Transitions in Health Information Management (HIM)

Health Information Management (HIM) has been a recognized healthcare profession for more than 90 years. During most of that time, the business of HIM was conducted in a paper-based environment. The patient’s medical record was composed of paper forms created by all parts of the hospital. The documents were collated, indexed, and filed in a very predictable method. Running a HIM department in California was just like running a HIM department in Virginia.

About 20 years ago, hospitals began implementing system-wide computer programs that dramatically changed the practice of medicine, but much of the documentation about what was happening still occurred via paper notes or forms. More progressive HIM departments would scan their paper records to create “electronic” medical records (EMRs). However, these scanned medical records didn’t support the ability to do computerized research to abstract and analyze patterns or care.

Later, as healthcare computerized systems matured; they were able to capture point of care data in a computerized form. However, each software vendor has their own method of storing data and that leads to a lot of variety when it comes to creating a computerized medical record. Today, HIM practice varies widely from one facility to another depending on the vendor they are using, the degree of data capture, and the desire of the healthcare organization to commit to a fully computerized form of data collection.

A variety of federal mandates have urged all healthcare providers to move to computerized health records, with the goal being a fully computerized medical record (eHIM practice). In a few short years, those organizations that continue to rely on paper records will pay stiff federal penalties to do so.

To meet these challenging demands, HIM departments must embrace health information technology (HIT) and undergo dramatic changes as they shift from paper records to eHIM. Every HIM function designed to support paper records will need to be redesigned to meet the demands of eHIM. New roles and responsibilities in HIM have been created in order to support the transition to eHIM.

Interested in learning more? Visit www.ahima.org and explore this career option. A fully online associate degree in Health Information Technology is offered at Northwestern College.