LESLIE: A draft HIM Core Model was introduced by the American Health Information Management Association (AHIMA) at the Winter Team Talks this past March, and continues to evolve based on feedback from HIM leaders who attended those meetings and component state association annual meetings. I want to better understand why the core model is important, why it is being created now, how will it help AHIMA and their members, and what elements are being included in the core model.

PATTY: I am interested in understanding how the core model relates to the future of the HIM profession and how it will help advance HIM best practices. In particular, how HIM practitioners will use the model to meet the needs of their healthcare organizations, develop future HIM organizational structures, define job positions and plan their careers.

LESLIE: Well we have certainly put out a lot of objectives for this column. I think we should interview someone who has been deeply involved in this process. I have invited Bonnie Cassidy, MPA, RHIA, FAHIMA, FHIMSS, vice president, HIM product management at Quadramed in Atlanta, to talk with us. Bonnie is also the president-elect of AHIMA and has participated in the AHIMA strategic planning sessions that initiated the development of the model.

PATTY: Bonnie, thank you for joining us to discuss the emerging core model. We would like to start our conversation with what is the core model?

BONNIE: The core model describes the robust set of functions and opportunities open to current and future health information managers.

LESLIE: The HIM profession has been around for more than 80 years. Why do we need to be describing these functions now?

BONNIE: We are in the midst of the greatest transformation of the healthcare system ever, bringing with it more than incremental change in the information needs of clinicians, patients, researchers, public health, insurers, government and others dedicated to the quality of health outcomes for citizens. With more health information available electronically, advances in medicine, and in the ways that care is delivered, it is not only possible but mandatory for us to have affordable quality healthcare in this country.

PATTY: To contribute to this greater societal good, we need to assess how completely we have defined and communicated the scope of HIM responsibilities to healthcare provider organizations and other users of health information. It is crucial that we clarify the HIM profession, and the core model will give us a way to think about that, a way to organize the functions that have evolved over time into the complex array of services that 50,000+ members of AHIMA provide to millions of users of health information. The clarity provided by the core model will help AHIMA members communicate how they can best serve in the various sectors of the healthcare industry in which they work.

BONNIE: That's exactly right, Patty. The AHIMA leadership sees that our members live in different parts of the model, and the association needs to have a broad, comprehensive view of their world to help us think about how to support the needs of everyone as they strive to meet the needs of their constituents. The core model will drive programs and services, training and education, curriculum development, advocacy, policy, and the support systems that need to be in place.

LESLIE: So if I am tracking with the two of you, the core model will do at least three things:

1. Guide the association in determining the best way to support members during the transformative times ahead;

2. Guide individual HIM practitioners in determining what expertise and services they need to be providing to their organizations; and

3. Guide all of us in how we communicate about HIM with our employers, with other professions, the public and even our own family members.

BONNIE: Yes, it will help the association in setting priorities, assessing resource needs and organizing to allocate resources to better serve members who work in all areas covered by the core model. We will be able to see what's missing, what's no longer relevant and what is in place that needs more resources. For example, guided by the core model we can better prioritize our work with alliance partners, determine the committees and workgroups that are critical for us to have representatives. The AHIMA board and staff will be able to work more closely with the component state associations (CSAs) to have a pipeline of members ready to take on appointments, give testimony and serve as AHIMA spokespeople.

PATTY: Bonnie, at some of the state meetings members told me that too often they were left out of important discussions about the electronic health record (EHR) systems that were purchased. They were brought into the design and implementation process too late in the game to help their facility avoid many of the back-end problems that users experience with EHRs, such as navigating the record for data retrieval and coding, formatting for legal record output, and supporting internal, external and public reporting. Many of our colleagues are frustrated when they realize they could have helped avoid the costs involved in redesign or sometimes even having to scrap a system and start over. They ask how AHIMA is helping them get to the table, to be part of the decision-making process during all phases of EHR selection, design and implementation.

BONNIE: I have had the same question asked of me. The core model will enable members to show others more clearly our role and responsibility for assuring successful use of EHRs in all settings. This point also reinforces the importance of all our members taking the time to look at the core model and tell us what is missing. We want to know what we hit, what we missed, and how the model can even more clearly define the work they are doing or believe they need to be doing in their organizations.

LESLIE: What I am hearing is that creating the HIM core model will serve as a framework for establishing the standard roles and functions needed to assure quality health information, much as the Joint Commission standards did for the profession in the last half of the last century.

BONNIE: Yes, when the Joint Commission established standards for HIM in accredited healthcare organizations, they defined critical roles and functions that depended on HIM expertise and involvement. While the Joint Commission still has HIM standards, health information usage is more complex than ever and it is our responsibility to define the scope and attributes of the delivery of HIM services -- not everything but certainly the critical strategies and initiatives. We are identifying all interdependencies in the system -- what is the end point, what has to take place to reach that point, where are the gaps. The model needs to support the continued evolution of the profession. We cannot depend on others to do this important work for us.

PATTY: This work is critical because by definition a profession needs clear boundaries. When we look at the professions of information technology and clinical informatics, we see overlaps with HIM. To maintain our own identity and to avoid erosion of our profession, we need this model to clarify the true scope of the HIM profession and describe the overlaps as areas where we need to be prepared to work collaboratively with these other professions. The model should show how by collaborating, the three health information professions will enable us to fully release the potential of health information in the service of quality health outcomes in our country.

LESLIE: Bonnie, we have kept this short discussion focused on why the core model is important and how it can be used by the association and the individual members. However, we also want to introduce our readers to the most current draft of the core model and its components.

BONNIE: I would be happy to do that. Graphic 1 shows the core model built on four foundational functions in managing health information-health data capture and maintenance, health information analysis and output, health information resource management and innovation, and health information governance and stewardship. It further shows there is a reciprocal relationship between these foundational functions and health information policy, standards, education and research. Graphic 2 shows a more detailed description of the components of the core model.

PATTY: As we conclude this discussion, what do you want our readers to do with this information?

BONNIE: I want them to tell us if they think the emerging core model reflects the purpose of AHIMA. The next draft of the core model will be presented at the summer Team Talks along with discussions of our mission and vision as an organization. It is still early in that dialogue and we are looking for widespread involvement and input from our members.

PATTY: This is a great opportunity for HIM practitioners to lead from any seat they sit in. Participating in this dialogue and communicating the definition of our profession, our values, our purpose, and our vision is the responsibility of all of us.

LESLIE: Yes, it all comes down to each of us understanding our responsibility to be a leader-to be present and accounted for in these discussions, to engage others in our organizations in ways that enable every healthcare organization and the whole healthcare system to function at a higher level. We owe it to the patients.

Leslie Ann Fox is chief executive officer and Patty Thierry Sheridan is president, Care Communications Inc., Chicago. They invite readers to send their thoughts and opinions on this column to lfox@care-communications.com or ptsheridan@care-communications.com.