Health Information Management
Health information management is a phrase used to describe the process of collecting and using data gathered by many different people in different places about services provided to individual patients or groups. Health information management describes both a process and a career choice in that people who are hired to manage health information are employed in a wide variety of health and health related settings.
People who choose to work in health related fields must have a working knowledge of the way health information is gathered, stored, retrieved, and used in today's marketplace. When a patient is seen by a health care agency, regardless of type, for the first time, basic demographic information is gathered by having the patient fill out a paper form, or by interview. Demographic information includes many things such as age, sex, marital status, address, phone number, social security number, insurance carrier, employer name and address, and next of kin. Each agency collects particular information for a reason. This data is then entered, saved, and stored in a computer. The computer is often networked or connected by a line that transmits the data to other computers within the agency or facility. The data can also be stored on a disk or in a special file, similar to a drawer in a filing cabinet, so the information can be used to collect facts and figures about the services provided by the agency at a later date. This data can be automatically sent to computers within the same building or at remote sites via telephone lines. The computer information can be accessed by other computers that are part of the network (shared function, software, and computer applications).
After the initial paper work or interview is completed, the patient is then directed to a diagnostic center, where a test is done to help the provider make a diagnosis, or to a therapeutic treatment center, where a particular treatment is given. It is usual that some additional personal information is collected at the center itself. This additional information will include particulars needed to provide a service to that patient in that specific center. As an example, if a patient is sent to a hospital for a chest radiology or x ray by a private physician, the patient fills out demographic information at the ambulatory admission desk. Then the patient is sent to the radiology department, where the technician enters the height and weight of the patient so the proper amount of energy is used to take the chest radiology x-ray correctly. The radiology xray machine takes the chest radiology x ray (a picture of the heart and lungs and the underlying structures) and puts the picture onto a film similar to the negative of a picture taken by a camera. The film is printed to a hard copy and/or the image is stored on a computer. The radiologist (a physician with special training) reads or interprets the chest x-ray and dictates the result of the film to a report. The report is printed and stored in the files in the computer. The results of the radiology x ray are also printed by the computer to a piece of paper that is mailed or transmitted to the patient's primary physician. The radiology department then initiates a request that the insurance company be billed for the cost of the service.
Data retrieval describes the process of accessing the stored information and then using the data for a specific purpose. In the example provided above, the billing department can access all of the different types of radiology x rays done in a day, and then issue a request for payment for these services. The payment can be sought from the individual patient, the private insurance company, Medicare for patients over the age of 65, or from Medicaid for patients who are on state public assistance. The radiology department can total up the number of radiology x rays of each type, for each day, to develop a report that identifies the volume of each particular service rendered for a specific period of time such as quarterly (every three months) or annually at the end of the year. The charge of the individual radiology x-ray can be handled in the same way.
This is a specific example of health information management. Although this is a brief description of how health information is managed, it does represent a rudimentary introduction to the process.
To expand on the concept of health information and how it is managed, the above example stated basic information is collected and stored. However, health information management includes evaluating the process of collecting and storing data, so that cost-effective and efficient changes can be made to improve outcomes or profits. The process can also be the transformation of a paper-based system into a high-tech computer database. Innovative approaches that might improve the system include developing a series of computer screens that are easy for the average patient or staffer to use. Computer screens modeled after those used by banks such as when people use an automatic teller machine (ATM) to get money out of their bank accounts are very easy to use. If the computer screens are carefully developed, the clerk in the admissions department is no longer needed to input the data about the individual patient, and thus a salary can be saved, or the staffer's time put to better use. Putting patient information into a database software package that can also be used to track billing charges allows manipulation of the data to provide more meaningful information to the facility or person using the data.
Within health care organizations, health information management is a task completed by assorted computer-literate individuals whose goal is to track costs, research, or services. Health information management professionals are people with advanced education, often at the master¸s degree level, who possess some knowledge of clinical medicine, patient records, national coding and classification systems, database software, and computer applications. The management professional integrates skills and knowledge to provide the agency, organization. or individual researcher with exact information. Thus, the way data is processed, analyzed, and reported back to users changes the overall outcomes for the agencies.
Health information management requires technical skills so that data manipulation provides useful reports. This means that a working knowledge of the integration of the data with database storage software and statistical analysis of the data is needed. The reports generated must serve as a communication link between many different individuals. Providers use information to make health care decisions, and health care facilities and organizations use it to make business decisions. Health information includes tracking data with the intent to make improvements in the system in some way, or to provide solutions to problems such as those related to research, planning, provision of care, and the evaluation of health care services. Thus the process of collecting and disseminating information must have a positive end goal, such as improving patient care. Outcomes that support quality patient care, medical research, health planning, health care evaluation, and financial reimbursement are a required component of the job. In the modern world of health care, an individual who develops and uses innovative approaches to solve problems, save money, or redesign work habits is highly sought.
The individual who is hired to manage health care information is required to have a working knowledge of medical ethics and the legal ramifications of inappropriate use of personal data. For example, the federal government is very clear about the rights of an individual patient, especially in medical research. It is imperative to store data in a way that protects the anonymity of the individual and his or her privacy rights when the data is accessed for research purposes. In addition, data must be stored to insure that confidentiality is maintained, and that access is denied to those individuals who have no need for the specific information about the individual patient. Data must be stored so that it can be used to compare a patient's care with standards of care and quality indicators, which are needed for evidence-based practice.
Those working with health information may be asked to produce a needs analysis, complete a systems analysis, or redesign the existing system, addressing quality of care, costs, care delivery processes, and financial questions. Tying reports to the volume of services, charges, costs, and reimbursements are current and future expectations. Managers of health information work in a wide variety of settings, such as with private physicians; in hospitals or nursing homes; with insurance companies, law firms, and government agencies; and for companies who specialize in information technology. In summary, the entire process of health information management is focused on securing, analyzing, and integrating the information so that it can used for a specific purpose.
Resources available about health information management are extensive. Universities, the world wide web, local hospitals, newspapers, and government agencies are resources that can be tapped to provide more specific information to the reader.
Haugh, R., and T. H. Thrall. "The Assault on Your Financials." Hospitals & Health Networks 74, no 1. (January 2000): 36-8, 40.
Hawkins, H., et al. "Conceptual Database Modeling for Understanding and Developing Information Management Applications." Radiographics 21, no. 3 (May-June 2001): 781-7.
Hobbs, G. R. "Data Mining and Healthcare Informatics." American Journal of Health Behavior 25, no. 3 (May-June 2001): 285-9.
Love, D. E., L. M. Paita, and W. S. Custer. "Data Sharing and Dissemination Strategies for Fostering Competition in Health Care." Health Services Research 36 (April 2001): 277-90.
Marietti, C. "Workflow Automation." Healthcare Information 17, no. 2 (February 2000): 62-4.
Moss, E. "A Bright and Challenging Future" Journal of Healthcare Information Management 29, no. 4 (2000):185.
Roos, L., and N. Roos. "Of Space and Time, of Health Care and Health." Journal of Health Services Research & Policy 6, no.2 (April 2001): 120-2.
Selsky, D. B., et al. "Knowledge Integration: Insight Through the E-portal." Journal of Healthcare Information Management 15, no.1 (Spring 2001): 13-24.
Carole Birdsall, R.N. A.N.P. Ed.D.