Industrial relations and human resources: management challenges for health information managers.
Article Type: Editorial
Pub Date: 02/01/2011
Publication: Name: Health Information Management Journal Publisher: Health Information Management Association of Australia Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 Health Information Management Association of Australia Ltd. ISSN: 1833-3583
Issue: Date: Feb, 2011 Source Volume: 40 Source Issue: 1
Accession Number: 252944957
Full Text: Welcome to this exciting issue of the Health Information Management Journal (HIMJ) where we present for the first time HIM-Interchange (HIM-I) as a 'pull out' section. You can read Kay Bonello's (1) introduction to this professional practice journal on the first page of HIM-Interchange.

Our theme for this first issue of HIM-I, 'health information management human resources and industrial relations', relates to those fundamental workplace issues that all HIMs should have a working knowledge of. For many, including some HIMs, the difference between human resources (HR) and industrial relations (IR) is a bit blurred. Ross Buchanan (Buchanan 2011), in his guest editorial in HIM-I, clearly distinguishes between these two disciplines, and discusses how the changing landscape for HIMs and clinical coders, especially in hospitals, will require us all to be more aware of both HR and IR practices. This Issue also includes articles that provide examples of developments in technology that are changing the way traditional health information management work is managed. As HIMs play a significant role in information management in health care organisations, it is imperative that they stay abreast of new ways of collecting, storing and exchanging health information, and understand that changes in these systems may also require changes in the way they work and relate to their workplaces. Claire Holt (Holt 2011) provides a fascinating discussion about the impact of social networks such as Twitter on the management of health information and points out that there will almost certainly be difficulties when reconciling electronic exchange of health information between clinicians and patients with the need to store that information in a paper-based medical record until we make the transition to a true electronic health record. These issues will need to be managed from human resources and industrial relations perspectives as well as from an operational perspective. Articles by Jacky Ting, Albert Tsang, Andrew Ip and George Ho (Ting et al. 2011) and Ross Buchanan and Chrisa Alexiou (Buchanan & Alexiou 2011) discuss the electronic storage of health information for more effective sharing of patient records. While the systems discussed, a radio frequency identification-based electronic medical record system and a medical record scanning project, are quite different, they both have potential to change the way health information management work is carried out and therefore will impact on traditional HR and IR policies.

Emily Price and Kerin Robinson (Price & Robinson 2011) have contributed a delightful piece that perfectly describes the complexity of the work of clinical coders, and highlights the importance of carefully managing this particular human resource. Conditions of employment and workplace arrangements must stay abreast of the needs of this group of people as the role of the clinical coder becomes increasingly important under the proposed activity-based funding (ABF) system. The importance of clinical coding work is also highlighted in articles by Dina Watterson and colleagues (Watterson et al. 2011) and Kate Curtis and colleagues (Curtis et al. 2011). Both of these articles describe work that was undertaken to assess the value of clinical codes or the resultant DRGs in adequately describing specific clinical scenarios, or both. HIMs and clinical coders are often unaware of how extensively their work is scrutinised and how many people are dependent on the information provided by clinical codes and DRGs. Both HR and IR play an important role in maintaining a workforce that continues to deliver a quality product to these stakeholders.

Colin McCrow provides a most useful discussion about clinical analysis, the discipline that underpins clinical costing and cost modeling that is fundamental to ABF models (McCrow 2011). The changes that a nationwide ABF system will impose on the health information workforce will include a need for more widespread knowledge about these costing systems and greater engagement of the health information workforce in their management. HIMs have a role to play in the development and successful implementation of these systems in hospitals and in government health departments. In a similar mode to that of the clinical coding workforce, the clinical costing workforce is set to become a valuable human resource that must be adequately managed in our HR and IR systems.

The national reform agenda and its impact on the health information management profession is discussed by Bob Blue (Blue 2011) in his article titled 'Health reform and the health information management profession'. Blue (2011), drawing on information from the Coding Workforce Shortfall report commissioned by the Australian Institute of Health and Welfare (AIHW), makes the point that while there are challenging times ahead for our profession there is also an 'outstanding opportunity for HIMs to establish themselves and the profession at the leading edge of healthcare reform'. We must make the most of this opportunity and ensure that our HR and IR systems are adequate for the task.

However, these developments and discussions must all be understood within the context of the particular responsibility we all have to protect the privacy and confidentiality of a person's health information. Judith Mair's (Mair 2011a) case study on 'Privacy, employees and human resources' is a most interesting report on a case where a patient's privacy and an employee's rights intersected in the one person, and reminds us that our role in the management of health information goes well beyond simply collecting and storing this information.

