PAGE ◁ 1ADVOCATING FOR ICD-10 PAGE 7 | GRACE AWARD WINNER PAGE 8 | STUDENT MEMBERS SHINE PAGE 11

N E W A N D N O TA B L E

An overview of the latest news from AHIMA

NOVEMBER 30Fellowship Application Deadline

PERSPECTIVES MANUSCRIPTexplores HIE metrics

HEALTH LITERACYNew guide available

A ROADMAP FOR HIT IN LTPAC

Learn more

FREE AHIMA TOOLKITS AVAILABLE

Login to the BoK

DISASTER PREPAREDNESS RESOURCESAvailable now

BRIDGING THE GAP TO HIM DEGREES

Learn more

INSTRUCTOR MATERIALS FOR ALL AHIMA

PRESS BOOKSNow Available

LATEST ICD-10 NEWSKeep current

MANAGE YOUR CEUsVisit the CEU reporting center

continued on page 3

October 2012 | Volume 16 | No. 5

A D VA N TA G E

Meaningful use. Health information exchange (HIE) and the

Nationwide Health Information Network (NHIN). Certified electronic health records (EHRs). Affordable Care Act (ACA). No matter what you read or where you go, these hot topics are being discussed. But what do they have to do with each other? And to what extent should you, the HIM professional, study and understand these topics?

In a nutshell, the answer to the first question is that these four initiatives point to the same goal—improved quality of care for all Americans through better data. Data is the new bottom line. More specifically, the right data delivered to the right person at the right time will improve patient care over the next decade.

‘HIM Supports Care’To answer the second question, let’s allow the great American writer Maya Angelou to say it: “When you know better, you do better.” Essentially, understanding how all these pieces fit will inspire and motivate you to make better decisions each and every day. Like Kathy Callan, MA, RHIA, Director, HIM/Clinical Systems in the Information Systems Department at Gundersen Lutheran Health System in LaCrosse, WI, you can

use your newfound understanding to help guide your organization to

develop tools to support better health outcomes.

“What makes my work more rewarding than ever before is how my work supports care,” says Callan, a member of the AHIMA HIE Practice Council. “Meaningful use requirements, regional health information exchanges, and certified EHRs directly enable patients and care providers to have access to current patient information that will improve the quality of care and reduce medical errors. I don’t think there’s ever been a time in my 35-year career when there has been such direct connections between our work and better health for our patients, making an impact for our organizations in terms of quality care, and the potential to lower healthcare costs.”

AHIMA Resources at Your DisposalAHIMA’s authoritative, up-to-date resources are designed to help HIM professionals understand HIE from a global perspective. From Journal of AHIMA articles to publications, and new books coming out all the time, as well as live meetings, distance education courses, and opportunities to get involved in your local component state association, AHIMA is at your side.

MX7248_AdvantageOct12.indd 1 10/9/12 10:25 AM

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AHIMA ADVANTAGE

Some first steps might include exploring AHIMA’s HIE Resources Page. Read the book, Electronic Health Records (Fifth Edition 2012). If resources permit, attend AHIMA’s “Health Information Integrity Summit: The Quest Safe, Usable, Quality Data in EHRs” November 8–9 in Chicago.

Here is an in-depth curriculum for the HIE expert-in-training, as well as suggestions for how to put your newly won knowledge to work at your organization.

Discover the National Objectives The Affordable Care Act (ACA) is about more than just insurance. It calls for a national strategy for quality improvement in healthcare that will include Department of Health and Human Services (HHS) plans, goals, benchmarks, and standardized quality metrics. This national strategy is under development now and will pursue three aims that will guide and assess local, state, and national efforts to improve the quality of healthcare:• Better care—Make healthcare more

patient-centered, reliable, accessible, and safe.

• Healthy people/healthy communities—Improve the health of the US population by supporting proven interventions.

• Affordable care—Reduce the cost of quality healthcare.

Read a white paper on the national strategy; it also refers to six principles, which you can read more about in the 2012 annual progress report.

Linda Bailey-Woods, RHIA, CPHIMS, Director of Navigant Consulting, Inc. in Tampa, FL, has been following the development of the ACA’s national objectives and other initiatives closely.

“HIM is at the steering committee table on every one of the most pressing American Recovery and Reinvestment Act (ARRA) initiatives: HIE, meaningful use, and ICD-10. They are all predicated on the EHR and the data it contains. It is our responsibility to ensure the integrity and completeness of the data, as it is the ultimate measure of the effectiveness and success of these initiatives,” says Bailey-Woods, a member of the AHIMA HIE Practice Council.

Learn the Framework The Office of the National Coordinator for Health Information Technology (ONC) is the federal agency that is helping HHS guide the nation’s health information technology efforts. ONC’s Policy and Technology Framework for Health Information Exchange is one of the best expressions of how the nationwide health information network will be developed. Study it to learn how the pieces fit, and how your organization

COVER STORY CONTINUED ◁

AHIMA ADVANTAGE

MEMBER PROFILE 5

HIE Practice Council Member Has a Passion for Moving Healthcare Forward

AHIMA BEST PRACTICES 6Mapping and Data Conversion Best Practices

WASHINGTON WATCH 7

The Adocacy Challenge of ICD-10

FOR YOUR BENEFIT 8

AHIMA at Work for You

MEANINGFUL USE UPDATE 10

Analyzing the Meaningful Use Regulation

STUDENT MEMBER UPDATE 11

Getting Connected at the 2012 Student Academy

CERTIFICATION UPDATE 12

CCHIIM Responds to ICD-10 Final Rule

CATCH UP WITH COMMUNITIES 13

2012 House of Delegates Meeting a Success

AHIMA FOUNDATION 14

Innovation on Display at 2012 Convention

REAL WORLD 16

Meet the 2013 AHIMA Board of Directors

C O N T E N T S

A D VA N TA G EAHIMA ADVANTAGE STAFF: Jewelle Hicks, Nick Tipton

CONTRIBUTING WRITERS: Laurie Casey, Chris Dimick

© Copyright 2012 by the American Health Information Management Association. All rights reserved.

