Winter Team Talks Update
by:  Karla Philippou, RHIA, CCS, CCS-P, CHCC
FHIMA Chief Delegate

On March 21, I attended winter Team Talks with Michelle Mock.  Team Talks are held twice a year and are free to AHIMA members.  Summer Team Talks are always in Chicago, but Winter Team Talks are held in various cities, usually at 4 or 5 different cites.  Members receive 2 CEU’s for attendance and learn about what’s happening and contribute to the strategic plans of our professional organization.  It’s an excellent opportunity to see what other states are currently doing, how they do it, and who helps them to do it.  As we network with others, we exchange a great deal of information and form new friendships.

Bryon Pickard, AHIMA president facilitated the meeting.  He reminded us of Dr. Brailler’s words at the national convention in Denver that HIM professionals need to be “larger, louder, faster” as we continue to increase awareness of our knowledge, expertise, and skill in the healthcare arena.  As AHIMA strives to become larger, louder, and faster, Sandy Fuller gave an overview of the value of membership.  AHIMA has as a part of its strategic plan, four key priorities:  e-HIM, Leadership Engagement/Impact, Building Value, and Grow & Strengthen AHIMA.  With 51,000 members currently, AHIMA strives to improve customer service, retain membership, and recruit new members.  Target areas for member recruitment are: current members, new graduates, previous “associate” members, health IT, consultants, and physicians office managers and others interested in HIM.

Key Focus Initiatives

In e-HIM, AHIMA has e-HIM workshops, task forces, and practice councils.  All work toward the establishment of an electronic health record, standards in classifications and terminologies, the personal health record, and privacy and security.  It works with federal groups, as well as, other organizations such as, AMA, AHA, MGMA, and AMIA promoting standards for the use of healthcare data.  AHIMA continues to be a leader in HIM through many new associate, baccalaureate, and masters programs, continuing research and development of graduate programs, and through is virtual lab to prepare students for the work setting.  AHIMA builds value through career building resources with it publications, books, and seminars and workshops.  FORE offers e-HIM workgroups, grants-in-aid, scholarships, applied research, triumph awards, and its FORE library.  The challenge is to engage members to get the education they need and demand a seat at the table. 

In addition, the policies shaping HIM practice and the speed of change were discussed.  Members should be attuned to e-alerts from AHIMA regarding the development of a legal EHR and an anticipated public comment period beginning sometime this spring.  The Office of the National Coordinator (ONC) still has the prevention, detection, and prosecution of healthcare fraud as a priority.  AHIMA is sponsoring legal EHR conferences in June and October in collaboration with IT and healthcare attorneys.  We need to align ourselves with other associations and professionals in Health Information Exchange (HIE).  As states like Florida continue toward the adoption of an HIE, HIM professionals are needed to ensure the privacy and security of the health information, and to examine the laws, policies and business practices of such information exchange.

AHIMA and AMIA continue to push everyone to have their own Personal Health Record (PHR).   An article in USA Today featured a joint effort by AHIMA and AMIA with guidelines on the Personal Health Record (PHR).  Many employers, insurers, individual companies and even WebMD have created versions for PHR.  Some act as free repositories of the information, others may have fees, and/or passwords to access the information.  AHIMA is continuing its efforts to train and educate individuals on the importance of a PHR.  There are multiple products available to the consumer and informing the consumer of what should be present in a PHR is essential.

There are a number of quality reporting initiatives that require oversight and alignment with health information management core values.  President Bush’s executive order of August 22, 2006, requiring the implementation of Information Technology in Federal Healthcare Programs; the CMS Value-Based Purchasing Plan, which provides incentives to hospitals based on performance; the CMS 2007 Physician Quality Reporting Initiative (PQRI), which is pay-for performance in the physician setting are just a few examples.  Without quality data collection and input, as well as, feedback from users of the data and the reliability and usefulness of the data, these programs will not work.  HIM professionals are key players and need to stay attuned to change.

