Case Study: Pam is the Director of Health Information Management in a 450-bed acute-care teaching facility with multiple ambulatory clinics and physician office practices throughout the region (Tri-State area). HIM was decentralized in all of the ambulatory care clinics and physician office practices but now the new CEO felt it was more cost efficient for all HIM processes to be brought under the main HIM department this fiscal year starting 6/30/18. The following functions fall under HIM and:

1) Coding - inpatient, outpatient surgery, observations, ambulatory clinics, ED and physician office coding. Coders have a multiple certifications: APC, CCA, CCS, CCS-P, RHIT and RHIA. Coders are not cross trained. Inpatient coding staff is short 3 - 4 coders. All the hospital coders work remotely. The coders for the ED, ambulatory clinics and physician offices work within the offices but they are physically decentralized throughout the organization. 2) Transcription - Transcription is performed by multiple outside vendors and is interfaced into the electronic health record at all sites. Transcription from the vendors comes into a central repository and two HIM clerks move the reports into the correct patient encounters. Duplicate medical record numbers are a challenge for the transcription clerks and often reports are not interfaced into the correct patient encounters. 3) Discharge Processing - All health records are electronic but the physician offices operate utilizing a different system than the main hospital and ambulatory clinics. HIM employees review electronic health records to ensure that all documents are present and signed within the EHR. Physician office staff review physicians' records to ensure that they are complete. 4) Document Imaging - HIM is responsible for ensuring the quality of the document images but much of the scanning is disseminated throughout the healthcare organization. 5) eMPI Integrity - HIM manages the electronic Master Patient Index (eMPI) for the organization. Two full time individuals perform eMPI clean up on a daily basis. Patients with duplicate medical record numbers has increased by 15% when the physician offices and ambulatory clinics were centralized within the healthcare organization's eMPI. 6) Data Analytics - HIM provides statistical data on healthcare outcomes and quality measures both internally and externally. The HIM Director has difficulties finding individuals who have the healthcare analytics background to perform the duties that are needed for the healthcare organization. Datamining and data visualization skills are not strong for the two RHIAs performing the jobs currently. 7) Release of Information - HIM now is performing release of information for the hospital, ambulatory clinics and physician offices. As noted above the physician offices use a different EHR platform so policies and procedures for ROI are significantly different in this setting. Creating printable reports from the EHR at the hospital has always been challenging but even more challenging within the physician offices. The hospital employs RHITs to perform ROI but ROI at the ambulatory clinics and physician offices were just trained on the job with no formal HIM education.

QUESTIONS A. Make a Health Information Management Health IT and EHR Mission and Vision Statement that matches the overall organization's strategic plan b. Make a Health IT and EHR Strategic Plan that aligns with the overall organization's plan but is specific to the needs of the HIM department. c. Perform environmental scan of health IT and EHR topics that are impacting healthcare and HIM. d. Select a Strategic Planning Model and outline a brief strategic plan for HIM specifically addressing the health IT and EHR needs for HIM. f. Develop a SMART Goal for meeting the strategic plan you have outlined