Share your feedback on AHIMA Advantage via e-mail at advantage@ahima.org

PAGE ▷ 3

continued on page 4

MX7248_AdvantageOct12.indd 3 10/9/12 10:25 AM

AHIMA ADVANTAGE4 ▷ PAGE

▷ COVER STORY CONTINUED

will ultimately function to support nationwide health information exchange. Find the framework at the ONC website.

Understand the Importance of InteroperabilityIf EHRs can’t speak to one another, then the goal of nationwide health information exchange will never be reached. Learn what it takes to develop an interoperable system and familiarize yourself with the standards that will shape it. Establishing standards for business, information, and technology architectures will provide an overall framework for interoperability, which is seen as the lynch pin for the nationwide health information network’s success.

Become familiar with the entities that certify EHRs, the standards group HL7’s efforts to develop a functional model, what functions should be in an EHR, and what’s involved in the clinical document architecture (CDA) standard.

Most physicians and hospitals have not yet invested in the hardware, software, testing, and training to implement advanced EHRs capable of interoperability. Learn why the current generation of certified EHRs are still evolving and that EHR products reflect the beginning stages. New updates with additional functionality will continually come to market in the HIE evolution. Communicate this

idea to your organization—that true health information exchange is on the horizon, but that the technology and thought leadership is still evolving. (See “Patchwork Regulations, Standards Complicate HIE.”) Major changes in business processes and practices will be needed throughout your organization.

Learn How to Report Quality InformationOne of the biggest challenges is getting an EHR system to report out the right data. The stakes are increasing each year under the meaningful use requirements. In stage 2, HHS calls for a qualified EHR to ‘‘capture and query information relevant to healthcare quality’’ and to ‘‘exchange electronic health information with and integrate such information from other sources.’’ While HHS is starting with nine clinical quality measures, eventually it will expect eligible providers and hospitals to report 64 specific clinical quality measures in order to qualify for incentive payments under Medicare and Medicaid.

HHS’ ultimate goal is that healthcare providers will have the improved means to track patient health improvement. If patients don’t improve, providers can intervene before the case becomes a costly emergency.

So what does this mean for the HIM professional? Acquaint yourself with

the meaningful use requirements and advocate for understanding how things like problem lists, medication lists, and allergy lists should be captured and reported according to meaningful use implementation guidelines. Own the enterprise master patient index (EMPI) and work to reduce error rates.

And, most importantly...

Advocate for Quality InformationHIM professionals have traditionally been advocates of accurate and reliable data. If you haven’t yet, it’s time to take these principles into the electronic age. In your organization, investigate how patient information is being captured and become aware of gaps and omissions in the data. Consumers expect the healthcare organization to do this, but IT specialists, clinicians, and others have their own sets of responsibilities and knowledge areas. HIM professionals are the best positioned for this type of consumer advocate role. Make sure that when you pull information, you’re not missing pieces, and that there is consistency across all the databases and data elements.

Read the AHIMA thought leadership paper, “Ensuring Data Integrity in Health Information Exchange,” which was co-authored by Bailey-Woods. Or, bring your passion and enthusiasm for data quality to a new position by exploring the Health Information Careers website.

One Step at a Time

Bailey-Woods and Callan didn’t come to their understanding of the new health information exchange paradigm over night. They’ve worked for years to put the pieces together. Like them, you can too.

“This past summer, my husband and I climbed a 14,400 foot mountain,” says Callan. “It was very much about one foot at a time. Back on the job, during very busy days, that’s how I approach learning about things that seem overwhelming: You take one article at a time, connect with one colleague at a time, and review one web site at a time.” v

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AHIMA ADVANTAGE ◁ 5PAGE

MEMBER PROFILE ◁

Kathy J. Westhafer, RHIA, CHPS, is the program manager of clinical information at Christiana Care Health System in Wilmington, DE. Christiana Care Health System was

one of the charter members of the Delaware Health Information Network (DHIN) and in 2007 became the first operational statewide health information exchange in the nation. Westhafer has a “passion for activities that move the healthcare industry—and HIM in particular, forward.”

Westhafer started her college career as a physical therapy major and discovered HIM (“or medical record administration as it was known back then”) while searching for an alternative to hands-on patient care. “After the first day as a volunteer in a physical therapy department, I realized quickly that hands-on care was not for me,” she said.

Making the Right Career MovesAfter making the transition, Westhafer moved up the HIM career path as an assistant and then director at mid-size to large organizations until about seven years ago. She became interested in the HIE aspects of HIM, but was patient instead of diving in head first. “Our then-CIO was looking to fill some new program management roles within IT. I had worked closely with him on a number of projects and he thought I may be a good fit for the clinical information position. Making the move was a hard decision because I enjoyed my former role. But in the end, I just couldn’t pass up the opportunity to help to shape our HIM future.”

Westhafer brings a variety of diverse skills to her position. “In my current role, I wear many hats, so I am working on several initiatives at the moment including ICD-10, electronic physician documentation, and the DHIN.” In addition, Christiana Care was a recent recipient of the highly competitive Center for Medicare and Medicaid Innovation grant which will be using EHRs, HIE, and the patient portal to improve outcomes for patients. “I’ve been really blessed throughout my career to have great mentors and wonderful opportunities to get involved in various organizations and projects that have been exciting and challenging,” Westhafer said.

Taking HIEs to the Next LevelAs the first operational statewide HIE in the country, the DHIN is committed to improving the quality of healthcare services throughout the state by sharing real-time clinical information among providers. “The DHIN started as a delivery service—the post office, if you will,” Westhafer said. “As the service was extended for inquiry and retrieval purposes, I was thrilled to be asked to the table to share my expertise. I have to give credit to those project managers who recognized the value of HIM involvement and invited each hospital participant to provide a HIM representative.”

Committed to LeadershipFor the past two years, Westhafer has served on AHIMA’s Health Information Exchange Practice Council. The practice council advises AHIMA leadership on national and state HIE initiatives as well as best practices in the areas of interoperability of health records, data integrity oversight, data and information exchange, patient identification, provider authentication, consent models, consumer engagement, network security, and privacy. The group identifies and evaluates how industry and advancing technology will affect the exchange of secure and accurate health information and interoperability in addition to the impact of health information exchanges on those who work in these environments.

