Health information management: at the heart of healthcare
Even before last month's national conference for the Health Information Management Association of Australia (HIMAA) and National Centre for Classification in Health (NCCH) opened, it was clear that health information management really is “at the heart of healthcare”, the theme for this year’s event.
In opening the annual conference for Australia’s health information management (HIM) and clinical classification peak bodies respectively, the secretary of Victoria's Department of Health and Human Services Kym Peake described state of the art developments for Australia’s health reform 'pathfinder' jurisdiction, particularly in the area of eHealth, and health information management and clinical classification were central to reform at every turn.
Later in the conference, delegates would hear concrete examples from HIM professionals involved in Victorian eHealth development, such as Jackie McLeod with her end-to-end account of the introduction of the Epic electronic medical records system at Melbourne’s Royal Children’s Hospital and Kate Horkings and Jasmine Souki on how eReferrals are transforming specialist clinics at Monash Health. These are HIMs working at an executive level in their organisations.
Cameron Barnes, director of health information and information governance at Cabrini Health in Melbourne, said he could identify so many HIMs around the country working at senior executive level that he challenged the conference next year for a tour de force showing of 'celebrity' HIMs.
As potentially the first HIM in a director of information governance role in the country, Mr Barnes personified the first major 'future HIM' theme of the conference: information governance. The first keynote address of the conference set the scene.
Deborah Green is the American HIM Association’s (AHIMA) walking oracle on information governance as the next advance for health information management in the eHealth setting. In her keynote, Ms Green took delegates through the work undertaken by AHIMA in building its information governance platform for HIM.
She cited research from the Poneman Institute in May 2015 which found that data breaches in 350 companies from 11 countries cost an average per country of $US3.79m. The total cost of data breaches globally has increased by 23 per cent since 2013. The cost of a data breach loss or theft of a medical record in the US was $US154 per item.
Ms Green said data breaches alone are enough motivation for health facilities to realise the importance of information governance, and to understand that this needs to cover the entire digital information system, not just the health record or even health information systems alone.
AHIMA is advocating enterprise information management (EIM) as one of the three cogs of an information governance framework for health facilities. They also emphasise the important difference between information and data in a health information system, which HIM professionals understand so well, but which other health professionals in the system seem to ignore happily.
The AHIMA information governance (IG) model identifies two other cogs in addition to EIM: data governance (DG), and information technology governance (ITG). AHIMA has developed key components of and core competencies for these three cogs, and also identified where they intersect to form core competencies for IG.
HIMAA immediate past president Sallyanne Wissman – another of Cameron Barnes’s Celebrity HIMs, as director of health information management with Mater Health Services in Queensland – presented on the introduction of a whole-of-organisation health information strategy for which she had been responsible, which went to the heart of information governance.
On the clinical classification front, Philip Hoyle from the Royal North Shore Hospital in Sydney, who is principal clinical adviser for the NCCH, presented a clinician’s view on ‘health information for a changing world’ and highlighted the threats and opportunities that health information professionals should be aware of in order to raise their profile and maintain their relevance as healthcare moves into a digitised age.
Dr Hoyle made a powerful statement which set the tone for the three-day conference. “The health information profession has a unique practical and ethical impact,” he said, “but to prosper it must continue, in the public interest, to drive the deployment of information and its ethical use.”
With the tenth edition of ICD-10-AM just around the corner, and ICD-11 creeping closer every year, there were a range of in-depth analyses of clinical classification from NCCH personnel such as executive manager (and celebrity HIM) Vera Dimitropoulos and classification support manager Anne Elsworthy, as well as shop-floor HIMs and clinical coders fascinated by the demands of their craft.
Activity-based funding (ABF) formed another eHealth theme, with a keynote and workshop on the view of ABF from the operational inside by John Pilla from NCCH partner KPMG.
Carol Loggie from the NCCH also updated the conference on the impending changes in the Australian Refined Diagnosis Related Groups (AR-DRG) for vVersion 9.0. This complemented the always-welcome update from the CEO of the Independent Hospital Pricing Authority (IHPA) James Downie, and IHPA’s director of classification Joanne Fitzgerald, also named amongst Cameron Barnes’ celebrity HIMs).
Workforce continues to be an inescapable theme at HIMAA NCCH conferences. Last year the conference separated itself out from the issue by holding a national Health Information Workforce (HIW) Summit in conjunction with the Australasian College of Health Informatics (ACHI) and Health Informatics Society of Australia (HISA). The report on that summit was published electronically by HIMAA and ACHI in July of this year, and launched in hard copy at the HIMAA AGM, held as part of the 2016 conference.
Summit outcomes were workshopped at the conference in the context of HIMAA’s 2015 positioning and advocacy toolkit to explore how members can implement workforce recommendations in their own work context. In HIMAA’s triennial membership census earlier this year, workforce had risen from second ranking in 2013 to front runner as the strategic priority for HIMAA; and up from third to first amongst strategic issues over the next five years. Members had also focused their thinking, identifying shortages as being at the hub of the workforce problem.
Once again in conjunction with the national conference, HIMAA, HISA and ACHI were joined by the Australian Library and Information Association’s Health Librarians Australia (ALIA HLA) group and the Australasian College of Health Services Management in holding a second HIW Summit designed to engage employers in the implementation of summit recommendations.
Research to develop a minimum dataset for HIW configuration and the development of a national capability framework for future HIW configuration negotiations between industry, education providers and the HIW peak bodies were amongst 20 recommendations from the 2015 summit to which employers in 2016 felt they could commit as achievable from now.
In launching the report at the HIMAA AGM, president Jenny Gilder stressed the extent to which the HIMAA board had listened to its membership on this issue, and believed the HIS summit report 2015 was the most comprehensive work on the subject HIMAA has ever produced. She acknowledged the contributions of fellow peak bodies ACHI and HISA in producing the summit, and thanked the HIMAA board’s workforce working group, chaired by Julie Brophy, for its stunning work in pulling the report together.
There were many other themes that caught the imagination of delegates at this year’s HIMAA NCCH conference – clinical documentation, HIM research, the My Health Record and the Australian Digital Health Agency's digital health strategy to name a few.
Attendances, topping the 400 mark, were at a record high, with networking ranking as the most valued aspect of the program by 95 per cent of delegates, up from 87 per cent in 2015.
Richard Lawrance is CEO of HIMAA.