And, of course, there are ongoing efforts to advocate for the adoption of ICD-10.  AHIMA continues to work towards any HIT or healthcare legislation bills containing language requiring the adoption of ICD-10.  The question is not if ICD-10 should be adopted, but when.  ICD-9-CM has exhausted its space and there is no room for additional codes, which leads to codes being placed anywhere in the classification without regard to the appropriateness of its placement there.  So watch for current legislation and be prepared to contact your legislators to show support for its adoption.

Preparing for the future

So as an HIM professional you need to talk “louder.”  Promote yourself and your profession.  Let others know what you do.  Talk “larger.”  Let others in on the knowledge base we possess, and how we can help problem solve, and move health information into the 21^st Century.  Talk “faster.”  Help others realize the need for more HIM professionals.

We can promote ourselves, train the future workforce, form alliances with other healthcare professionals, and adopt and adapt to the future of the Electronic Health Record.  Let’s take Dr. Brailler’s words to heart and toot our own horn.

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Building a Stronger Organization 
by:  Karla Philippou, RHIA, CCS, CCS-P, CHCC

Look down the road ten years from now and speculate about the future of FHIMA.  The current leaders may no longer be involved.  Strategies need to be put in place to guarantee continued growth and interest in FHIMA.  What needs to be done now to ensure the strength and viability of FHIMA in the future? 

FHIMA 2007 

Currently, there are 2,873 Active, Graduate, Honorary and Student members, and 984 more credentialed professionals who are not members of FHIMA or AHIMA.  Inclusive membership was passed at the October 2006 HOD.  FHIMA will be adopting these bylaws changes in June and with it the opportunity to diversify.   

Florida was the first CSA to conduct its own Hill Day.  Other states have followed in our footsteps and the increasing importance of state and national legislation is obvious.  Couples that with AHIMA’s own Hill Day and legislative efforts, and it is apparent that more legislators recognize the Health Information Management professional and their expertise.   

Florida’s Health Information Infrastructure Initiative has also need the input of HIM professionals.  AHIMA has worked closely with Florida, and Governor Crist recently requested support from FHIMA to assure appropriate privacy and security of healthcare data, as our state and the nation move towards the electronic health record.  There is no more exciting time to be an HIM professional.

Building a Future

Building a stronger organization requires continued growth, fresh ideas, new leaders, new skill sets and knowledge, and openness to change.  Members must be willing to share information, broaden their horizon, and encourage questions, even when there are no answers.  How can it be done?  Many times organizations are too busy with running the business to drive an organization in a new direction.

In an article from the Wall Street Journal, “Leadership From Below,” the traditional organizational chart with downward direction is disparaged in favor of the horizontal organization.  Peer connection provides important feedback that can lead to customers, suppliers, and others outside the organization.  Building on the strength and knowledge of the group brings in fresh ideas.  Keeping the group in focus becomes the job of the leader, who may be someone from below.  Such will be the focus of the HOD issue groups in June.

Delegates will brainstorm to create new avenues to leadership at the regional and state level.  Looking forward to the next decade, FHIMA will need all of those students who are currently seeking HIM credentials and more.  Where will HIM be in ten years?  Who will be its leaders?  What alliances need to be forged and what knowledge base needs to be tapped?  Delegates will look at strategic plans for their regions and for the state and look to the future.  Delegates will help FHIMA bridge the gap, adopt inclusive membership, stay abreast of legislative issues, and most importantly, grow new leaders.

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FHIMA Bylaws Need a Facelift
By: Dwan Thomas Flowers, MBA, RHIA, CCS
2007 Bylaws Chair

As many are well aware, the American Health Information Management (AHIMA) “Inclusive Membership” consideration was passed. As a result, this positions each Component State Association (CSA) to take a serious look at its bylaws.  Since FHIMA is once such CSA, a comprehensive review of its bylaws is in order.  With its commitment to align with AHIMA’s bylaws, the most severe change is the reduction in the number of membership categories. Additionally, FHIMA considers suggested changes from its membership, and there are a few, minor changes suggested to better reflect the current operations of the association. 

