Health information management (HIM) is a unique concept within Healthcare Administration and Finance that differentiates the industry from others. It encompasses health sciences, information technology, policy, law and business approaches. Changing government requirements, healthcare regulations and insurance and reimbursement models further complicate the task. The increased demand on administrative staff to keep up with these changes while managing the patient clinical and financial experience may lead to a decreased operational efficiency, revenue management or even gaps in compliance.
Having a good team of HIM professionals by your side will help your organization to manage and disseminate essential information to internal and external stakeholders for decision-making, improved quality and reporting, compliance and revenue management.
AJHC Financial Partners HIM professionals use their knowledge of the industry to form the link between clinicians, administrators, technology designers, and information technology professionals, by incorporating the disciplines of medicine, management, finance, information technology, compliance and law into the practice. Our team of HIM professionals will work in lockstep to update and educate your internal team about industry intricacies, ensure the most efficient RCM process possible while being in line with compliance. When possible, automating some of the processes can significantly reduce administrative and time burdens.
AJHC Team will work with your practice on the following areas under the HIM umbrella: REVENUE CYCLE MANAGEMENT (RCM), INFORMATICS and DATA ANALYTICS and INFORMATION GOVERNANCE and COMPLIANCE.
Healthcare Informatics is defined as “the integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information” (Saba & McCormick, 2015, p. 232).
Current demand in the field is being fueled by the healthcare industry’s focus on evidence-based medicine, quality improvement, and data security and accessibility for patients. President Obama signed the American Recovery and Reinvestment Act (ARRA) into law in 2009. This law includes the Health Information and Technology for Economic Clinical Health Act (HITECH). HITECH formulated the Meaningful Use (MU) program under the Centers for Medicare and Medicaid Services (CMS). Meaningful Use shifted into the Merit-Based Incentive Payment System, or MIPS, in part due to the introduction of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. These incentive programs are now a part of Medicare Promoting Interoperability Program. They all started by incentivizing providers to use their Electronic Health Records (EHR) and reporting patient care quality measures by financially rewarding them when demonstrating their use, but also posed a threat by penalizing them if not used in the future. Many similar changes constantly happen in the healthcare field, as we move towards the Value Based Healthcare (Value-Based Programs , or VBP, by CMS), while standards for data management, security and integrity get more stringent. Policy makers are now able to utilize electronic data submitted by healthcare providers to Managed Care Organizations or other stakeholders to inform their decision-making about public-health issues and needs.
The information modernization undoubtedly leads to positive results, such as enhanced delivery of care, prevention and disease management on a bigger scale, improved health outcomes and advanced patient education. However, with any innovation there are challenges, whether foreseeable or coming to light after unveiling of the new process or a product, in the form of clinical, administrative, or policy implications. The key to continually improving the process is rooted in setting attainable benchmarks and regularly measuring results.
AJHC Financial Partners supports healthcare systems and providers in changes required by the changes in policy and healthcare modernization (HITECH) to implement innovative systems, workflows and applications with smoother transition and better outcomes. We do so by training the key stakeholders, creating templates and automating the process, where possible.
Overregulated in every direction, Healthcare infrastructure brings dozens of variables into play. Rapidly adapting to progression in artificial intelligence, data security standards, data management and integration with other systems, organizations grapple with existing rules and regulations. With every change in policy, there is a new set of specific security and compliance provisions to be fit into the current workflow. The stakes are high, so are the risks and penalties. Providers who do not adapt at the initial learning curve stage, find themselves in a trapped chaotic state until they find a team of professionals to step in and stabilize their businesses (reactive approach clients), while others look for ways to improve the processes and drive efficiency and automation (proactive approach clients). Over and over AJHC Team has been recognized for making the terrifying compliance process a breeze, sometimes a fun learning process, becoming true partners for healthcare providers and finance teams.
