By Lisa A. Eramo
In this age of data-driven healthcare, population health monitoring (PHM) programs are springing up everywhere. These new and emerging programs rely on healthcare data and health information management technology (HIMT) to manage and monitor patients who are healthy as well as those who are at risk for health problems and/or chronic conditions. The goal is to keep patients as healthy as possible, thereby reducing costs for expensive interventions. According to the Institute for Health Technology Transformation, the objective is to “modify the factors that make people sick or exacerbate their illnesses.”
HIM professionals are at the forefront of this revolution because they possess the information governance and data management/analysis skills that are necessary to ensure successful PHM programs. In fact, AHIMA has even dubbed PHM as the “next HIM frontier.”
The good news is that HIM professionals, particularly those who have pursued health information management and technology degrees, are well prepared for this new wave of healthcare data application. Consider the following ways in which HIM professionals can use their existing skills to contribute to the PHM revolution:
- Capture, validate, and maintain data on which clinical decisions are based. HIM professionals know how and where to access clinical, claims, administrative, and self-reported patient data. They can explain who generates this data and in which specific systems. They understand the role of health information exchanges and can articulate the ways in which the electronic medical record can be used to generate and cross-tabulate this data. As data sources grow and expand to incorporate mobile devices, personal health devices, and more, HIM professionals can take inventory of this data and ensure that PHM programs capitalize on it as much as possible. They also understand and can apply important data retention requirements.
- Articulate what the data means and how it can be used to perform decision support. HIM professionals can translate SNOMED-CT, ICD-9-CM, and/or ICD-10-CM/PCS data into information that others can use to improve care. They can explain how and why certain conditions are coded and sequenced. This information provides a crucial context in which the data must be interpreted.
- Ensure data integrity and accuracy. Simply collecting massive amounts of data is not sufficient. That data must also be as accurate as possible. HIM professionals can educate physicians and others who contribute to the medical record about the importance of their documentation. Documentation must tell the patient’s story with as much detail as possible. Accurate and complete documentation leads to accurate and complete coding. This coding is a driving force behind PHM programs. By applying AHIMA’s Data Quality Management Model, HIM professionals can ensure that data is accessible, consistent, current, granular, precise, accurate, comprehensive, relevant, and timely.
- Explain the limitations of current information systems. Although today’s information systems can capture more data than was ever possible before, a lack of interoperability as well as the absence of real-time prompts to improve care are two major drawbacks. HIM professionals must help develop new solutions that will capture and integrate data from hospital EMRs and physician practice management systems. These solutions must rely on this integrated data to activate pre-defined rules for specific patient populations that alert providers directly and help them make informed clinical decisions across the continuum of care. They must also engage patients directly via portals and automated outreach.
- Drive change within the organization. HIM professionals have already proven that they possess the communication and leadership skills necessary to support a PHM program. Many professionals have successfully worked with IT to implement EMRs and other technologies. They are likely leading the ICD-10 transformation as well. HIM leaders can – and should – pave the way for PHM today and beyond.
HIM professionals possess the knowledge and skills to move population health efforts forward, and they should take every opportunity to do so.