First, the effects of Inclusive Membership are addressed. Prior to the change, there were five (5) membership categories, but the Associate and Corporate membership categories have been removed. In the new environment, there are now only three (3) membership classes—Active, Student and Honorary:

An Active member can be any individual “interested in the AHIMA purpose and willing to abide by the Code of Ethics” who is “employed and resides in the state of Florida or who is employed or residing in another state and selects Florida for association membership.” These members (credentialed or not) can vote, hold certain offices, can serve as Committee Chairman or committee members and can serve as members of the House of Delegates.

A Student member consists of any individual who holds student membership in AHIMA and is formally enrolled in an AHIMA accredited or approved program and selects the state of Florida for his or her association membership.  These members are not entitled to vote, hold office, serve as Committee Chairperson or as a member of the House of Delegates.

Still, another decision that will be up for discussion is whether or not the FHIMA President and President-Elect shall be a credential holder. According to a recent announcement from AHIMA’s President, Bryon Pickard, “based on the AHIMA bylaws that give the CSAs the explicit right to set their own qualifications for their officers, it was decided that CSAs may determine if the CSA President is an Active member and/or a credential holder.”  A vote during the 2007 FHIMA House of Delegates session will finalize the decision.

Other proposed amendments received thus far include a revision to the Elections section to add electronic balloting procedures to the bylaws.  Basically, the proposal is to have the Executive Director “to provide access to the electronic ballot for one designee, as appointed by the Management Steering Committee, who shall verify ballot results along with the Executive Director.”  This would replace the paper process of the Chief Teller meeting with all appointed tellers to tabulate valid votes and destroy those deemed invalid due to receipt after the deadline, when electronic balloting is used.

Another proposed change, if passed, will shorten the time frame in which proposed bylaw amendments must be submitted from the current 120 days to 90 days.

Thus far, this summarizes the major proposed and mandatory changes.  A proposal for amendment may be submitted by the Board of Directors, the Bylaws Chairperson, any Active member or any Regional Association.  Please share your opinions or ideas to contribute to the facelift.  If there are other proposed changes to the bylaws, please submit the changes to: Dwan Thomas Flowers, Bylaws Chairperson, via e-mail: HIMprofexcel@bellsouth.net or to Carolyn Glavan, Executive Director via e-mail: info@fhima.org.  Only the FHIMA House of Delegates has the power to amend bylaws and articles; thus, proposals for amendment must be submitted for prior approval before they are submitted to the membership for adoption.

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Capitol Hill 2007
by: Karla Philippou, RHIA, CCS, CCS-P, CHCC
      FHIMA Chief Delegate

Michelle Mock and I attended AHIMA Hill Day in Washington, D.C. on March 20.  There were one hundred twenty-two attendees from thirty-seven component state associations.  These people met with one hundred seventy-seven congressional representatives or aides.  It was all very exciting!

On Tuesday afternoon, AHIMA provided a two hour briefing of our advocacy issues.  Don Asmonga, Director of Government Relations; Dan Rode, Vice President of Policy and Government Relations; Sue Bowman, Director, Coding Policy and Compliance; and Alison Viola, Director, Federal Relations; each spoke of those specific areas of advocacy that needed to be emphasized during our visits.  On Wednesday morning, Michelle and I attended a breakfast briefing where we received packets with our appointments schedule, summary of key talking points, and materials to be distributed to our congressional staff members.  We had three appointments and one drop off.  We visited the offices of Senators Bill Nelson, and Mel Martinez, and Representative Gus Bilirakis.  We dropped of information to Representative C.W. Bil Young.

At the end of the day, AHIMA held a reception in the Rayburn Building for our alliance partners, and those policymakers we had visited during the day.  Only a couple actually attended, since both houses of congress were in session.

