electronic, patient-centered, comprehensive, longitudinal, accessible, and credible." 

The task force's vision is not only theoretical, but it also offers practical guidance for anyone traveling the road toward e-HIM. Advancing the recommendations of the e-HIM Task Force, AHIMA created workgroups to develop practice standards that focus on areas that play an integral role in the transition from paper to electronic health records. 

The following issues were selected for the initial standards development: The Complete Medical Record in a Hybrid Electronic Health Record Environment: 

  1. Implementing Electronic Signatures 
  2. E-mail as a Provider-Patient Electronic Communication Medium and Its Impact on the Electronic Health Record 
  3. Electronic Document Management as a Component of the Electronic Health Record 
  4. Core Data Sets for the Physician Practice Electronic Health Record 
  5. Speech Recognition in the Electronic Health Record 

Note: The outcomes are presented in a series of documents that can be found on the AHIMA Web site. To view more information about the e-HIM initiatives, go to and click HIM Resources.

From HIM to E-HIM 

The knowledge and expertise for managing handwritten medical records containing source patient data have evolved through these steps:

·        Independent management of paper medical records in settings across the continuum of care

·        Scanning the paper documents for multiple user access

·        Entering data into automated systems that generate electronic patient data

·        Integrated delivery systems that electronically manage the patient across the continuum of care

·        Network integration and e-health information management. 

HIM professionals remain actively involved in developing effective processes to preserve patient privacy, confidentiality, and security. This is because the introduction of the Internet for accessing, transferring, and transmitting health information expanded the uses of source patient data (that is, the medical record as HIM professionals traditionally know it) as Internet-based business-to-business companies and business-to-consumer companies flourished. 

Career Opportunities for e-HIM Professionals 

The application of HIM skills, expertise, and experience described in the previous section meet the job requirements of several roles in e-health businesses. This section discusses mission-critical functions and processes in e-health companies that HIM professionals can develop, manage, or perform. Some skills transfer easily into the e-health environment while some require translation due to the differences in the work setting or to accommodate differences in the capabilities of advanced technologies. 

Many of these e-HIM processes are interrelated or complementary. Processes and/or functions may be decentralized in some e-health organizations and centralized in others in much the same way as HIM processes have always composed an HIM department in traditional healthcare provider organizations. In e-health companies as well as traditional settings, many HIM functions exist outside of the HIM department. With e-health companies and providers varying in purpose and scope (from traditional healthcare provider organizations delivering services electronically, to clinical systems vendors, to application service providers, to consumer healthcare Internet Web sites) the concept of a professionally led HIM function or department will vary depending on the organization's structure, resources, and needs. 

In the traditional and e-healthcare organizations, HIM professionals are responsible for managing two basic healthcare business objectives: 

  1. Enabling the collection and storage of complete, accurate, and legal health information 
  2. Facilitating the use of health information for patient care, quality evaluation, reimbursement, compliance, utilization management, education, research, funding, and in legal proceedings 

The first objective is accomplished in the traditional setting through functions generally consolidated and managed under the auspices of the HIM director. It includes such functions as record assembly, analysis, coding and abstracting, correspondence, special registries, and medical transcription. 

The second objective includes use of the information through functions such as creating and maintaining efficient filing and retrieval systems, master patient indices, chart and information retrieval and filing, release of information, and data retrieval for quality assurance, registries (for example, tumor, trauma), and other evaluative purposes. 

These objectives are met within a highly regulated environment and managed with limited resources. This necessitates professional guidance by those with health information management skills, which includes knowledge in the administration of highly regulated activities. 

Clearly, e-health companies having many of the same business objectives and challenges as traditional healthcare organizations need HIM knowledge and skills in developing processes that will meet their business objectives with a high level of quality and cost benefit. 

Roles, Resources, and Competencies in e-HIM 

"Revolution" is an overused word, but when applied to the effect of all that is digital, automated, or electronic in the healthcare industry, it is entirely accurate. Over the last decade, established relationships, value chains, and strategies have been radically altered or swept away. 

As the revolution continues, the "front-line" challenge to HIM professionals is clear. They can allow the technologies to roll uncontrolled through and around their organizations--in effect, handing over their rich knowledge base and expert skills to faster-moving, better-focused professionals in professions that don't even exist yet. Or they can understand the potential of the Internet and control and direct its power to the benefit of their customers, health plan members, and patients.

Future of eHIM and Where You Might Work

Domain manager: Owns responsibility for a defined body of knowledge such as HIM, coding, laboratory, pharmacy, and such. Knowledge and authority may cross organizational lines as they maintain the integrity of the technical implementation of that body of knowledge. May work closely with product managers, operations staff, quality control, and such.

Project manager: Manages the implementation of systems necessary to support personal health records, website content, and other projects.

Medical language and classification expert systems: Employs skills in the design and use of medical vocabularies and classification; defines data and retrieves information from e-health systems.

Compliance officer: Designs, implements, and maintains a compliance program that assures conformity to all types of regulatory and voluntary accreditation requirements governing the provision of healthcare products or services via the Internet.

Information security expert: Designs, implements, or maintains an information security program that balances requirements of privacy, integrity, and availability of data. Understands the legal and social issues related to information security.

Patient information coordinator: Provides services to patients wanting to understand how to optimize their experience on the e-health website and create and maintain accuracy of their personal health records. Educates patients on protecting the privacy of their personal health information.

Reimbursement manager: Designs systems and procedures that assure generation of accurate clinical documentation needed to substantiate billing. Also involved in designing systems to efficiently classify information for billing. Develops and implements systems to assure the secure transfer of required data to billing centers, clearinghouses, or third-party payers.

Data quality manager: Ensures the quality of health information by performing quality reliability and validity checks. Develops reports and advises clinicians on identifying critical indicators.

Privacy officer: Oversees all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization's policies and procedures covering the privacy of, and access to, patient health information in compliance with federal and state laws and the healthcare organization's information privacy practices.

Product manager: Responsible for overall implementation of a specific product or product line. This may include coordinating and managing the use, case design, development, quality control, version control, modifications and updates, and such.

The e-HIM Task Force (AHIMA) report outlines new roles and competency areas to help you envision ways to expand your scope of knowledge. 

Business process engineer, information system designer and consumer advocate are just a few new paths open to HIM professionals. Decision support is another important area, where HIM professionals will be building, querying, and analyzing databases to give clinicians the information they need to decide how to treat current patients or analyze patterns in past patient care. 

Coders will have several migration paths once code assignment becomes automated. Coders will play key roles as data quality and integrity monitors and data analysts. Others will become clinical vocabulary managers, helping to make the national information infrastructure a reality by ensuring consistency and linkages between different codes. Check out the AHIMA Web site to explore more information on these exciting emerging roles for HIM professionals. 


Source: Cassidy, B. 2004. e-HIM framework and Case study. 2004 IFHRO Congress & AHIMA Convention Proceedings. Chicago: AHIMA.

Real-World Case Discussion Questions

1.         Will the HIM profession be eliminated with the advent to e-HIM?


2.         What e-HIM role appeals to you? Why?


3.         Why do you think AHIMA used a task force to develop the vision of the future of 
            health information?


4.         How does e-HIM impact an HIM professional that has been in the field for 10 years or more?



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