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Health
Information Management Journal
ISSN
1833-3583 (Print) ISSN 1833-3575 (Online)
Volume
39 Number 3
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Contents
Volume 39
Number 3
See previous
issue> HIMJ 39(2)
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The
health information management workforce: changes and opportunities
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| Guest
editorial: |
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The
health information management workforce: when opportunities abound
Vicki Bennett p4 [
more
]
Abstract
In the last issue of HIMJ, in her guest editorial, Kerryn
Butler-Henderson outlined many of the proposed changes that the
health system is likely to face in the near future. Change seems
to be a constant theme that we must get used to and adapt to if we
are to survive in the 21st Century. But Health Information
Managers (HIMs) are like chameleons – we have always adapted and
changed to embrace our emerging role in the evolving health system
structures. We were once known as Medical Record Librarians and
then we transformed into Medical Record Administrators. When we
realised we were not content to stay in the ‘basement’
forever, we emerged as Health Information Managers. So, what is
next for our profession?
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| Reviewed
articles: |
| Research |
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Matched
comparison of GP and consultant rating of electronic discharge
summaries
Lesley Stainkey, Tilley Pain, Margaret McNichol, John Hack
and Lynden Roberts p7 [ more
]
Abstract
Queensland Health is implementing a state-wide system to
electronically generate and distribute discharge summaries.
Previously, general practitioners (GPs) have indicated that the
quality of the discharge summary does not support clinical
handover. While the electronic system will address some issues
(e.g. legibility and timeliness), the quality of the discharge
summary content is predominantly independent of method of
generation. As discharge summaries are usually generated by
interns, we proposed that improvement in the quality of the
summary may be achieved through education. This project aimed to
compare the perceptions of hospital-based consultant educators and
recipient GPs regarding discharge summary content and quality. The
discharge summary and audit tool were sent to the recipient GP
(n=134) and a hospital consultant (n=14) for satisfaction rating,
using a 5- point Likert scale for questions relating to diagnosis,
the listing of clinical management, medication, pathology,
investigations, and recommendations to GP. Sampling was performed
by selecting up to 10 discharge summaries completed by each
first-year intern (n=36) in 2009, during the second, third and
fourth rotations at the Townsville Hospital until a total of 403
was reached. Matched responses were compared using the Kappa
statistic. The response rate was 93% (n=375) and 63% (n=254) for
consultants and GPs respectively. Results from this study
demonstrated that GPs were more satisfied with discharge summaries
than were consultants. An anomaly occurred in three questions
where, despite the majority of GPs rating satisfied or very
satisfied, a small but proportionally greater number of GPs were
very dissatisfied when compared with consultants. Poor or fair
agreement between GPs and consultants was demonstrated in
medications, pathology results, investigations and recommendations
to GP, with GPs rating higher satisfaction in all questions. Lower
consultant satisfaction ratings compared with GP ratings suggest
that consultants can evaluate discharge summary content to the
level required by GPs for clinical handover. Therefore,
consultants can appropriately educate interns on discharge summary
content for GP needs.
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Reliability
of ICD-10 external cause of death codes in the National Coroners
Information System
Lyndal Bugeja, Angela J Clapperton, Jessica J Killian, Keran L
Stephan and Joan Ozanne-Smith p17 [ more
]
Abstract
Availability of ICD-10 cause of death codes in the National
Coroners Information System (NCIS) strengthens its value as a
public health surveillance tool. This study quantified the
completeness of external cause ICD-10 codes in the NCIS for
Victorian deaths (as assigned by the Australian Bureau of
Statistics (ABS) in the yearly Cause of Death data). It also
examined the concordance between external cause ICD-10 codes
contained in the NCIS and a re-code of the same deaths conducted
by an independent coder. Of 7,400 NCIS external cause deaths
included in this study, 961 (13.0%) did not contain an ABS
assigned ICD-10 code and 225 (3.0%) contained only a natural cause
code. Where an ABS assigned external cause ICD-10 code was present
(n=6,214), 4,397 (70.8%) matched exactly with the independently
assigned ICD-10 code. Coding disparity primarily related to
differences in assignment of intent and specificity. However, in a
small number of deaths (n=49, 0.8%) there was coding disparity for
both intent and external cause category. NCIS users should be
aware of the limitations of relying only on ICD-10 codes contained
within the NCIS for deaths prior to 2007 and consider using these
in combination with the other NCIS data fi elds and code sets to
ensure optimum case identification.
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A
response to Bugeja, Clapperton, Killian, Stephan and Ozanne-Smith
Jessica Pearse and Leanne Daking p27 [ more
]
Abstract
The National Coronial Information System (NCIS) Unit welcomes
all studies that aim to assess the reliability of the NCIS and to
increase understanding of any limitations when using these data.
In accordance with the limitations outlined in the study by Bugeja
et al. (2010), we endorse the authors’ recommendations against
sole reliance on ICD-10 codes to identify cases of interest on the
NCIS, and encourage supplementing searches by using additional
NCIS data fields such as Intent, Mechanism of Injury, Object or
Substance Producing Injury. These extra data fields may allow for
identification of cases that do not have an ICD-10 code (due to an
inability to match NCIS and Australian Bureau of Statistics [ABS]
data), or more recent cases that have not yet been assigned an
ICD-10 code. We also acknowledge that the NCIS has limitations
when it comes to the completeness of ICD-10 codes across the NCIS
dataset and we are working with the ABS to improve the
data-matching process between our two data collections.