In addition to her work with AHIMA’s HIE practice council, Westhafer is involved in the Delaware component state association, currently serving as treasurer and recently as president. In addition, she also serves on the advisory board for Delaware Technical and Community College and has been actively engaged in their coding program and the development of an HIM associate’s degree program. Westhafer also chairs the DHIN’s HIM committee which was formed to provide guidance and oversight on patient identity management, data integrity, access management, and HIPAA privacy and security issues.

Looking AheadWesthafer’s advice to AHIMA members is to be prepared by keeping current on HIE initiatives in your respective state and to pay attention to the progression of the nationwide health information network and the increase in the number of independent HIEs. “Keep abreast of activities through AHIMA and other industry resources. Take what you read and apply those good old fashioned HIM tenets and, by all means, take advantage of any opportunity to get involved.”

“I’m challenged every day by being on the forefront of a changing healthcare environment,” Westhafer said. “A colleague described it as building a bridge while you are walking on it because for most things that I am involved with, there’s not always a book or person to go to for an answer. It’s a matter of doing your research, keeping up with industry information, networking, and drawing on the basic health information tenets that we all learned.” v

HIE Practice Council Member Has a Passion for Moving Healthcare Forward

Kathy J. Westhafer, RHIA, CHPS

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AHIMA ADVANTAGE6 ▷ PAGE

▷ AHIMA BEST PRACTICES

After determining a strategy for transitioning to ICD-10-CM and/or ICD-10-PCS, adhering to best

practices will allow your organization to transition successfully. Many payers and providers have started translation projects using CMS general equivalence mappings (GEMs) as their foundation and spreadsheets as the tool to perform translations. Others have contracted with a vendor to provide either ready-made “canned” maps or services to manage the conversions. Internal maps created with tools, general equivalence, and mapping service solutions help provide differing levels of needed assistance for the migration from ICD-9-CM to ICD-10-CM/PCS.

Developing internal resources to oversee mapping projects is recommended for the most reliable and reproducible results. Providing service guidance costs less than commercial services and tooling used for the mapping can be reused for other mapping tasks.

Mapping Best PracticesSince translation of the entire ICD-9-CM code set is impractical and unnecessary, most organizations focus on specific subsets of codes for translation projects. From a financial perspective, it is useful to concentrate on high-volume and high-risk diagnoses. The high-risk codes can be gleaned from financial analysis reports such as those that simulate ICD-10-CM/PCS claims and identify those cases likely to shift reimbursement following the transition. Other areas of focus should relate to internal research areas or data warehouse needs.

Many providers have already made remarkable progress in working with an experienced vendor partner to create internal maps. A body of knowledge exists to provide guidance for creating applied maps, and companies or individuals with data mapping experience can successfully guide any organization through the process. Some of the recommendations from organizations that have already completed the process include.

Benefits, RewardsMany early adopters have discovered that the transition to ICD-10-CM/PCS provides numerous opportunities to improve current processes. Examples include clinical documentation, physician and coder satisfaction, increased data consistency, process governance, and the establishment of a single source of truth within the enterprise. Providers have recognized that a strategic approach enables early detection of fraud. Some organizations are concerned that if their processes are not improved now under the ICD-10-CM/PCS mandate, the opportunity to improve every business unit consistently and simultaneously will be lost.

Mapping GovernanceA final area to consider before initiating any translation project for implementing a code set is a data governance process. An application that incorporates and provides the ability to manage and maintain maps will assure consistency and track accountability with structured communication and defined processes.

Organizations often require guidance from an experienced vendor in prioritizing remediation activities, creating an organizational foundation map, reviewing and refining unit-specific remediation outcomes, and providing end-to-end testing and outcomes analysis. A knowledgeable vendor will utilize a qualified project manager, assure

appropriate resource training and include a pilot program. With a veteran vendor and solid tested tools, your organization can not only achieve your organization ICD-10-CM/PCS implementation goals, but also improve your business processes so that your practices are more efficient than ever.

Best Practices for Creating Applied Maps Between ICD-9-CM, ICD-10-CM/PCS» Focus on high-dollar and high-volume

diagnoses and procedure codes

» Use GEMs as the foundational map since it is 99 percent accurate

» Consider the reverse GEMs maps for added specificity

» Include research such as coding guidelines and instructional notes as map heuristics

» Review reimbursement maps to validate reproducibility and reliability

» Keep projects small where possible

» Plan for automated workflow and review

» Follow an enterprise-defined governance process

» Research additional codes by key word search and code roots to identify additional codes not included in GEMs v

Mapping and Data Conversion Best Practices

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AHIMA ADVANTAGE PAGE ◁ 7

Advocacy is defined as the pursuit or influencing of outcomes, the active support of a cause. ICD-10

has been a cause for AHIMA for many years and our advocacy challenge is not yet complete. Although the compliance date delay was limited to one year, from October 1, 2013, to October 1, 2014, a major challenge still remains. The challenge before us involves educating a largely resistant physician community and assisting them with implementation.

AHIMA, following the recommendation of the State Advocacy Council, is developing the AHIMA CSA ICD-10 Advocacy Initiative. The objective of this initiative is “to develop and identify specific resources to assist AHIMA’s Component State Associations and members with education and outreach to the provider community to assist with their implementation and understanding of ICD-10, its benefits, the need for clinical documentation improvement and the ultimate impact on the revenue cycle. Resources will be developed or identified that not only guide the CSA on its outreach strategy but will also include resources to assist the provider community.” It is our goal to go live with this initiative in January 2013.

This initiative will be a challenge, a challenge where AHIMA will be calling upon the CSAs and AHIMA members to be advocates, or ambassadors, to the physician community on ICD-10.

Identifying Key ElementsIn developing this initiative, AHIMA has identified three key elements that are being addressed:

1. What will AHIMA do? Determine what needs to do to guide the CSAs in their front-line role of working with physician groups in the states

2. What resources will be provided to CSAs? Identify and develop resources for CSAs for outreach to physician groups

3. What resources will be provided to physicians? Identify and develop resources for physicians to educate and advise on ICD-10 implementation

The Role of AHIMAFor this initiative to be successful, AHIMA will need to provide direction and support to the CSAs. With the physician community largely being the last stalwart against ICD-10, AHIMA needs to do an effective job of defining to the CSAs the need for outreach and who should be the target of that outreach. Defining the need and how we achieve it requires that we address several questions:

• What are the benefits of this effort? • What are the consequences if we do not

take on this effort? What are the HIM consequences? What are the industry consequences?

