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Cost, Efficiency And Expertise Challenges For Health Information Management Today And In the Future

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Laureen Miller & HIM Outsourcing | Medical Records Associates

The Growth In HIM Roles

In just 10 short years, the times have changed and with those changes the challenges facing today’s healthcare organizations are impacted by the speed of technology and continued decreasing revenue margins. When we think back to Health Information Management (HIM) Departments a decade ago, we were focused on managing a medical record that was hybrid, electronic and paper, yet still very paper intensive requiring staffing resources and physical space. Today’s challenges are comprised of:

  • Conversion to and/or implementation of new Electronic Health Records (EHR)
  • Education and training of staff for ICD-10 proficiency
  • Recruitment of knowledgeable, experienced staff in compliance and privacy standards
  • Coding and billing compliance based upon regulations with the Medicare Administrative Contractors (MAC), Recovery Auditors (RA), Office of Inspector General (OIG) and multiple state and payer agencies
  • Staff productivity and accuracy with document scanning
  • Disclosure management and safeguarding Protected Health Information (PHI)
  • Staff layoffs due to the demands to continually improve efficiency and do more with less

Positives To Outsourcing HIM

With these challenges executive leaders responsible for HIM departments now have the opportunity to utilize third parties and outsource these functions. Building a partnership with an outsourced HIM service provider can deliver essential expertise to healthcare organizations and save valuable dollars in staffing and physical space requirements. For smaller community based hospitals, whether part of a larger system or independent, outsourcing key functions can afford savings to the organization and present highly trained, credentialed staff to meet the challenges outlined above. The positives to outsourcing HIM department operations include:

  • Improved staff productivity based upon implementing industry best practices
  • Credentialed HIM management team with expertise in The Centers for Medicare and Medicaid Services (CMS) Conditions of Participation as well as accrediting standards such as The Joint
  • Commission and DNV-GL (CMS approved deeming organizations for Hospital Accreditation)
  • Well versed team in healthcare compliance and HIPAA risk areas
  • Credentialed, certified coders, proficient in ICD-10, charge capture and physician coding
  • Integration of Clinical Documentation Improvement (CDI) teams with coding staff
  • Dedicated management team to effectively manage day to day operations and ensure limited coding, scanning and release of information backlogs
  • Reduction in HIM resources by utilizing virtual office staffing models where appropriate
  • Variable HIM staffing costs eliminated and department costs allocated to outsourcing partner
  • Focus on quality as well as quantity in each HIM functional area
  • Expertise for EHR conversions to ensure best practices are implemented in the future state for the highest standard of clinical care documentation
  • Use of Key Performance Indicators (KPIs) and best practices for executive leaders to measure the return on investment (ROI)
  • Shared savings models structured to improve ROI
  • Onsite staff that recognizes they are part of the hospital team and provide top quality HIM services

Partners For HIM

The role of HIM has shifted from a task oriented environment to one of data integrity and data analytics. Embracing technology and utilizing it to drive efficiency in the HIM arena is key for a successful healthcare delivery system in the future. The ability to utilize virtual staffing with the use of technology brings the best staffing resources to HIM departments without the challenges of competing for talented resources in the local market. Executive leaders responsible for HIM should consider, cost of staffing and resources, operating efficiency and the expertise required to implement best practices with the goal of continually improving the quality of services provided to the care team and patients. A partnership with the right HIM outsourcing vendor who is forward thinking and looks out for your best interest today and in the future can be an enhancement to your operation. Saving valuable resources that can be dedicated to other organizational strategic initiatives is key to continued success of healthcare in the future.

Contact MRA For Our Professional Services In Outsourcing Health Information Managment

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