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Marking 8 decades of leadership and innovation in the HIM field, the American Health Information Management Association (AHIMA) gathered in Seattle for the 2008 Convention and Exhibit on Oct. 11-16. The action-packed conference celebrated the association's past accomplishments, but leaders put a greater focus on maintaining momentum to ensure AHIMA reaches its centennial mark.
While track-based seminars addressed current concerns about ICD-10, MS-DRGs and recovery audit contractors (RACs), general sessions offered progressive perspectives on the potential of genomic medicine, HIT and personal health records (PHR). With technology on everyone's minds, AHIMA didn't just talk the talk; PowerPoint presentations-displayed on two jumbo screens during the general assemblies-provided engaging multimedia experiences for attendees at nearly every session.
In keeping with the future-focused event, AHIMA launched its green initiative during the convention, handing out flash drives and reusable water bottles with conference materials to cut down on paper and plastic waste, respectively. Evaluations and continuing education units (CEU) certificates also went online, and attendees were frequently reminded to visit www.wyndhamjade.com/ahima08ceu to receive credit for attending a session.
Welcome to Washington
After 2 days of pre-conference sessions and activities, the convention officially kicked off Monday morning with an address from Seattle mayor Greg Nickels. Keeping the mood light, Nickels welcomed AHIMA members to the home of Starbucks and fish slinging. The convention was last held in Seattle in 1990, and Nickels expressed hope that attendees will return to the "creative and innovative" city soon.
Washington HIMA president Carol Quinsey, RHIA, CHPS, took a friendly jab at the host city during her welcome address. "It's not raining," she noted. "Isn't that special?" Quinsey urged attendees to step outside their comfort zones during the convention and speak to someone new every day.
Reinforcing the importance of activism, artist and environmentalist Chris Jordan gave an eye-opening presentation about mass consumerism and wasteful habits during Monday's general sessions. Having just arrived from the airport, many attendees were sent on a guilt trip when Jordan showed a photo of an industrial pipeline he digitally constructed from 1 million plastic cups-the amount airlines use in 6 hours.
Jordan urged audience members to make an effort to reduce excessive consumption of resources. "Once we become aware" of our effect on the environment, Jordan said, "then we have a choice we didn't have before."
It's in the Genes
Following a short break, presentations on personalized medicine showed attendees where continued momentum can take them. Linda Avey from 23andme, a company that maps customers' genetic profiles, explained how genes can unlock new approaches to disease management and treatment. By combining genetic information with customer surveys, Avey hopes to identify correlations that could identify underlying factors in disease risk and drug response. "This is the vision we have for the future," Avey said.
Alan Guttmacher, MD, from the National Institutes of Health, expanded upon the immense potential genomic medicine holds for health management. "We're just now at the beginning of the genome era," he affirmed.
According to Dr. Guttmacher, genetic profiles can lead the way to defining disorders based on causation, not symptoms; personalized screenings and presymptomatic therapies; and pharmacogenetics, which he defined as finding "the right drug for the right person at the right time."
Dr. Guttmacher also urged attendees to explore their family health histories as a precursor to genetic-based personalized medicine.
Balancing out the morning's sessions, Wyllie Burke, MD, from the University of Washington, identified risks that may accompany the growth of genetic profiling, including false positives, unnecessary care and stigmas associated with results. In addition, while "compelling examples" of genetic-based medicine already exist, such as the BRCA test, many genetic links are not "highly predictive," Dr. Burke said.
Summarizing a key point from all presenters, Dr. Burke said genomic medicine has only just begun: "We need to do the research to answer the questions," she affirmed.
Leading Reform
While Monday's sessions previewed possibilities down the road, Tuesday's sessions addressed actions needed to put health care in the right direction. Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) Kerry Weems took the stage to discuss "the elephant in the room": rising health care costs. Weems said if costs continue to go unchecked, health care will soon consume 20 percent of the federal budget. States are also under pressure to cover health care costs, he noted, and educational programs are paying the price.
Weems emphasized the need for value-based purchasing, which would use performance measures to rate the quality and cost of care from providers. "Our main objective is to raise the quality of health care and make health care safe," he said.
While many attendees were concerned about ICD-10 changes and impending RACs, Weems said such policies will improve specificity and reduce claim denials in the future, leading to better health care overall.
Long-term improvements in health care and reduction of costs, however, will be impossible without EHR, Weems said. In fact, he identified PHR as a potential "game-changer" that will enable value-based purchasing and make health care more accessible and responsible. "Value-based purchasing isn't utopia," Weems said, but "it's reasonable, it's practical and it's necessary."
Jetting ahead to 2018, Jonathan Perlin, MD, PhD, MSHA, FACP, FACML, clinical services, HCA, also championed EHR as an essential tool for reducing health care costs. Dr. Perlin said people need a health care system that is not only "cognizant of the patient," but can also relay that information to clinicians. As new communication outlets and globalization shrink distances, health care systems will also need to function on an international scale, Dr. Perlin said. "We need to be thinking not only cross town, but cross country and across the world," he asserted.
Like Weems, Dr. Perlin saw value-based purchasing as an answer to problems in health care, as high performance will lead to greater volumes of patients and increased revenue. Dr. Perlin admitted that the future may be bumpy, but he geared up the crowd for the road ahead. "I'm excited for the future, and you all will be the people whomake that future possible," he said.
Charging HIM with the responsibility of empowering consumers and educating physicians, Dr. Perlin said: "Each of you will be at the vanguard of this movement." Glad to be recognized for the crucial role they serve, HIM professionals erupted in a standing ovation.
Hailing from the New York State Department of Health, Lori Evans, MPH, MPP, presented a stateside approach to improving health care. Noting the challenges ahead, including health care costs and aging boomers, Evans said states should pick up where the federal government leaves off in establishing health information exchanges (HIE). According to Evans, governance, accountability and funding are the key components to building HIE from the bottom up.
HIE is in progress or has been established in several states, including Indiana, Rhode Island and New York. Evans said such successes can be attributed to governing bodies that set and aligned policies like pay-for-performance and privacy protections.
Evans stressed that HIM professionals must always bear in mind that building a health information infrastructure is the means to reduce costs and improve care, not the end, so continued growth and evolution is essential.
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