• What are our milestones and how do we reach them?

• What is our communication and incentive plan?

Resources from AHIMA for CSAsFor this initiative to be successful, it is incumbent upon AHIMA to provide the CSAs with resources that will not only assist in educating HIM professionals on how to get started, but also to provide detailed information on what resources we have to help the physician community. We will need to provide the following guidance and outreach:

• How the CSAs should approach other groups to educate and train their members

• Specific information on how to educate and train others

• Examples from CSAs who have done outreach

• Sample scripts, letters, and presentations

• Potential groups to approach and opportunities for outreach.

Next, we will need to provide detailed information to the CSAs on AHIMA and what ICD-10 resources we have to offer. These resources are wide-ranging and many are readily available on our website. All that we need to do is push people there.

Finally, to measure success, we will need to develop a tool to track the progress of this initiative. Specifically, we will need to measure the level of outreach completed by our CSAs.

Resources for the Physician CommunityAHIMA has long seen the need to and benefit from migrating to ICD-10. We have produced resources to assist with this transition and implementation.

Not only do we have expertise on staff, we have ICD-10 expertise in our membership. We need to utilize this expertise to assist with implementation. In presenting our resources to the physician community, AHIMA will follow its already published phased approach where physician groups can choose their starting point for education and training:

1. Implementation plan development and impact assessment

2. Implementation preparation

3. “Go live” preparation

4. Post-implementation follow-up

In addition, we’ll also provide the basics by including presentations and information on understanding ICD-10, why it is necessary, and frequently asked questions. AHIMA, the CSAs, and our members are uniquely placed throughout the country to be advocates to the physician community and many other groups. Our healthcare system is changing rapidly and our time is now! ICD-10 is a prime opportunity for us to enhance our relationships and showcase our expertise and leadership capabilities. v

The Advocacy Challenge of ICD-10

WASHINGTON WATCH ◁

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AHIMA ADVANTAGE8 ▷ PAGE

E V E N T SUPCOMING MEETINGS

MULTIPLE DATES AND LOCATION AVAILABLE

AHIMA Trainer Academy for ICD-10

MULTIPLE DATES AND LOCATION AVAILABLEAHIMA Coder Workforce

Training for ICD-10

OCTOBER 12–13AHIMA: Progressing HIM

Professionals to the Future

OCTOBER 16Genitourinary System Coding in ICD-10-CM

OCTOBER 18Coding Genitourinary System

Procedures in ICD-10-PCS

OCTOBER 23Applications of ICD-10-PCS

Root Operations

OCTOBER 25Change Management and

the Switch to ICD-10

OCTOBER 25–26AHIMA: Progressing HIM

Professionals to the Future

NOVEMBER 2–3AHIMA: Progressing HIM

Professionals to the Future

NOVEMBER 6Coding for Obstetrics in

ICD-10-CM/PCS

NOVEMBER 8Coding for Injuries and

Poisonings in ICD-10-CM

NOVEMBER 8–9Health Information Integrity Summit: The Quest for Safe, Usable, Quality Data in EHRs

NOVEMBER 151012 Coding Clinic Updates

NOVEMBER 17–18AHIMA: Progressing HIM

Professionals to the Future

DECEMBER 4–5Certified Documentation

Improvement Practitioner (CDIP) Exam Prep Workshop

Las Vegas, NV

▷ FOR YOUR BENEFIT

University of Wisconsin Hospital and Clinics Wins Inaugural AHIMA Grace AwardGrace Award judges selected University of Wisconsin Hospital and Clinics as having the most innovative approaches to HIM and the winner of the first AHIMA Grace Award. The award was presented to University of Wisconsin leadership on October 2 during AHIMA’s annual Convention in Chicago.

Finalists included:• Boston Children’s Hospital • Cleveland Clinic Health System

• Vanderbilt University Medical Center

Honorable mentions included:• Banner Health

• BayCare Health System

• Children’s Hospital Colorado

• Henry Ford Health System

• New York-Presbyterian Hospital

• Springfield Clinic, LLP

• Truman Medical Centers

Keep watching for how you can participate next year.

AOE Yields Reality 2016 OutcomesThe Council for Excellence in Education, AHIMA, and the AHIMA Foundation would like to thank members, leaders, and educators for their thoughts and feedback regarding Reality 2016 at the 2012 Assembly of Education Symposium. Based on the feedback received by these parties the CEE has initiated two new advisory groups to assist with the advancement of Reality 2016.

1. Graduate Resources Alliance—Advisory group to the CEE and foster a collaborative community of graduate level health information educational program, advise in the development of graduate curriculum, assist in developing a national network of educators and resource partnerships.

2. Associate Education Coalition—Advisory group to the CEE and foster a community of associate level health information educational programs, advise in the development of associate level curriculum and specialty programs, develop a national network of resources and partnerships.

The CEE will continue to request feedback from members through scheduled webinars and a special educational session at Convention.

Fellowship Application Deadline is Coming SoonThe next application deadline for AHIMA Fellowship is November 30. The AHIMA Fellowship Program is a program of earned recognition for AHIMA members who made significant and sustained contributions to the profession. Apply today using the online application form.

Take the Next Step in LeadershipIf you are interested in being considered for a 2013 elected volunteer position, visit the AHIMA Web site and complete the Application to Serve today. Review the descriptions of available volunteer positions on the Volunteer Opportunities page. Elected positions include the Board of Directors, Commissioners and the Nominating Committee. You can be a part of AHIMA’s legacy of leadership. Consider nominating yourself for the AHIMA Board of Directors, or as the next President-elect. Applications for elected positions are due March 29, 2013.

AHIMA’s Free Career Prep Webinar Series ReturnsAHIMA is committed to the success of its members. For students and new grads just getting started in the profession, we want to prepare you for landing that first job and beginning your HIM career. For more seasoned professionals, we want to empower you to seek a promotion or apply for a new position. Because we know your career is important to you, please save the date for the next webinars: November 19 from 1–2 p.m. ET and December 5 from 1–2 p.m. ET. Registration information will be sent closer to the date and included in an upcoming issue of the weekly e-alert. For those members who cannot attend, recordings will be made available at a later date.

