Posted on Oct. 20, 2008

As reality shows have taken the television industry by storm, the American viewership has made one thing clear: We like watching opposites "trade places," whether they're swapping spouses or decorating each other's living rooms.

In the health care provider world, the IT and HIM departments have often had opposing agendas and goals - and what's more, they've come from very different backgrounds and career paths. Now, as more hospitals are working in a hybrid medical record environment, imagine what a reality TV show would reveal "behind the scenes" as these two critical teams learn, adjust and rise to the occasion of meeting their strategic objectives in a hybrid environment. This month, our panelists discuss how the IT and HIM relationship has evolved - and how the two positions have learned the lessons of "trading places."

BRANDWEIN: What changes have you noticed in the relationship between your HIM and IT departments?

Glennda Gore, RHIA, vice president, corporate compliance and risk management; former HIM director, McAlester (OK) Regional Health Center: The most obvious change is that we have a better understanding of each other's departments. The entire process of becoming e-enabled has "thrown us together" and given each department a more thorough knowledge of the other's strategic goals and day-to-day activities.

BRANDWEIN: This type of mutual understanding doesn't happen overnight. How did you help facilitate a better relationship between the two teams?

Beth Kost-Woodrow, RHIA, assistant vice president and chief privacy officer, WellStar Health System, Atlanta: We really did have a "trading places" situation. I asked the IT project manager in charge of EHR implementation to live in the HIM department until he understood who our customers were, the "pain points" in our jobs and how we impact the hospital.

BRANDWEIN: What was the outcome of your "trading places"?

KOST: I think the biggest thing the IT department took away was how bright and dedicated the HIM team is. And the HIM department has a better understanding of the IT department's breadth and responsibilities across the entire hospital. When I first asked the IT project manager to sit in the HIM department, I didn't understand that IT had approximately 130 live projects on their schedule. They were and are stretched thin, but they're dedicated to doing things right.

BRANDWEIN: Throughout your collaboration with the IT department, what have been your greatest lessons learned?

KOST: I think we've developed a greater mutual respect for each other, which ultimately helps us work more efficiently and strategically. We understand each other's roles: Overall, IT's focus has traditionally been on the technology itself, while the HIM department's focus is on the process and how it impacts our "customers" - namely, the clinicians.

A "lesson learned" I would pass along to colleagues is establishing your model for system ownership up front. In years past, we haven't had a consistent model; for instance, operations "owned" certain applications, while IT "owned" others. Now, we have a new CIO and organizational structure, and it's more clearly defined. Within the IT department, we have analysts responsible for watching workflow and managing certain systems' uptime. When we have issues, we now have clarity of ownership and a faster, clearer path to resolution.

GORE: I've noticed the same thing, and I think the two departments' mindsets lend themselves to collaboration. IT sees how to get things done, and HIM sees why it should be done. Hospitals need both sides, and they need them working together to be efficient, compliant and legal.

Also, our IT department already has a nurse devoted to nursing informatics as well as a financial person devoted to the A/R system. In the future, I'd like to see an HIM person in the IT department. Particularly with the legal aspect of medical records, I think it makes sense and would add value to both sides - HIM and IT.

BRANDWEIN: It's clear that the hybrid medical record environment can benefit the HIM department by showing IT and the rest of the hospital what a critical role it plays. In addition, by collaborating with IT, HIM has an excellent opportunity to evolve and have a more strategic position. Next month, as we wrap up our roundtable, we'll talk about our greatest lessons learned during the entire EMR implementation process, so stay tuned! 
 
Aaron Brandwein is divisional vice president for HealthPort, formerly SDS. He is responsible for HealthPort's EDMS technology division and currently serves on the AHIMA Exhibit Advisory Committee and has spoken at numerous AHIMA national and state conferences on the topic of electronic and hybrid records.