Evaluate health information systems and data storage design 5 *Storage media, disaster recovery, and cloud computing Manage clinical indices/ databases/registries 5 *Policies for secondary data sources, registries, and indices Apply knowledge of database architecture and design to meet organizational needs 3 *Data dictionary, data modeling, and data warehousing; Database architecture and design Evaluate data from varying sources to create meaningful presentations 5 Subdomain I.E Secondary Data Sources Validate data from secondary sources to include in the patient’s record, including personal health records 3 *Data stewardship & Information Governance Standards; Patient-Centered Health Information technology and portals Domain II. Information Protection: Access Disclosure, Archival, Privacy and Security Subdomain II.A. Health Law Identify laws and regulations applicable to health care 3 *Health information laws and regulations including HIPAA, The Joint Commission, State laws, and Centers for Medicare and Medicaid Services (CMS) Analyze legal concepts and principles to the practice of HIM 4 Subdomain II.B. Data Privacy Confidentiality and Security Analyze privacy, security and confidentiality policies and procedures for internal and external use and exchange of health information 4 *Patient verification and identity management policies; Privacy, confidentiality, security principles, policies and procedures, and federal/state laws; E-Discovery Recommend elements included in design of audit trails, data quality monitoring programs 5 *Data security (audits, controls, data recovery, e-security, disaster recovery planning, and business continuity planning) Collaborate in the design and implementation of 4 *Health information archival and retrieval systems; Data security protection methods
intranet and Internet applications technologies (Intranet, web-based systems, standards SGML, and XML) Evaluate system architecture, database design, data warehousing 5 *System testing; Interface management; Data relationships Create the electronic structure of health data to meet a variety of end user needs 6 *Data information and file structures (data administration, data definitions, data dictionary, data modeling, data structures, data warehousing, and database management systems) Subdomain III.B. Information Management Strategic Planning Take part in the development of information management plans that support the organization’s current and future strategy and goals 4 *Corporate strategic plan, operation improvement planning, and information management plans; Disaster and recovery planning Take part in the planning, design, selection, implementation, integration, testing, evaluation, and support of health information technologies 4 *Systems development life cycle (systems analysis, design, implementation, evaluation, maintenance, EHRs, HIEs, and RECs) Subdomain III.C. Analytics and Decision Support Apply analytical results to facilitate 3 *Data display, power point, and dashboards Apply data extraction methodologies 3 *Healthcare statistical formulas (LOS, death, birth, and infection rates); Data capture tools and technologies (forms, computer screens, templates, other health record documentation tools; clinical, financial, and administrative) Recommend organizational action based on knowledge obtained from data exploration and mining 5
Analyze clinical data to identify trends that demonstrate quality, safety, and effectiveness of healthcare 4 *Descriptive statistics (mean, standard deviation, ranges, and percentiles); Inferential statistics (T-tests, ANOVA, regression analysis, reliability, and validity); Epidemiological applications Apply knowledge of database querying,and data exploration and mining techniques to facilitate information retrieval 3 Evaluate administrative reports using appropriate software 5 Subdomain III.D. Health Care Statistics Interpret inferential statistics 5 *Inferential statistics (T-tests, ANOVA, regression analysis, reliability, and validity); Computerized statistical packages (SPSS & SAS) Analyze statistical data for decision making 4 *Data reporting of statistical healthcare data and presentation techniques Subdomain III.E. Research Methods Apply principles of research and clinical literature evaluation to improve outcomes 3 *Research design/methods (quantitative, qualitative, evaluative, mixed, and outcomes); Literature review and evaluation; research techniques (Medline, CMS libraries, AHRQ, and other websites) Plan adherence to Institutional Review Board (IRB) processes and policies 3 *National guidelines regarding human-subjects research (IRB process); Research protocol data management Subdomain III.F. Consumer Informatics Educate consumers on patient-centered health information technologies 3 *Patient centered medical homes; Patient portals, patient safety, and patient education; Personal Health Record (PHR) Subdomain III.G. Health Information Exchange Collaborate in the development of operational policies and procedures for health information exchange 4 *HIEs, local, regional including providers, pharmacies, and other health facilities
outpatient, physician offices, and other delivery settings Take part in selection and development of applications and processes for chargemaster and claims management 4 *Chargemaster management Apply principles of healthcare finance for revenue management 3 *Cost reporting, budget variances, and budget speculation Implement processes for revenue cycle management and reporting 3 *Corrective Coding Initiative (CCI)-Electronic Billing X12N; Compliance strategies and reporting; Audit process (compliance and reimbursement); Revenue cycle process; Utilization and resource management Domain V. Compliance Subdomain V.A. Regulatory Appraise current laws and standards related to health information initiatives 5 *Compliance strategies and reporting; Regulatory and licensure requirements; Elements of compliance programs; Patient safety Determine processes for compliance with current laws and standards related to health information initiatives and revenue cycle 5 *Policies and procedures; Non-retaliation policies; Auditing and monitoring Subdomain V.B. Coding Construct and maintain processes, policies, and procedures to ensure the accuracy of coded data based on established guidelines 6 *UHDDS and Federal compliance guidelines; Official coding guidelines from CMS, AMA, National Committee on Vital and Health Statistics (NCHVS), National Correct Coding Initiative (NCCI, and AHA Manage coding audits 5 *Audit principles and reporting Identify severity of illness and its impact on healthcare payment systems 3 *Case mix; Computer Assisted Coding (CAC) systems
3.2. Take precautions to ensure and maintain the confidentiality of information transmitted, transferred, or disposed of in the event of termination, incapacitation, or death of a healthcare provider to other parties through the use of any media. 3.3. Inform recipients of the limitations and risks associated with providing services via electronic or social media (e.g., computer, telephone, fax, radio, and television). IV. Refuse to participate in or conceal unethical practices or procedures and report such practices. A health information management professional shall: 4.1. Act in a professional and ethical manner at all times. 4.2. Take adequate measures to discourage, prevent, expose, and correct the unethical conduct of colleagues. If needed, utilize the for potential ethics complaints. 4.3. Be knowledgeable about established policies and procedures for handling concerns about colleagues' unethical behavior. These include policies and procedures created by AHIMA, licensing and regulatory bodies, employers, supervisors, agencies, and other professional organizations. 4.4. Seek resolution if there is a belief that a colleague has acted unethically or if there is a belief of incompetence or impairment by discussing one’s concerns with the colleague when feasible and when such discussion is likely to be productive. 4.5. Consult with a colleague when feasible and assist the colleague in taking remedial action when there is direct knowledge of a health information management colleague's incompetence or impairment. 4.6. Take action through appropriate formal channels, such as contacting an accreditation or regulatory body and/or the AHIMA Professional Ethics Committee if needed. 4.7. Cooperate with lawful authorities as appropriate. A health information management professional shall not: 4.8. Participate in, condone, or be associated with dishonesty, fraud and abuse, or deception. A non-inclusive list of examples includes: Allowing patterns of optimizing or minimizing documentation and/or coding to impact payment Assigning codes without physician documentation Coding when documentation does not justify the diagnoses or procedures that have been billed Coding an inappropriate level of service Miscoding to avoid conflict with others