It's been quite a year for HIM, so we were eager to launch our 2009 Team of the Year Contest for the full report on department achievements. And, boy, have you all been busy!

EHRs have been on the rise for years, and more of you are climbing aboard the bandwagon. We heard about document scanning initiatives, hybrid environments and fully digital systems. Some teams are even tackling computerized physician order entry (CPOE), which will come in handy when applying for those stimulus incentives. Whether the EHR system is purchased or homegrown, you're taking the change in stride and encouraging other departments to follow suit.

New regulations and government programs put HIM into the spotlight, and department members have embraced opportunities to lend their expertise. Teams conducted facility-wide seminars and one-on-one meetings to prepare for recovery audit contractors (RACs); others appointed clinical documentation improvement (CDI) specialists to ensure physicians follow best practices. You shared success stories at conferences and advised the public on privacy issues. Through these efforts, HIM has earned greater visibility and recognition both in and out of the larger organization. As one entry stated, "This department is no longer known as the one that 'files' records, but one that is the heartbeat of change and opportunity."

Despite these advances, many of you felt the economic strain. Hospitals across the nation reported downsizing and cuts, but through it all, you kept a positive attitude. We heard about teams that adjusted schedules-flexing hours, working 10-hour days or pulling weekend and night shifts-to stretch budgets but ensure operations run smoothly. Some departments went completely offsite, while others brought services back in-house to save money. When departments faced shortages, employees learned new skills and donned a few more hats to help weather the storm. It's part of the camaraderie and cooperation that define HIM.

Busy as ever, our 2009 judges carved out time to help select this year's winner. They scored each entry based on seven criteria: awards and recognition; initiative; adaptability; teamwork; above and beyond; knowledge; and additional information.

We tallied the scores, and we're proud to announce the 2009 HIM Team of Year!

THE WINNERS:
Maine Medical Center
Portland, ME
Leader of the Pack

Avedian was touched by the tribute and delighted to hear the team had won. "It's a really nice honor and it validates for me what I've known all along about the team-they are exceptional," he said.

Maine Medical Center has a history of being on the cutting edge. It launched CPOE in 1975 and, in 1987, became the first hospital to implement document imaging for record storage-tasks many facilities are just tackling now. Implementation of a new document imaging system in 2002 also facilitated the move to a paperless department.

The hospital is the largest facility in northern New England, so proposals often come to them, Avedian said-like when a group of entrepreneurs invited the HIM department to test their developing SR engine. Fortunately, staff has always been willing to lead the pack. "I'm very proud of the management team and staff for continuing to sign up and be present and.stepping up to the plate," Avedian said.

The SR venture was a risky move at the time, but it paid off. This year, the department received an award from the technology provider for saving more than $3 million in transcription costs. "It was an accomplishment for us, certainly, but [also] an accomplishment for the entire institution," Avedian said.

In addition to SR, the HIM department juggles about 30 applications to make operations paperless: physicians complete charts online, most workflow processes are automated and records can be sent directly from the computer to fax machine for release of information. The department also implemented a clinical documentation management program, which not only improved documentation and DRG accuracy, but also resulted in "better synergy and teamwork" among employees, Avedian said.

As paper records declined, visibility soared; HIM is an active part of discussions about HIT and EHRs, and physicians frequently call staff members when they have computer problems. "That elevates the responsibility of the medical record analyst to know more, be able to problem solve a variety of issues and to understand how the EHRs are flowing to downstream systems," Howe said.

HIM expertise is even more critical now as the institution participates in the statewide HIE. Once data is uploaded to the network, errors can be difficult to track down and correct, Howe noted, so the hospital authenticates information before sending it out. As the privacy and security officer, Avedian knows the value of data integrity, so he participates in the HealthInfoNet Privacy and Security teams and advises others on related issues.

While some staff attribute the department's success to strong leadership, Avedian stressed the role teamwork has played over the years. "My goal has always been never to be an integral part of the day-to-day operation" he said. "We're 24/7; we have a big responsibility, so it can't ever be contingent upon a person or two people-it's all about teamwork."

Staff members don't just stick to what they know; as part of HIM Week, employees developed a fun scenario that followed "Charlie Brown's" record from creation to release of information, so they learned how other areas in the department function. That made it easy for them to step into other roles. During a coding backlog, for example, employees from other parts of the department were cross-trained in charge entry to speed the billing process. 

The 2009 HIM Team of the Year contest is sponsored by:

Management development is also an ongoing project at Maine Medical Center. Promising HIM staff members are appointed "Team Leaders" and are required to participate in a training program to build their management skills. "They're a big part of our operation," Avedian said.

Maine Medical Center has a lot on tap for HIM, but its past successes bode well for the future. Besides preparing for ICD-10 and RACs, the department is focused on integrating its clinical and EHR systems. Currently, information is segregated into sections for nursing, nutrition, progress notes, etc., so HIM is looking to create a more consolidated record. "Interdisciplinary progress notes, if you will," Howe explained.

The hospital is also installing a new registration and billing system, and administrators are at a "decision point" regarding the next direction to take the enterprise patient index, according to Avedian. "We're involved in a lot of big projects, and what's great about Maine Medical Center and this department is we're actively at the table," he said. "People seek us out to be active participants ... and that's a tribute to our skill set."

(continue to page 2 for our runners-up.)