Health information systems around the world are dealing with the same issues related to workforce and new technologies that we are confronting in Australia. Kelly Abrams and Gail Crook (Abrams & Crook 2011) discuss the Canadian Health Information Management Association's activities since 2007 to plan for the future of the health information workforce in Canada. These measures included a 'sector study' and a 'strategic planning process', with one of the objectives being to 'recommend strategic human resources planning initiatives'.

Joanne Chicco's report on the Reform in Primary Health Care Conference held in Sydney in September last year shows us that the primary care sector has perhaps been the 'sleeper' in the world of health information management (Chicco 2011). Similar opportunities exist in the primary care sector as in hospital sectors for HIMs to be involved in the development and maintenance of processes that address access to healthcare and improvements in quality, safety, performance and accountability of healthcare systems.

The low profile that HIMs tend to have in the healthcare system is highlighted by Michelle Leeding in her professional practice profile (Leeding Cope 2011). Michelle was initially inspired by the HIMs in her first place of employment, eventually undertook health information management training and then, after a very interesting journey through several other places of employment, found herself back at the beginning but in a new role! In common with many others, Leeding Cope (2011) urges HIMs to engage in their own futures and to 'promote the valuable work that we do'.

Finally, we have a review of the book 'Health Care and the Law' by Judith Mair (Mair 2011b). As custodians of the medical record it is incumbent on HIMs to understand issues related to informed consent, patient information and privacy. Mair (2011b) reports that this book is an enjoyable read and recommends it to us all as essential reading. Books such as this offer an opportunity for professional development; maintaining currency in this area is an important professional asset for HIMs.

I do sincerely hope you find the time to read the current issues of HIMJ and HIM-I, that you enjoy the read, and that you may be inspired to make a contribution to one of these journals yourself in the future.

References

Abrams, K. and Crook, G. (2011). The Canadian Health Information Management Association: health information management in Canada. HIM-Interchange 1(1): 17-21.

Blue, B. (2011). Health reform and the health information management profession. HIM-Interchange 1(1) 3-6.

Buchanan, R. and Alexiou, C. (2011). Medical record scanning project, Alfred Health, Melbourne: implementation of Cerner Provision Document Imaging (CPDI). HIM-Interchange 1(1): 1-2.

Chicco, J. (2011). Reform in Primary Health Care Conference. Sydney 28-29 September 2010. HIM-Interchange 1(1): 24-25.

Curtis, K., Mitchell, R., Dickson, C., Black, D. and Lam, M. (2011). Do AR-DRGs adequately describe the trauma patient episode in New South Wales, Australia? Health Information Management Journal 40(1): 7-13.

Holt, C. (2011). Emerging technologies: Web 2.0. Health Information Management Journal 40(1): 33-35.

Leeding Cope. M. (2011). Proud to be a HIM! The long road to awareness - but I finally made it! HIM-Interchange 1(1): 26-27.

Mair, J. (2011a). Privacy, employees and human resources: a case report. Health Information Management Journal 40(1): 36-42.

Mair, J. (2011b). Review of Health Care and the Law (5th ed.) by Janine McIlwraith and Bill Madden. Health Information Management Journal 40(1): 43.

McCrow, C. (2011). Clinical analysis of coded data and the effect on quality of care. HIM-Interchange 1(1): 10-16.

Price, E. and Robinson, K. (2011). The coding masterpiece: a framework for the formal processes and pathways of health classification. Health Information Management Journal 40(1): 14-20.

Ting, J.S.L., Tsang, A.H.C., Ip, A.W.H. and Ho, G.T.S. (2011). RF-MediSys: a radio frequency identification-based electronic medical record system for improving medical information accessibility and services at point of care. Health Information Management Journal 40(1): 25-32.

Watterson, D., Cleland, H., Picton N., Simpson, P.M. and Gabbe, B.J. (2011). Level of agreement between coding sources of percentage total body surface area burnt (% TBSA). Health Information Management Journal 40(1): 21-24.

(1) Kay Bonello, Chair, Editorial Board.

Jennie Shepheard RMRL, GDipHthAdmin, CertHthEco, MPH

Principal Health Information and Classification Advisor

Funding and Information Policy

Hospital and Health Service Performance

Department of Health

50 Lonsdale Street

Melbourne VIC 3000

AUSTRALIA

Tel: +61 3 9096 0484

email: Jennie.Shepheard@health.vic.gov.au

The Council of Australian Governments (COAG) signed a revised health reform package on 13 February 2011, which will form the basis of a new National Health Reform Agreement to replace the existing National Health and Hospitals Network (NHHN) Agreement. However, activity-based funding (ABF) remains a fundamental component of the agreement and references to ABF in the various articles throughout the current issues of HIMJ and HIM-I remain relevant for the health information workforce.
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