Wednesday, October 22, 2014

Are We There Yet?

Health information professionals – are we there yet? I suggest that we are not there…not yet. But what is the final destination? When I was a CSS student over 20 years ago (okay, maybe a little more than 20), I remember the very forward thinking, innovative faculty in the HIM program encouraging us as students to get out there! “Get to the table! Healthcare is transitioning to the electronic health record and this can’t happen without HIM professionals leading the way!! Don’t hesitate – get out there!” So we did! The EHR took a little longer to come around than anticipated, but it has arrived for most of us. Are we as HIM professionals there to help lead the way? Sure! Maybe not everywhere we want to be and maybe not until we are sorely missed when important areas of health information management are forgotten, but sure – we are out there doing our best to ensure secure and private health information; accurate and proper documentation for correct billing, reimbursement, and reporting; well-designed EHR systems; properly trained health professionals; compliance; and more.

So we are there then? I don’t think so. We have done a lot, but there is so much more yet to do.  Healthcare continues to evolve and change, and then change further.  We are now using the long anticipated EHR, but we still have challenges. What will we do with all of this data? How can we use it to improve the quality and decrease the cost of healthcare? How will we get information out of the EHR? How will we keep it secure? How will we ensure that it is governed in an organized, effective, and compliant manner? How will we help healthcare organizations meet all the regulations required of them? No, we are not there yet. We have not arrived at a final destination. As HIM professionals, our biggest challenges are yet to come.  

My colleague, Amy Watters, recently wrote a blog on mindset. Are we, as HIM professionals, of the mindset that we can and will continue to be leaders implementing needed change and taking on the many challenges of healthcare innovation?  I have been participating in a work group looking at how learning works. One of the principles being explored is how one’s prior knowledge can help or hinder learning and how important it is to make the connections between previous and new knowledge (Ambrose, Bridges, Lovett, DePietro, & Norman, 2010). It makes me think about the last 20+ years and how much I have built upon the HIM foundation that I learned in the classroom, how I have applied my work experience to that foundation, and how I still am not done. I continue to take classes and continue to bring that knowledge to my work, and there is more change.  I participate in conferences, MOOCs, workgroups, projects, training…and yet there is more to learn. There is HIPAA and Big Data and Meaningful Use and ICD-10 and Patient Portals and Telehealth….and more. HIM professionals have the foundational skills, knowledge, and experience that allow us to continue to learn new things, be creative and strategic, and continue to lead!  

Are we there yet?  I don’t think so.  But isn’t the HIM profession one of the greatest journeys to be on as we try to reach a final destination?

Ambrose, S. A., Bridges, M. W., Lovett, M. C., DiPietro, M., & Normal, M. K. (2010). How learning works: 7 research-based principles for Smart Teaching.  San Francisco, CA: Jossey – Bass.
Watters, A. (2014, September 3).  Grow your mindset [blog]. Retrieved from

Wednesday, September 3, 2014

Grow Your Mindset

Through my doctoral studies and a recent professional development opportunity at the College, I’ve been learning a lot about mindset, specifically how one’s mindset related to intelligence influences achievement.  Think about these two questions: When you encounter a challenge, how do you approach it, and why do you approach it the way you do?  What are your beliefs about risk and failure?  Although these seem like abstract questions, they are important to examine because research shows that your beliefs related to how human traits are developed, such as intelligence and personality, strongly influence the way you live your life and how you approach achieving your goals.  If you believe that human qualities like intelligence are carved in stone (i.e. you only have a certain amount of intelligence) then you have a fixed mindset.  If you believe that these qualities can be nourished and developed through effort, then you have a growth mindset.  You may find yourself strongly aligned with one mindset, or you may fall somewhere in the middle of the continuum between a fixed vs. growth mindset. 

Understanding mindsets is important for us in education.  Students with fixed mindsets often identify themselves as successful when they validate themselves by proving their intelligence, while growth mindset students view themselves as
Amy Watters
successful when they embrace those moments that challenge them to learn something new.  So, a person’s mindset greatly impacts how they respond to challenge and effort, which certainly influences a student’s approach to education.   It is also beneficial to understand this phenomena as it affects how our colleagues may approach a challenge in the professional environment.  

It has been found that people with a growth mindset are oriented toward learning so they often don’t worry about how they look to others.  They see value in effort, feel smart when they are working hard, and embrace mistakes and setbacks, viewing them as an important part of learning and growth.