In MemoriamBarbara J. Hawkins, RHIT, of Redford, MI, died in April 2012.

•

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AHIMA ADVANTAGE PAGE ◁ 9

E V E N T SAHIMA AT WORK FOR YOU ◁

DECEMBER 6CY13 CPT Updates

Visit www.ahima.org/events for more information on these and other AHIMA meetings.

The following memorial gifts were made to the AHIMA Foundation between July 1 and September 11.

In Memory of Harlan E. BaldwinKimberly A. Baldwin-Stried Reich, RHIA, FAHIMA, MBA, MJ, PBCI,

CPHQ

In Memory of Diana L. Burns, RHIAKaren Bakuzonis, PhD, RHIA

In Memory of Melissa D. Cannon, RHIAChristy R. Hileman, RHIA, CCS

In Memory of Ruth B. Daniels, RHIABetsy J. Shiland, RHIA

In Memory of Rita M. Finnegan, MA, RHIA, CCSEllen B. Jacobs, PhD, RHIA

In Memory of Rose GirardGloryanne H. Bryant, RHIA, CDIP, CCS, CCDS

In Memory of Gail P. Hall, RHITMattie G. Wilson, RHIA

In Memory of Dana Harris, MSW, RHITMichigan Health Information Management Association

In Memory of Barbara J. Hawkins, RHITMichigan Health Information Management Association

Renew Your AHIMA Membership TodayThere are three easy ways to renew your AHIMA membership—online, by mail, and by phone at (800) 335-5535. AHIMA is committed to your success and provides the benefits and resources to enhance your career. Renew your membership today and continue to utilize AHIMA’s many member benefits and resources. Including some newly designed and recently launched benefits, including the AHIMA mentor program and Career Assist: Job Bank. We appreciate your support and look forward to another year of partnering with you to support your professional endeavors and deliver opportunities to advance your career.

Order ICD-10 Online Course Collections, with Extended Access through 2014The ICD-10-CM Coding: Online Course Collection includes the 6-CEU ICD-10-CM Overview: Deciphering the Code course plus 22 one-hour courses focused on the specific chapters of ICD-10-CM. Coders in all settings will benefit from this thorough study of ICD-10-CM coding. The ICD-10-PCS Coding: Online Course Collection consists of the 6-CEU ICD-10-PCS Overview: Deciphering the Code course plus 10 shorter courses focused on the root operations and medical and surgical-related procedures of ICD-10-PCS. Coders in inpatient acute care settings will benefit from this thorough study of ICD-10-PCS coding. Register for either course collection before November 1 to retain access to the course material through 2014 as a reference—even after you have successfully completed the courses.

Get Ready for the Future and WinAHIMA’s regional meetings “Progressing HIM Professionals to the Future,” will help you prepare for the changing healthcare landscape by enhancing your knowledge and skills in data analytics, ICD-10-CM/PCS planning and implementation, and clinical documentation improvement. During this two-day interactive meeting, AHIMA experts will provide you with the information you need to efficiently, and effectively transition your skills for the future and help you identify new and emerging career paths. Attendees will be entered into a drawing to win an iPad. One iPad will

be given away at each meeting. Visit our calendar of events for dates and locations.

Mark Your Calendars for Health Information Professionals Week 2013AHIMA invites all health information professionals to join the celebration and be recognized during the 24th annual Health Information Professionals (HIP) Week. Formerly known as Health Information & Technology Week, HIP Week will be held March 17–23, 2013. A planning kit for the 2013 HIP Week will be available beginning in January.

New HIE Publications Available• e-Discovery and Electronic Records• A Practical Approach to Analyzing

Healthcare Data • CHDA Reference Guide • Clinical Documentation Improvement:

Achieving Excellence• Documentation for Health Records (replaces

Documentation for Medical Records)

New CDI Resources AvailableClinical documentation improvement (CDI) programs were formed to facilitate appropriate reflection of the quality of patient care while increasing accuracy in coding and reporting. AHIMA offers free CDI resources, including tool kits, practice briefs, and articles to support CDI efforts. In addition, AHIMA has introduced the Certified Documentation Improvement Practitioner credential, which distinguishes professionals’ skills relative to clinical documentation in the patient’s health record. Find eligibility requirements and exam preparation here.

Free HIM Toolkits AvailableHIM toolkits provide practice guidance on some of the hottest topics challenging HIM today. The free toolkits include helpful tools such as sample templates for policies and procedures, forms, and workflow processes. They are created with the in-depth knowledge and experience of subject matter experts throughout the industry. Some of the topics covered include ICD-10, recovery audit contractors, and EHRs. AHIMA members can click here to access all the toolkits. v

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AHIMA ADVANTAGE10 ▷ PAGE

In late August, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National

Coordinator for Health Information Technology (ONC) published some much-anticipated final regulations. In just a matter of days, the CMS issued the Electronic Health Record Incentive Program Stage 2 (meaningful use) and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets final rules, and ONC issued the Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record (EHR) Technology 2014 Edition final rule.

Healthcare industry stakeholders were anxiously awaiting these regulations, as preparing and implementing the requirements for ICD-10-CM/PCS had essentially trickled down to very little activity and the program conditions for meaningful use stage 2 were urgently needed to move forward from stage 1 and maintain momentum with EHR adoption among providers and hospitals.

Breaking Down the RegulationOne item of particular importance was the revelation in creating the term “Common MU Data Set” by ONC for certification. They received several comments during the proposed rule stage stating much of the same data in the “view, download, and transmit to a third party,” “clinical summaries,” and both “transitions of care” certification criteria were repetitive and why couldn’t ONC develop a single definition that included this common data and then reference that definition in the applicable criteria. The table above outlines the required data which comprises the new common set of data.

Breaking Down Objectives, MeasuresAs discussed in the proposed regulation, CMS retained the concept of “core” and “menu” set of objectives and associated measures. They also discussed the intent of transitioning all of the menu set of objectives to the core set and adding some new measures to the menu set. The final regulation presented two menu objectives that did not make the final cut to the Core set with good reason, which CMS describes in the rule.

The “capability to submit electronic syndromic surveillance data to public health agencies” remained within the menu set for eligible providers as CMS’ experience demonstrated with stage 1 that few public health agencies do not have the ability to electronically accept syndromic surveillance data; therefore they believed the current infrastructure doesn’t support moving this objective to the core set.