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| Professional
Practice and Innovation: |
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Geographical
information systems: an effective planning and decision-making
platform for community health coalitions in Australia
Scott Baum, Elizabeth Kendall, Heidi Muenchberger, Ori
Gudes and Tan Yigitcanlar p28 [
more
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Summary
The development of locally-based healthcare initiatives, such
as community health coalitions that focus on capacity building
programs and multi-faceted responses to long-term health problems,
have become an increasingly important part of the public health
landscape. As a result of their complexity and the level of
investment, it has become necessary to develop innovative ways to
help manage these new healthcare approaches. Geographical
Information Systems (GIS) have been suggested as one of the
innovative approaches that will allow community health coalitions
to better manage and plan their activities. The focus of this
paper is to provide a commentary on the use of GIS as a tool for
community coalitions and discuss some of the potential benefits
and issues surrounding the development of these tools.
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| Reports: |
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Current
issues impacting on the education of the health information
management workforce: role of the HIMAA Education Committee
Alex Toth p34 [ more
]
Abstract
Rapid changes in the health sector and the consequent demand for
Health Information Managers (HIMs) who have the required
competencies to practice in the profession means that the
Education Committee1 of the Health Information Management
Association of Australia (HIMAA) and HIMAA more broadly have to be
flexible and respond to this changing landscape. This issue is
compounded by major changes currently occurring within the
tertiary education sector, including restructuring of university
courses, which has impacted on university staff and created huge
upheaval for these staff, including those delivering programs in
health information management. The challenge for both the HIMAA
Education Committee and for HIMAA as a professional organisation
is to tackle all of these issues on the many levels involved in
order to ensure the continuing strength of the Australian health
information management profession, both now and into the future.
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Health
information management and clinical workforce issues
Jennie Shepheard p37 [ more
]
Abstract
In early 2008, it became apparent that many Victorian hospitals
were having
difficulty filling Health Information Manager (HIM) vacancies and
that the service area most specifically affected was the clinical
coding services. However, at that stage there was only anecdotal
evidence to support the suggestion of a workforce shortage. There
was no knowledge of the underlying issues and no understanding of
the profile of the existing HIM workforce in Victoria. Nothing was
known about attrition rates and, importantly, no definitive
knowledge of vacancy rates. As this perceived shortage of clinical
coders had the potential to adversely impact on the casemix
funding model, the Victorian ICD Coding Committee (VICC) decided
to undertake a survey and they enlisted the help of the Victorian
Department of Health (DH) Workforce unit to do so. Two follow-up
studies were subsequently undertaken by a small graduate group2
within the DH. The findings of the initial survey and the two
follow-up studies supported the contention that Victoria had a
workforce problem.
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Coding
in Ireland: time for recognition
Deidre Murphy p42 [ more
]
Abstract
Recognition of skilled coders’ work within the Irish health
system is long overdue. A project being undertaken in Ireland now
by the central office for coding at the Economic and Social
Research Institute (ESRI) is exploring ways to raise the coders’
profile, promote a profession of clinical coders and ensure
quality benchmarks for all stakeholders, including the
introduction of accredited training. The Hospital Inpatient
Enquiry (HIPE) at the ESRI uses ICD-10-AM and trains and supports
coders in all aspects of their work. This paper also presents some
preliminary findings of a HIPE workforce study undertaken in early
2010. The establishment of a recognised clinical coder profession
through engagement with all stakeholders and the accreditation of
Irish coder education would enhance the position and recognition
of coding as a skilled profession within the Irish healthcare
system, and also ensure those data meet the highest national and
international data quality standards.
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Casemix
funding optimisation: working together to make the most of every
episode
Carly Uzkuraitis, Karen Hastings and Belinda Torney p47 [
more
]
Abstract
Eastern Health, a large public Victorian Healthcare network,
conducted a WIES optimisation audit across the casemix-funded
sites for separations in the 2009/2010 financial year. The audit
was conducted using existing staff resources and resulted in a
significant increase in casemix funding at a minimal cost. The
audit showcased the skill set of existing staff and resulted in
enormous benefits to the coding and casemix team by demonstrating
the value of the combination of skills that makes clinical coders
unique. The development of an internal web-based application
allowed accurate and timely reporting of the audit results,
providing the basis for a restructure of the coding and casemix
service, along with approval for additional staffing resources and
inclusion of a regular auditing program to focus on the creation
of high quality data for research, health services management and
financial reimbursement.
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'Write
Right': the GSAHS clinical documentation project
Ann Stewart and Tony Robben p50 [ more
]
Abstract
The Clinical Documentation Project was piloted at one site in
Greater Southern Area Health Service (GSAHS) in New South Wales;
it aimed to improve the standard of clinical documentation by 50%
between March and August 2005. The main intervention was the use
of a Self Directed Documentation Learning Package (SDDLP). Results
achieved a 75% improvement in clinical documentation within six
months and a 46.5% improvement in clinicians’ confidence in
their level of knowledge on documentation requirements.
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| Conference
Reports: |
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Clinical
Documentation, Coding and Analysis Conference
Jennie Shepheard and Brian Stanley p53 [ more
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Technology
in Healthcare Summit
Glenda Wyatt and Jenni Webster p55 [ more
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| Professional
Practice: |
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The
role of a Health Information Manager in creating data fit for
purpose
Brooke Macpherson p58 [ more
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Solomon
Oslands experience - holiday with a heart
Kerrie Clement p60 [ more
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| Professional
Profiles: |
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Sue
Walker: a wonderful career
p63 [ more
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Narelle
Portakiewicz: Chief Health Information Manager, SA Health
p66 [ more
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| Obituary: |
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Vale
Joyce Wilson
Phyllis Watson p68 [ more
]
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Even more reasons
to join!
©
2010 Health Information Management Association of Australia
Limited
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