By mid March 2020 the Health Information Management Association of Australia, along with every other organisation in Australia and around the world, had to rethink the delivery of professional practice sessions in the context of a highly infectious pandemic. Subsequently all previously scheduled face-to-face meetings were cancelled and a schedule for the delivery of digital professional development content to members was implemented. This was done through a series of webinars with the first one being delivered on 23 April 2020. On Friday 29 May 2020 a webinar titled ‘Challenges of managing health information in COVID-19 times’ was delivered. This article discusses these challenges across a range of health services and various health information management tasks.This and other webinars are available to members for viewing at: : https://himaa.eventsair.com/MemberPortal/membership/members-portal/ContentPage/ContentPage?page=1
Formal health classifications facilitate the collection of significant quantities of health data in the form of clinical codes. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) is used in Australia (and many countries around the world) primarily to report information about admitted patients’ diagnoses while the treatment provided to the patient is reported using the Australian Classification of Health Interventions. The Australian Refined Diagnosis Related Groups usethese clinical codes to group patients into like categories and represent another important health classification that is widely used by managers of health information in government departments, hospitals and health funds. In Australia, the Independent Hospital Pricing Authority is responsible for managing these classifications (IHPA, 2019). Health information managers (HIMs) and clinical coders (CCs) are responsible for the clinical coding of admitted patient records, thereby creating the bulk of these health data. The data are reported to state and federal government departments from where they are made available for use by multiple stakeholders, such as researchers, program managers and funding model developers. Within individual hospitals, researchers, funding managers and other stakeholders will also access these data to inform their work.
Communities of practiceSince the recognition of communities of practice (CoP) as a key concept in knowledge creation, acquisition and resource sharing, they have become increasingly popular, with a growing number of healthcare organisations investing in them to manage knowledge and improve performance.
The 19th International Federation of Health Information Management Associations (IFHIMA) Congress was held in Dubai, United Arab Emirates from Sunday 17 to Thursday 21 November 2019, with the major theme being ‘empowering health information management professionals through a global voice’. The congress was hosted by the Saudi Health Information Management Association with many representative attendees from countries in the region as well as representatives from Australia, United States of America (USA), Canada, England, Korea, and Indonesia to name a few.
While searching the Internet for an article recently, I came across an article by Google Australia’s Engineering Director, Alan Noble. His topic struck a chord in his opening line: “…in the corporate world there are few more irresistible – and dangerous – forces than inertia. On the road to success lie the carcasses of countless companies whose dying words were ‘but that’s how we’ve always done it…’” (Noble, 2017). This caught my interest, as I often puzzle over how the human services sectors can be so busy and so inert at the same time. Noble argued that, once an organisation gets to a certain size and maturity, the temptation to “stay put” in a state of inertia is strong (inertia being described as “the tendency of things to keep going at a certain velocity”). But the world around the organisation is anything but inert, and to stay relevant and thrive in a changing environment, innovation is a key element.
Belief is such an interesting thing – central to who we are, what we do, and how others see us. What does this have to do with quality of care? Well, quite a lot as it turns out. In the various health, community, and aged care organisations I visit, I see a lot of “belief-based quality”. What does that mean? Boards and executives are generally very optimistic about the quality of care their organisation provides. They all think their care is above average (hmmmmm) and that in general their staff are out there every day doing a great job. Sometimes they have valid and reliable information to support this view, sometimes they do not. Many of you will have heard my theory on this: we have a deep belief, embedded in our healthcare DNA, that high quality care is created by smart, well trained, well intentioned people coming to work and doing their best. Even in the face of copious evidence to the contrary, in the shape of adverse event studies and public inquiries into poor care, many boards and executives cling steadfastly to the view that all is well – until it’s not. Their mantra is: “We’re accredited and we have great staff. What else is there?”
One of the biggest challenges facing the health information management workforce in the healthcare system in Australia is the tyranny of distance. The National Rural Health Alliance (2016) lists workforce shortages as one of the key issues in rural and regional health. Shepheard (2015) identified the issues facing regional and rural Health Information Managers (HIMs), including isolation, communication, workforce retention, and technological opportunities and challenges. Over the last few years Australian regional and rural HIMs have been working with their state branches and the Health Information Management Association of Australia (HIMAA)on ways to support the rural and regional health information management workforce, including the dissemination of information, implementing ways to provide professional development, and support of each other in overcoming the obstacle of distance.
The release of “Targeting Zero: Report of the Review of Hospital Safety and Quality Assurance in Victoria”1 in October 2016 seemed a long time coming – but it was well worth the wait. From my perspective, it’s a racy page turner: a good hard look at Victoria’s clinical governance gaps and how to close them, which will be useful for anyone seeking to provide safer, better care. It is fantastic to see authentic safety and quality issues being named and explored, with associated recommendations for real change; exciting to see leadership and culture recognised as key to that change, at both state and health service levels; a relief that out of such tragedy at the Djerriwarrh Health Services comes an honest appraisal of system gaps and clear direction for improvement.