The second menu objective which remained was the “record advance directives” for eligible hospitals and critical access hospitals. CMS expressed their continued concern about potential conflicts between storing advance directives and existing state laws. The HIT Policy Committee Meaningful

Use work group expects to conduct a day of hearings regarding this subject area to explore this topic and associated challenges further in order to inform the requirements for meaningful use stage 3 and beyond.

CMS replaced the following objectives, provide patients with an electronic copy of their health information and provide patients with an electronic copy of their discharge instructions with objectives and measures for stage 2 that enables patients to view online, download, and transmit to a third party their health information and hospital admission information.

The two measures that correspond with this objective for eligible hospitals and critical access hospitals must both be met in order to satisfy this requirement. CMS reduced the amount of time in which a patient’s health information must be made available online to the patient or their authorized representative, to within 36 hours of discharge.

Despite folding the two objectives stated above into this single objective, stage 1 required copies of health information be provided within three business days and copies of discharge information at the time of discharge. The eligible providers must provide online access within four business days after the information is available but with the ability of the provider to withhold certain information at his or her discretion.

Stay tuned to AHIMA for the latest meaningful use updates. v

Analyzing the Meaningful Use Regulation

▷ MEANINGFUL USE UPDATE

Common MU Data Set1. Patient name 2. Sex3. Date of birth 4. Race5. Ethnicity 6. Preferred language7. Smoking status 8. Problems9. Medications 10. Medication allergies11. Laboratory test(s) 12. Laboratory value(s)/result(s)13. Vital signs 14. Care plan field(s), including goals and

instructions15. Procedures 16. Care team members

“CMS expressed their continued concern about potential conflicts between storing

advance directives and existing state laws.”

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AHIMA ADVANTAGE PAGE ◁ 11

STUDENT MEMBER UPDATE ◁

AHIMA student members have a bright future with so many opportunities in the HIM profession. The options are almost endless as students map their future career

paths as new professionals—perhaps a foray into privacy and security, venturing into data governance, or working in EHR implementation. AHIMA strives to do its best to support students’ success through online benefits and resources, like the new career prep webinar series and the new HIM Career Map, as well as through in-person events.

The largest event for AHIMA’s Student members is the Student Academy which takes place at AHIMA’s annual convention. The Student Academy is a free educational session for AHIMA student members included in their convention registration fee. This special interactive session includes speakers on student-focused topics like starting a career in HIM, getting certified, and making the most out of the convention experience. Student attendees also met with AHIMA mentors who provided advice on starting a career, networking, and more.

Highlights from the Student AcademyThis year a record number of over 150 students participated in the Student Academy on September 30. AHIMA president-elect Kathleen Frawley, JD, MS, RHIA, FAHIMA, provided opening remarks and words of wisdom and encouragement to the student members who make up the not only the next generation of HIM professionals, but also the next generation of AHIMA leaders. She also advocated the importance of continuing your education in HIM to advance your career.

Another presentation highlighted the importance of getting certified. AHIMA’s senior certification manager Jonathan Santos, RHIA, discussed the importance of early testing to help students get ahead. Santos told students that “you’ve done the hard part by getting your degree; taking advantage of early testing is the easy part.”

Members of the Student Advisory Council Share ExpertiseAnother highlight of the day was the presentations by AHIMA’s Student Advisory Council (SAC). All six SAC members presented briefly on areas of interest to them and to their student colleagues. Presentation topics included study tips to prep for your certification exam, continuing your education in HIM, non-traditional HIM careers, getting involved beyond the classroom, and explaining the value of HIM to others.

The students shared not only research and facts, but their real-world experiences, and provided the audience with useful knowledge to put into action. As Kayla Zirbes of the College of St. Scholastica said in her presentation, “you can never stop learning and building on your skills in HIM.”

It was also apparent from the smiles on their faces and the discussions that were quite hard to interrupt that many students really enjoyed the mentor-facilitated breakout sessions. “The students were thrilled to talk to real-life HIM leaders from various organizations, geographic locales, and backgrounds about the vast array of opportunities in HIM,” said mentor Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P.

Mentors enjoyed the conversations as well. “As an HIM professional, the opportunity to work with HIM students is as rewarding for me as it is for the students. It’s an opportunity to help students have a better feel for what HIM really is and the limitless possibilities available to them. I wish this had been available to me when I was a student,” said Kathy DeVault, RHIA, CCS, CCS-P.

AHIMA’s chief executive officer Lynne Thomas Gordon, MBA, RHIA, FACHE, CAE, shared her guidance and expertise with the student attendees in the closing remarks. Her message to the student attendees was focused on how to achieve professional success. She inspired the students with her remarks which emphasized that education is the key that unlocks your future.

She then outlined 10 characteristics of success and told stories and gave inspiring examples of each trait. She provided students interview tips and even conducted a demonstration of the correct way to shake hands, something important for all professionals to know. The students left the day’s session on a high note, inspired by Thomas Gordon’s address, and with the power to make their future a success. v

Getting Connected at the 2012 Student Academy

Members of the Student Advisory Council got a chance to meet AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, FACHE, CAE, at the 2012 Student Academy.

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AHIMA ADVANTAGE12 ▷ PAGE

▷ CERTIFICATION UPDATE

With the recent announcement from the Department of Health and Human Services

(HHS) that the implementation deadline for ICD-10 will be October 1, 2014, the Commission on Certification for Health Informatics and Information Management (CCHIIM) has released the following information:

• RHIA, RHIT, CCS, CCS-P, and CCA will launch as ICD-10 compliant exams on April 1, 2014

• CDIP will launch an ICD-10 complaint exam on July 1, 2014

• CHDA and CHPS will launch ICD-10 complaint exams on January 1, 2015.

What are CCHIIM’s ResponsibilitiesThe most important role of CCHIIM is overseeing test development for AHIMA certification exams. The commission decides the measurable skills and knowledge that HIM professionals will be tested against to determine competency. The commission also ensures that AHIMA certification exams are valid, reliable, and legally defensible.

There are several processes that are completed to ensure that all AHIMA certification exams meet these high standards.

