Before attending my first session ever of an American Health Information Management Association convention, I wanted to get the word from the trenches.
Not being a shy person, I walked up to a table of three attendees at the Sunday night pre-convention reception, introduced myself and invited them all to dinner.
As much as any profession in healthcare, it seemed to me, the 50,000 or so medical records specialists who AHIMA claims as members are a group in transition whose very jobs are threatened by the advent of information technology in healthcare. Templated electronic medical-records systems and computerized coding software empowered by natural language processing that can read and comprehend text documents could be to many medical records professionals what a spike-driving machine was to John Henry, or at least so I thought going into the conference.
But I didnt get a sense of panic from my dinner guests. Quite the contrary. All three women -- the predominance of AHIMA members are women -- exuded the quiet confidence of people secure in the knowledge that they know their jobs well and that they know the importance of their work.
Proper reimbursements, claims approval/denial rates, legal compliance, errors monitoring, quality improvement, accurate clinical documentation -- all of the basic blocking and tackling of a healthcare enterprise -- start or are just one step removed from and are essentially dependant upon what AHIMA members do.
Two of my dinner guests had been hip-deep in healthcare IT evolutions at their facilities, and they both expressed a seasoned, if not jaundiced, skepticism about the breathless claims of IT system vendors and their cheerleaders. Theyve been to the mountaintop and seen not so much a promised land, but a confused, sweaty climb. They know how imperfect the vendors software and their vaunted installation and implementation schemes have really been. So, for them, separating the IT hype from the reality is one issue far more pressing than job insecurities.
Another issue was privacy. Several of the women expressed skepticism of the official AHIMA policy in support of a single national healthcare privacy standard -- questioning whether it would afford the same protections of the various, more stringent state privacy laws now permitted under the Health Insurance Portability and Accountability Act. None of my dinner guests said they could cite an example in which variance in state privacy laws had caused them any problems in digitizing their record systems.
Ill give AHIMA credit though on being proactive on healthcare IT in other areas. Ive been writing about healthcare information IT for six years, and I learned a lot from attending the AHIMA sessions and speaking with IT vendors and users at the show, which was held in a cold and rainy Denver from Oct. 9-11.
One of the goals I set for myself before the show was to learn as much as possible about computerized coding. AHIMAs Susan Fenton, a manager in the organizations practice leadership division, has made herself an expert in the field. And while, less than 10% of healthcare organizations use true computer-assisted coding in which the software reads the text and recommends an appropriate code, according to Fenton, AHIMA already has exhibited leadership in the field. In September, it hosted a national a summit on the technology, which could lead to an effort to establish national standards for the software systems.
During the conference, I met Patricia Brown, a senior coder with Comforce Coding Services, Tampa, Fla., who seemed to personify the AHIMA zeitgeist: a mix of skepticism and pragmatism. Brown said she has been coding for 18 years.
She and I had just finished watching a demonstration of a computer-assisted coding software program that could read and code a two-page physicians report in about a second. I asked her What do you think?
"I'm scared, but I'm impressed," she said.
The system demonstrator, a physician from New Zealand who founded his coding software company more than 10 years ago, pledged that the technology should be seen as a boon to coders in that it will eliminate much of the grunt work of routine coding cases, thus ennobling the profession. It would transform coders to editors and auditors of those cases and elevate them to more highly-valued specialists who only will be called upon to put human eyes on the tougher, more complex medical reports.
But Brown had seen this movie, too.
In theory, she said, it sounds very logical."
Except Brown said shes seen technology implemented before by healthcare systems focused on using it to improve the bottom line, while paying only lip service to improving the quality of output and patient care. (Think offshore transcription.)
Right now, she said, The backup systems are human beings. But, as often happens, when the technology comes online too fast, jobs are slashed and expertise is lost. Now, if the systems should crash, you dont have those people to help. But we have to embrace technology and face change."