- To ensure hospital ratings accurately reflect care quality, health information management (HIM) experts should help organizations develop audit plans that focus on maintaining high data integrity, a recent article from the Journal of AHIMA says.
Hospital ratings have grown increasingly important as the industry becomes more consumer-focused. More patients are relying on publicly available ratings when seeking care, and more payers are financially penalizing organizations that fail to meet quality benchmarks.
However, ratings can often be skewed by poor quality data or inaccurate assessments of quality and outcomes. Data oversights, including coding mistakes and the copy and paste of EHR information, can negatively impact organizations’ rankings.
In order to ensure ratings reflect care quality, healthcare entities must assess the integrity of their clinical documentation and coded data, author Daniel Land, RHIA, CCS, noted.
“Savvy healthcare organizations utilize their ratings as an opportunity to do a deep-dive into the integrity of their institutional data. This multi-factorial analytical process should provide an objective assessment of institutional data quality,” Land wrote.
“The findings can be used to correct current deficiencies, identify opportunities for improvement, and proactively monitor data quality over time—which should ultimately improve an organization’s ratings.”
Providers should conduct audit plans to evaluate their data, and HIM experts are essential for carrying out these plans.
HIM professionals can serve as subject matter experts on the coding elements that factor into healthcare rankings, the article says. HIM specialists can also create and update databases of these elements as needed.
Additionally, organizations could have these experts collaborate with clinical documentation improvement teams to examine the findings from data audits. Together, they could come up with ways to address data gaps in their organization.
Land also stresses that healthcare executives recognize the critical role HIM professionals can play in maintaining or raising their organization’s ranking, and suggests that they incorporate these experts on quality teams.
These recommendations build on AHIMA’s efforts to help HIM professionals adapt to a rapidly changing industry.
In 2017, the association laid out a roadmap to help these experts develop the informatics and data analytics skills necessary to succeed in a value-based, data-driven environment.
“There are enormous opportunities ahead for HIM professionals in emerging areas such as information governance (IG), data analytics, informatics, patient advocacy, entrepreneurship, project management, privacy and security, a range of payment reforms and more,” former AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA, said at the time.
“These opportunities will give HIM professionals increased chances, to not just collect and process data, but analyze and apply it.”
AHIMA suggested that HIM experts collaborate with other stakeholders, explore specialization opportunities, and obtain higher degrees in informatics or public health to keep pace with industry changes.
With this new set of recommendations, AHIMA is further encouraging HIM professionals to grow beyond the scope of their traditional roles, and to recognize the critical role they can play in improving healthcare ratings.
“In order to grow beyond the bounds of traditional HIM roles, professionals must position themselves strategically to demonstrate their ability to positively influence healthcare organizations on a broad scale,” Land concluded.
“Locking arms with their organization to achieve desired rankings is a perfect example of the importance of continually scanning the healthcare landscape for ways in which HIM professionals can use their skills in new and different ways.”