Exam Development Committees (EDC)• Job analyses• Examination blueprints and specifications• Item writing, review, revision, and

approval• Maintenance of certifications

For more information please refer to the CCHIIM Exam Development webpage.

Examination Blueprints and SpecificationsCertification exams are based on exam blueprints that define the knowledge, topics, and tasks that will be tested on the exam. Job analyses (performed every three to five years) serve as the foundation for the examination blueprint. First, individual competencies are grouped into domains that represent specific and similar areas of content. Next, the percentage weighting of each content domain is determined. Domains with competencies that have higher criticality scores (more important or more frequently performed) typically represent a larger percentage of test items than those domains with lower criticality scores for its respective competencies.

The Role of Exam Development CommitteesExam Development Committees (EDCs) evaluate the certification exams each year. The experienced, credential-specific subject matter experts who serve on these committees represent HIIM leaders, practitioners, and other relevant stakeholders. EDC responsibilities include recurring review of content relevancy, both item-level and examination-level performance data, and expertise with respect to establishing the cut score for their respective certification examinations. Exam Development Committees meet annually to ensure that the examination is current and that content is accurate.

Are you interested in learning more about test development? For more detailed

information on test development, please visit the CCHIIM web site.

Certification Exam Eligibility Updates by CredentialCHPS and CHDARevised eligibility requirements are now in effect! Candidates are now able to sit for the CHPS and CHDA exams with the pre-requisite combination of education and experience. For more details on the new eligibility requirements, for more information please visit www.ahima.org/certification.

CCS and CCS-PBeginning on January 1, 2013, the CCS and CCS-P exams eligibility will be expanded to require the following:

Candidates must meet one of the following eligibility requirements:

• By credential—RHIA, RHIT, or CCS/CCS–P

• By education—completion of a coding training program that includes anatomy and physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding; or

• By experience—minimum of two years of related coding experience

• By credential with experience—CCA plus one year of coding experience

• Other—coding credential from other certifying organization plus one year coding experience

For any questions regarding the CCS or CCS-P eligibility changes, please contact certification@ahima.org. v

CCHIIM Responds to ICD-10 Final Rule

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AHIMA ADVANTAGE PAGE ◁ 13

CATCH UP WITH COMMUNITIES ◁

More than 220 CSA delegate leaders from across the country met for the 66th

House of Delegates (HoD) meeting held in conjunction with the AHIMA Convention and Exhibit. HoD activities took place on September 29-30. The HoD on-site meeting brought the best in profession governance, professional development, and opportunities to network with and learn from fellow delegates. The HoD has been on an exciting journey of change and progress this past year.

The meeting was led differently compared to previous years as there was no parliamentarian, no classroom style seating. or on-site voting. Instead, the program included activities and opportunities for delegate engagement in discovery, discussion, and collaboration. Through hands-on work and application, the on-site meeting proved to be an important step toward implementing the roles and responsibilities of delegates in governing and advancing the HIM profession.

Topics for the annual HoD business meeting included:

• Background of the HoD journey of change

• Envisioning collaborative activity, identifying and validating trends to help guide strategy

• Discussion of House leadership charges and opportunities

• Advancing HIM priorities through advocacy and leadership

• Importance of public relations and the CSA, values and tactics for delegates

• Affiliates report on initiatives and activitiesThe HoD meeting welcomed internal and external speakers to present on various topics to help inspire and ignite “big picture” thinking and a new way for delegates to collaborate and work. Special guests included Pamela Lane, MS, RHIA, CPHIMS, the California Deputy Secretary of Health Information Exchange, who offered an insightful and inspirational talk about being engaged in your career and HIM. Dorothy Pirovano from PCI led an interactive session on the value of public relation strategies and tactics and how delegates can utilize PR at a state level.

During CSA sharing, delegates provided their feedback on ideas stemmed from the all-day meeting. Some of these takeaways included conducting environmental scanning locally at CSA meetings to decide which issues are affecting their states and sharing that information with

membership. One CSA suggested hosting a state-wide essay contest for mega issues. All essays would be published in a booklet to be distributed and available for their CSA members.

The HoD meeting also offered opportunities for members to join and support their CSA delegate(s) and were welcomed to observe the meeting on Setember 30. In addition, members of the Student Advisory Council also took advantage of this unique opportunity to listen and observe their state leaders in action during the afternoon activities.

Outcomes from the strategic work sessions and results from the business meeting will be reported in the State Leaders and House community on the Communities of Practice (CoP), topic 2012 House of Delegates Meeting in Chicago, IL. v

2012 House of Delegates Meeting a Success

AHIMA members network during a break at the 2012 House of Delegate meeting.

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AHIMA ADVANTAGE14 ▷ PAGE

Innovation on Display at the 2012 Convention

▷ AHIMA FOUNDATION

Ideas that transform industry can come from any level of the workforce, and in health information

management, this type of change can lead to radical improvements in quality of life and patient care. With an eye towards exploring new and innovative approaches and technologies, AHIMA and the AHIMA Foundation welcomed attendees of the inaugural Health Information Innovation Leadership Conference. AHIMA members, members of the C-suite, healthcare professionals, venture capitalists, owners of start-up companies, and other individuals interested in the rapidly changing health information landscape participated in this informative and interactive event.

Innovation in ActionThe Innovation Conference, sponsored in part by TrustHCS, was held October 2–3 at the 84th AHIMA Annual Convention and Exhibit in Chicago, IL. Featuring two half-days of dynamic presentations by recognized leaders in their fields, the event combined moderated discussions and demonstrations, and offered opportunities for interaction and collaboration on innovation in healthcare.

Geared towards showcasing innovative progress in workforce development, academia, and the corporate and governmental spheres, the event included keynote speaker presentations from John W. Kenagy, MD, MPA, ScD, FACS; the author of Designed to Adapt and Wil Yu, Senior Advisor, Innovation, City and County of San Francisco.

Innovation Speakers• Richard F. Averill, Senior Vice President

of Clinical and Economic Research, 3M Health Information Systems, Inc.

