Health Information Management (HIM) in the Department of Veterans Affairs

Transcription

1 Health Information Management (HIM) in the Department of Veterans Affairs Pamela Heller, MSHI, RHIA, CCS-P, FAHIMA Director Health Information Management Veterans Health Administration

2 Veterans Health Administration Size of Organization and Organizational Structure The Veterans Health Administration (VHA) is home to the United States' largest integrated health care system Consists of 167 medical centers and over a 1,000 outpatient sites. Type of Health Records Longitudinal

3 How VHA is Similar to Community Single-Facility Organizations

4 How VHA is Similar to Community Health Care Systems

5 VHA Enterprise Information System

6 Backbone of Electronic Health Record VistA Veterans Health Information Systems and Technology Architecture VBA = Veterans Benefits Administration NCA = National Cemetery Administration

7 VHA Electronic Health Record Computerized Patient Record System

8 Cover Sheet Tab 8

9 Documentation in Longitudinal Electronic Health Record

10 Scanned Data VistA Imaging within CPRS 10

11 VistA Imaging Remote/External CPRS VI Viewer: Uses Internet Explorer / User signs in with Access and Verify codes Printing allowed with signature code or MAG ROI key 11

12 VLER Health Information Exchange VLER = Virtual Lifetime Electronic Record

13 Veteran Heath Information Exchange (VHIE) 75% of Veterans seek/use non-va Health Care VA Clinical Adoption VHIE develops Data Content, engages providers, establishes use cases, and incorporates HIE into the clinical workflow Veteran Engagement VHIE enables Veteran Authorization and Veteran- Initiated HIE Technology Solutions Exchange VA Direct Messaging Value Added Process (VAP) Blue Button Next Generation HIE Community Partners VHIE builds the secure network and establishes Trust Agreements Improved Continuity of Care Reduced duplication of tests/ procedures 13

14 Health Information Management (HIM) and VA Organizational Structure CODING CLINICAL DOCUMENTATION IMPROVEMENT File Room / Scanning Electronic Health Record /Health Record Data Records Management / Release of Information REPORTING Special Project/Program Leadership Subject Matter Expert on many projects International Classification of Diseases, 10th Edition, Clinical Modifications (ICD- 10 ) Implementation Speech Recognition HEALTH INFORMATION GOVERNANCE HIM PROGRAM GOVERNANCE VHA LEADERSHIP FACILITY LEADERSHIP HIM LEADERSHIP HIM STAFF

15 HIM Governance & Oversight VHA HIM Program Office

16 HIM Resources and References CDI = Clinical Documentation Improvement ROI = Release of Information

17 Technical Career Field (TCF) Program

18 Since 2003 Graduated 117 trainees 2 classes currently underway 36 graduates on 2 nd or 3 rd progressive job at VA 18

19 VHA Data as a Business Asset Master Data Identity Management Multiple data sources Data is not linear or unidirectional Single Version of the Truth Data Management Completeness Accuracy Data Quality Data Stewardship

20 Data/Information Types of Data VA Provided Care Data Clinical Administrative Claims Employee Care in Community on behalf of VA Clinical Administrative Claims Using Data Clinical Care Reimbursement Research Data Reporting Process Improvement

21 VA Enterprise Data Warehouse OIT REGION 1 (R1) OIT REGION 2 (R2) OIT REGION 3 (R3) OIT REGION 4 (R4) Vx Vx Vx Vx Vy R2 R2 Vy Vx Vx Vy Vn R1 R1 RPT Vy Vn Vn VISN:12-17 VISTAs: 29 RPT Vn VISN:1-5 VISTAs: 28 Vy Vn R4 R4 RPT Vy Vn VISN:18-22 VISTAs: 33 Vx Vx AI = Analytics & Informatics BI = Business Intelligence CDW= Corporate Data Warehouse GP = General Purpose OIT = VA Office of Information & Technology RD = Research & Development RPT = Report Vn, Vy, Vx = VISN Servers VISN = Veterans Integrated Service Network Enterprise RD GP CDW AI BI VISN:6-11 VISTAs: 41 Vy Vn R3 R3 RPT Vy Vn Governance Boards Strategy Policy Priorities Requirements

22 VHA Support Service Center (VSSC)

23 Turn Data into Information through Metrics Coding Turn-A-Round Time: Inpatients and Outpatients

24 Meaningful Data Used = Information Metrics

25 Using Data Analytics to Tell the Story Reported Issue/ Pattern Data Review Data Broadened Universe to look at all Facility Ask the question Why? Take Action Monitor/Measure

26 Data Driven Analytics Unsigned/Un-cosigned Documentation

27 Data Collection & Data Analytics Automated and Manual

28 Data Collection & Data Analytics Automated and Manual

29 Using Big Data Shape and Standardize Processes Coding Release of Information Unauthenticated Documents Lack of Documentation Scanning File Room Activities Clinical Documentation Improvement Training Standard Process Analytics/ Metrics Outcome

30 HIM Governance Training Provide minimum of monthly trainings on specific process or best practice within process Webinars targeting specific audiences (coding) Talent Management System s on-demand training for HIM Functional Areas HIM SharePoint of References and Resource Libraries Training Standard Process Analytics/ Metrics Outcome

31 Let the Data Speak for Itself Analytics/Metrics Health Record Completeness Coding Accuracy and Monitoring Coding Turn-A-Round Time and Days Outstanding Training Standard Process Analytics/ Metrics Outcome

32 Use Data to Guide the Process

33 Questions