Michelle and I had never attended Hill Day before, but when we met with the staff members of our congressmen, it was obvious that they were familiar with AHIMA.  It was refreshing to be able to discuss our advocacy issues without having to first explain who we were and why we were there.  It was very thrilling to see our legislative process at work and to feel that we might be able to personally influence the outcomes.  It was an honor to represent AHIMA and FHIMA at the 2007 Capitol Hill Day.  I was amazed at the number of states who sent four or more representatives, including Oklahoma, Tennessee, and Georgia.  Having more board members attend Hill Day allows for more continuity with key legislators and advocacy issues. 

Key Advocacy Issues of AHIMA’s Policy and Government Relations Team

Adoption of HR 1467, the “10,000 Trained by 2010 Act”

• Authorizes the National Science Foundation to award grants to institutions of higher education to develop and offer education and training programs

• AHIMA is seeking Senate sponsorship of the bill

• Helps to address the workforce shortage of HIM professionals that projects a 49 percent growth in the number of HIM workers by 2010

• Authorizes grants for research and informatics research centers

• Help to establish or improve undergraduate and master’s degree information programs

Genetic Information Nondiscrimination Act

• House (HR 493): 216 bipartisan cosponsors

• Senate (S.358): 26 bipartisan cosponsors, including Senator Bill Nelson

• Prohibits enrollment and premium discrimination based on request or receipt of genetic services

• Prohibits requiring genetic testing

• Prohibits collection and disclosure of genetic information

• Makes HIPAA applicable to genetic information

• Covers health plans and insurers, employers, employment agencies, Medicare supplemental policies, and others

Health Information Technology and ICD-10-CM and ICD-10-PCS

• No main bills yet in our new congress

• S.628, the Critical Access to Health Information Technology Act (Sen. Coleman, R-MN) includes language for adoption of ICD-10

• Any IT bill needs language providing for adoption of ICD-10 by October 1, 2011

• Currently, the United States is the only industrialized nation not currently using ICD-10, which limits comparability with data from other countries

• A modern classification system is key component of other current initiatives;

  • Quality measurement

  • Biosurveillance

  • Pay-for-Performance initiatives

  • PPS refinements (APR-DRGs)

  • National health IT strategy

  • Patient safety improvement efforts

Health Information Infrastructure, Health Information Technology and Electronic Health Records

• US needs a standard electronic health record (EHR) and data that can facilitate the primary purpose of supporting quality clinical care and through automated architecture, as well as provide secondary data to facilitate a variety of purposes including quality monitoring, injury prevention, public health and biosurveillance monitoring, medical research, reimbursement, and healthcare policy making.

• The US needs to have and use a coordinated, integrated, and standardized set of terminologies and classifications to support its HIT goals.

• The US needs a properly funded and maintained health information infrastructure (HIE) to facilitate the confidential exchange of standard primary data for healthcare delivery—the EHR—wherever an individual may need it.

• The US needs a statutorily authorized office (Office of the National Coordinator), under the Department of Health and Human Services, that can coordinate the development and construction of such an infrastructure within the federal government and in the private sector, so that the existing multiple efforts can be done effectively and efficiently

• The Personal Health Record (PHR) needs to have standards in order to ensure interoperability

• AHIMA and AMIA advocate empowering individuals to manage their healthcare through the use of PHRs

• Every person should have control over how their PHR information is accessed, used, and disclosed.  All secondary uses of PHR data must be disclosed to the consumer, with an option to opt-out, except as permitted by law.

• PHR products should be certified by CCHIT to comply with data standards, include a minimum data set, identify each data’s source, and meet security criteria consistent with HIPAA.

• Representative Patrick Kennedy (D-RI) is currently sponsoring HR 1368, Personalized Health Information Act of 2007.

As you can see, there is a great need for HIM professionals to actively engage their congressional leaders to advocate, educate, and assist them, both on the Hill and back home in their districts.  Never before has your voice been recognized as it is now.  We need all of you.  There is a lot of work to be done, but the payoff is rewarding:  greater recognition, more demand for HIM professionals, and better salaries as we advance into the future.

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