• David S. Hanekom, MD, F.A.C.P, C.M.P.E, Chief Medical Officer, MDdatacor

• Nicole Y. Lamb-Hale; Assistant Secretary for Manufacturing and Services, U.S. Department of Commerce, International Trade Administration

• Joseph W. York, PhD, MBA, National College Dean, College of Health Sciences, DeVry University

Warren Jones, MD, FAAFP; Medical Director at Provider Resources, Inc. and Immediate Past Executive Director at MIGMH and Distinguished Professor of Health Policy at the University of Mississippi Medical Center; and Richard Kneipper; Interim CEO and Chief Strategy and Innovation Officer at Anthelio Healthcare Solutions, Inc. served as moderators for the event.

In addition to this impressive list of speakers, six “Innovators” were selected using a double-blind selection process from a pool of more than 30 who submitted abstracts. The selected presenters were offered the opportunity to introduce their new concepts and innovative technologies, and vie for the 2012 AHIMA and AHIMA Foundation Innovation Award. The award recipient was Jonathan D. Katz, CEO of MedAdherence, Inc., who presented on October 3.

The other presentations by the Innovators focused on:

• John S. Eberhardt III, DecisionQ Corporation; Developing Quality Insights Using Registry Modeling

• Jonathan D. Katz, CEO, MedAdherence, Inc.; Using the Mobile Phone to Help Improve Patient Engagement and Outreach in Underserved Populations

• James Maisel, MD, Chairman and CEO, MediSapien; Natural Language Processing: An innovative, disruptive technology for ICD-10 Coding, Secondary Data Use, and EHR Data Capture

• Naveen Sarabu, Director of Product Management and Strategy, Liason Healthcare Technologies; Speeding healthcare interoperability through cloud-based integration and data harmonization

• Robert Teague, MD, Physician Advisor, Dell Healthcare & Life Services; Advancing Meaningful Use through Healthcare Analytics Innovation

• Susan P. Trewhella, RHIT, CPC, Associate Vice President, Revenue Management, Geisinger Health System and Dee Lang, RHIT, Vice President, Product Management & Strategy, Precyse; Geisinger Health System’s Best Practices in Computer Assisted Coding: CAC Deployment to Support Improved Coding Efficiency and ICD-10 Preparations

In addition, patient rights activist and artist, Regina Holliday, created a painting offering a visual representation of the patient’s view of concepts discussed during the conference.

Bill Rudman, PhD, RHIA, executive director of the AHIMA Foundation and vice president of education visioning for AHIMA noted that “These two days have allowed us to showcase some of the ‘big ideas’ and trends that will shape the future of healthcare, going beyond health information, and opening doors to looking at how innovation in other industries can shape our own.”

Following the success of this year’s Innovation Conference, AHIMA and the AHIMA Foundation are already looking forward to next year’s meeting and the opportunity to explore new areas of HIM. v

Jonathan Katz was announced as the winner of the 2012 Innovator Award at the AHIMA National Convention. Pictured left to right are Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA; Jonathan Katz; Lynne Thomas Gordon, MBA, RHIA, FACHE, CAE; and Peter Enko, JD.

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PAGE ◁ 15

Join AHIMA for this two-day meeting, bringing together thought leaders and policy makers to explore:

As more health information is captured electronically and healthcareinstitutions are required to manage “bigdata,” the challenges to health information integrity are growing.

» The relationships between information integrity and data governance.

» How information integrity affects healthcare transformation—new care and payment models.

» Policy and/or standards needed for health information integrity and governance

» The impact of ICD-10 on documentation integrity

» Analytics and the use of data to ensure healthinformation integrity and quality care

» Other topics related to the use and integrity of health information in EHRs

Register today at ahima.org/eventsMX7257

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AHIMA ADVANTAGE16 ▷ PAGE A H I M A A D V A N T A G E

The 2013 AHIMA Board of Directors was announced in the August 2012 issue of AHIMA

Advantage. The group will begin their three-year term on January 1, 2013. AHIMA Advantage recently spoke with the new Board members about their thoughts on serving on the AHIMA Board of Directors. Look for these Board members next year and view the current list of AHIMA Board of Directors here.

“ I am so grateful to have the opportunity to serve my profession as AHIMA President/Chair-elect. It’s a role I have dreamed about for a long time. I feel honored that my colleagues have chosen me to represent the profession. It’s with great delight that I embark on this wonderful, professional journey.”

—Angela Kennedy, EdD, MEd, MBA, RHIA, CPHQ,

AHIMA President/Chair-elect

“ I consider being elected as a director on the AHIMA Board an opportunity not only to serve the association and membership, but as a way for me to help guide the path of the HIM profession as we respond to the many challenges that impact our world of health information management. My passion is to demonstrate the value of health information professionals and to help us excel in today’s changing healthcare environment.”

—Susan W. Carey, RHIT, PMP, AHIMA Director

“ I am excited that AHIMA members have voted me to a Board of Director position with AHIMA. I hope to show that their confidence in me is well placed by being an active Board member who brings forward ideas and concerns of AHIMA members for consideration by the Board.”

—Dana C. McWay, JD, RHIA, AHIMA Director

“ Becoming a member of the AHIMA Board allows me the opportunity to have a voice in shaping the future of the HIM profession. As the healthcare industry continues to change and transform, I hope to strategize the advancement of HIM professionals to be industry leaders in this age of technology and information.”

—Cindy Zak, MS, RHIA, PMP, FAHIMA, AHIMA Director

“ It is an honor and a privilege to serve as Speaker. The Speaker’s role is to serve as a dutiful and impartial bridge between the House of Delegates and the Board of Directors. Toward that end, I will stay in close contact with the Speaker-elect, and together we will help to move AHIMA forward by working collaboratively together to have HIM professionals recognized as the leaders in all matters related to information governance, privacy and security.”

—Kimberly A. Baldwin-Stried Reich, MBA, MJ, RHIA, CPHQ, FAHIMA,

AHIMA Speaker of the House

REAL WORLD ◁

Meet the 2013 AHIMA Board of Directors

The 2013 AHIMA Board of Directors met at the 2012 House of Delegates meeting. Pictured (left to right) are Angela Kennedy, EdD, MEd, MBA, RHIA, CPHQ; Susan W. Carey, RHIT, PMP; Dana C. McWay, JD, RHIA; Cindy Zak, MS, RHIA, PMP, FAHIMA; and Kimberly A. Baldwin-Stried Reich, MBA, MJ, RHIA, CPHQ, FAHIMA.

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