According to knowyourphrase.com, the phrase, “Where the Rubber Hits the Road” means “When a theory or idea is put to the test to see if it actually works.”
More and more often when I finally catch an elusive HIM Director on the phone, I am referred to the IT department. No one in particular, just The IT Department. To me this is the equivalent of being shown the back door. Whenever I get relegated to IT, my plea is always the same, “but they’re not familiar with the unique HIM challenges addressed by Extract’s automation software! We solve HIM issues, not IT issues, so they won’t care.” This response has a zero percent success rate of furthering the conversation.
Although a call with IT is always the second or third step in the sales process, IT is never the first point of contact - unless of course a CIO is engaging Extract to achieve HIMSS Stage 7. This isn’t to say that Extract doesn’t have an appealing message for IT - quite the opposite. We are not “just one more vendor” with a point product solution. Extract offers an interoperability safety net across a healthcare system by converting unstructured and non-interfaced documents into discrete data, making data actionable and EMRs more meaningful. Even this value proposition tends to fall on deaf ears without a department head championing us to IT.
So not only are HIM Directors more often referring solution providers (that could help them) to IT where the value proposition is irrelevant, but what is even worse is IT is pushing out software solutions without first consulting their HIM Director.
Even the CIO effort to achieve HIMSS Stage 7 (a true technological achievement), which entails using data warehousing and advanced analytics to share clinical information, cannot be done without IT engaging the HIM Director. You could say that IT and HIM are opposites but complementary. IT manages software and technology to move data and automate processes, while HIM manages people and physical/manual workflows to address what couldn’t be streamlined by IT.
Historically, HIM Directors were the ones making buying decisions for new technology and services, but this changed as meaningful use began to drive the institution of certification requirements. That change shifted decision making to the IT department and HIM Directors became less influential in choosing their own HIM applications.
What could possibly go wrong?
The recent article in the Journal of AHIMA, Fail-Safe: HIM Experts are Essential Early in the IT Adoption Cycle by Mary Butler, illustrates the pitfalls when IT bypasses HIM Directors. The article cites a 2017 study published in the journal Procedia Computer Science that, “healthcare technology projects fail 70 percent of the time”; and a report from the Fox Group that estimates, “at least 20 percent of EHR implementations, usually the most consequential technology investment in most health organizations, fail due to software incompatibility, technical implementation failures, lack of a return on investment, and other people-related issues.”
If implementations move forward without consulting the HIM Director, it is only a matter of time until the project slows down - either before or after go-live - until all the challenges presented by the HIM department are addressed, i.e. complex workflows, compliance issues, accountability and employee productivity metrics. Because directors’ expertise incorporates everything from pre-admit scanning, admission, concurrent or post discharge scanning, coding, claims, and denial management, their input is critical throughout an implementation and beyond to predict and head off any issues.
Of course, the role and expectations of an HIM Director differs in every health system. The biggest variable is the latitude the director is given to initiate change. Some systems still have a “Medical Records Director” which connotes a medical librarian and is reminiscent of 1938 when AHIMA was known as American Association of Medical Record Librarians (AAMRL) and its members were known as medical record experts or librarians who studied medical record science.
Ideally, the HIM Directors who have been granted latitude embrace technology and meet with vendors to continually look for innovative solutions to optimize their department. They will champion the vendor to their IT group and convey the solution’s value specific to HIM. Needless to say, HIM departments have a unique set of requirements and problems that a one-size-fits-all solution pushed out by IT won’t address.
Because so much accountability falls on HIM Directors, they can’t stand by and have decisions made for them, nor can they let IT projects move forward without their involvement. HIM Directors have unique and comprehensive qualifications combined with an understanding of terminology and classification systems, data integrity, data analysis and data management - all critical when IT solutions eventually have to mesh with HIM processes and work queues without adversely affecting productivity.
Ultimately, it is the HIM Directors and their staff who have the invaluable experience and foresight into “the last mile” of an implementation - where the rubber hits the road.
About the Author: Eric Olson
Eric is a Regional Business Development Manager at Extract Systems with more than 10 years of experience in the healthcare technology marketplace. His healthcare background includes data backup, disaster recovery, SaaS, value-based care, HIM process improvement, regulatory guidelines, and quality analytics. He earned a bachelor’s degree from Skidmore College in Saratoga Springs, NY and enjoys hiking and camping in our national parks. Eric engages and challenges his customers to find ways of leveraging technology to streamline workflows, improve processes and ultimately reduce costs. Eric is committed to being accountable and responsive to his customers, focusing on developing long-term relationships because he understands that his customers are buying from him as much as they are buying from Extract Systems.