A person’s mindset can be changed.  If you’re interested in growing your mindset, try implementing these strategies:
1. Recognize that a growth mindset is beneficial, and its benefits are supported by science  - the brain actually changes when we work hard to improve ourselves.
2. Find ways to learn & teach others about how to develop our abilities.
3. Be mindful!  Listen for your fixed mindset voice & talk back with a growth mindset voice.

This information is based on the work of Carol Dweck, Ph.D., who wrote the book Mindset: The New Psychology of Success – a great read if this is an area of interest to you!  

Friday, August 29, 2014

College helps local agency with electronic records

See below for a story published today at the College of St. Scholastica about a collaboration between the HIIM Department and the Social Work Department regarding an grant we've just started with the Human Development Center. Enjoy!

College helps local agency with electronic records

Thanks to a new grant, The College of St. Scholastica will be able to help a Duluth-based human services agency put its health records into an electronic format. The partnership is just the latest innovation from the College's industry-leading Health Information and Informatics Management program.
Paula Tracey, St. Scholastica Social Work;
Mike Kongsjord, HDC's IT director;
and Brooke Palkie, St. Scholastica HIIM

St. Scholastica's HIIM and Master of Social Work programs are teaming up to help the Human Development Center.

"The HDC is one of the leading mental health agencies in our community," said Paula Tracey, assistant social work professor. It's a win for St. Scholastica students as well as for HDC.

"We're using this as a training opportunity for our students while we're also training staff out in the field," Tracey explained. "It's a chance for the students to be engaged in the process with clinicians."
Yet another benefit is the donation of EHR software to St. Scholastica. Qualifacts Systems Inc. is allowing the College to use its CareLogic EHR software for free.

Asia Johnson, HDC's director of compliance, called the collaboration "an opportunity to strengthen the workforce in the HIM and Social Work areas that will greatly impact both the College and our agency."

The cutting-edge grant will help HDC comply with several upcoming federal requirements.
The government wants health agencies to move to electronic recordkeeping and start using the 10th edition of the International Classification of Diseases (ICD-10-CM/PCS) and the 5th edition of the Diagnostic and Statistics Manual of Mental Disorders (DSM-V).

HDC will also be required to collect and analyze data for reporting purposes. Many health service providers are struggling to find the time and funding to train staff members in documentation and coding; much less data analytics, according to Brooke Palkie, associate HIIM professor. She worked on the grant along with Tracey,MSW Program Director Lee Gustafson, Health Informatics Director David Marc, and HIIM Chair Ryan Sandefer.

Starting this September, College faculty and students will work with HDC staff to develop and implement training on elements of the electronic health records system.
St. Scholastica and HDC staff time will be covered by a $77,603 grant from the Minnesota Department of Employment and Economic Development. Seventy-nine HDC employees will receive training.

Palkie and Tracey are excited about the collaboration, and the potential for the future.
"I hope this spurs more community/college partnerships," said Palkie. "I just think that is extremely important. We learn so much, and we have a lot to give."

"It falls very much in line with our Benedictine values," Tracey added. "Not only that, but the mission of HDC as well."

Tuesday, August 5, 2014

HIM Graduate Students Learning in Community

Amy Watters
In early June we had 57 HIM graduate students on the Duluth campus (our largest graduating class thus far!) to complete their week-long capstone experience.  It was an energetic and engaging week for all, affirming the value of learning and constructing knowledge together in community.  Community is a central theme for us during the capstone week.  Not only do we learn together in community, but we study the concept of community as well.  This year we read the book Community: The Structure of Belonging, by Peter Block.  Block states that an invitation to work/learn in community is more than just a request to attend; it is a “call to create an alternative future”.  That’s quite a statement!  Think about the meetings you’ve attended this week, or the projects that you’ve worked on with your colleagues – what sort of “alternative future” are you creating?

Thursday, July 24, 2014

Statistics! RUN!!!

David Marc
Speak the following word slowly and loudly: "Statistics"

The word was likely to generate a thought about a primary inducer of fear or pleasure, that when brought to your working memory, elicited a somatic state. The nature of that somatic state may differ depending on the primary inducer, but your amygdala is likely activated causing either a fight or flight response or euphoria and pleasure.

In other words, statistics may either frighten the daylights out of you or make you grin like a Cheshire cat.
Cheshire cat from Alice in Wonderland

I'm here to tell you to get over your fear! Statistics rule (especially in healthcare)! 

At the basic level, descriptive statistics (i.e. mean, median, mode, range) can tell you a lot about the utility, efficacy, and costs of medical goods and services. However, the real power of statistics is the ability to adopt techniques to quantitatively measure performance outcomes. Rao Castro explains how "Hospitals and other large provider service organizations implement data-driven, continuous quality improvement programs to maximize efficiency. Government health and human service agencies gauge the overall health and well-being of populations with statistical information." 

In the end, "Statistics" is not just something that we learn in school, read about in newspapers and periodicals, or hear about on the news. Statistics are a driving force of the healthcare industry.  Ultimately, you can choose to either wallow in your fears and avoid statistics all together or jump on the bandwagon and join the statistically significant party. 



Wednesday, July 9, 2014

Big Data, Data Analytics, Innovation, and Other Buzzwords…

David Marc
David Marc
Have you tried Googling the words “Big Data”? Go ahead, do it. You’ll get around 15 million hits.  Evidently, big data is a big deal! So what is this thing called, “Big Data”, and why is it so darn popular? Well, think of big data as a fishing net dragging the bottom of the sea picking up all sorts of flotsam and jetsam, in massive amounts! The same thing is happening in healthcare. We have this thing called an electronic health record (EHR) that is picking up all sorts of data including clinical notes, medications, lab results, and a bunch of other stuff.  The result is a massive warehouse of clinical data. 

But this begs the question, “What do we do with all of this data?” Cue up the term “data analytics”!  We have all read the facts. In the US, the cost of healthcare is rising, we have mediocre outcomes, we are being told that we are at the brink of imminent disaster!  

I say, nay nay. We have an opportunity to leverage the “big data” to identify how we can cut costs and improve outcomes by using “data analytics”. Yes, we do face challenges with analyzing big data including access to the data, a limited workforce that has analytics expertise, access to analytical software, security and privacy issues, among others. 

This brings me to my last buzzword, “Innovation”.  Although there are ample challenges to go from “Big Data” and “Data Analytics” to “Innovation” in order to reduce costs and improve outcomes...we have actually started the process! Dr. Bonnie Feldman, a prolific blogger, dentist, and businesswoman, recently wrote a report where she provided examples of how healthcare organizations are capitalizing on big data to reduce costs and improve outcomes, including: engaging patients, supporting genomic research, and developing predictive analytic models for chronic diseases. 

As an academic institution, we also have an opportunity to capitalize on big data and analytics. The College of St. Scholastica and the HIIM department are doing so by incorporating large healthcare datasets into our curriculum and offering students a hands-on data analytics experience.  In essence, the College of St. Scholastica is developing future healthcare professionals that will have the competencies to take on big data, mount their white stallions, and thwart off the sludge that the US healthcare system is currently under. We are creating big data analytics gurus, hot shots, bombshells, heroes, and any other word you want to use to describe an awesome person! I recommend that you take the red pill and join the ranks.

“This is your last chance. After this, there is no turning back. You take the blue pill – the story ends, you wake up in your bed and believe whatever you want to believe. You take the red pill – you stay in Wonderland, and I show you how deep the rabbit hole goes. Remember, all I'm offering is the truth – nothing more.”

-Morpheus (from the movie, Matrix)



Monday, June 16, 2014

Let's learn to say..."it's possible"

Ryan Sandefer
This week the HIIM Department hosted Gail Graham, Assistant Deputy USH for Informatics and Analytics, Veterans Health Administrationon St. Schoalstica's Duluth Campus. Graham was the keynote speaker for the LaTour Eichenwald Forum on HIM Leadership and Innovation, which is held annually in conjunction with the MS HIM Graduate Capstone Session. Graham spoke about the VA's vision for improving patient care by leveraging technology and data. You can view her presentation in its entirety HERE

One of Gail's key points was that it is tough to see progress when we are resistant to change. She spoke about the need to say yes to effectively address the challenges associated with patient engagement, health information exchange, data utilization, and software development. Of course we can not always say yes, but Gail's point is that we should not be so quick to say no. Perhaps we can start by saying..."maybe." Or,  "potentially." Or better, yet -- "it's possible."

Electronic health record adoption continues to be a major area of transition for us in this field, and Gail remarked on the struggles at the VA. This is also a major issue for those of us teaching in academic programs. I recently attended the American Medical Informatics Association's Academic Forum meeting in Ann Arbor, MI. The main topic of discussion was strategies for effective EHR use in the classroom, and I had the opportunity to speak about CSS's experience. What is clear is all academic programs are challenged--there are issues with access, cost, technical support, and curriculum development. Nevertheless, there are some cool things happening across the country. Check out the conference program and slides HERE

Healthcare is changing rapidly. Gail spoke eloquently about HIM's role in every aspect of this change. We look forward to working with you all to address these challenges. 

Here's to "it's possible!"