
Advocacy Agenda

AHDI engages in year-long, proactive advocacy to promote the critical value and contributory role of the healthcare documentation sector in tandem with the goals of the US system for interoperable health information exchange, meaningful healthcare reform, and health information privacy and security. AHDI collaborates with other clinical documentation organizations, such as the American Health Information Management Association (AHIMA), to ensure patient health information is captured, documented, standardized, accessed, and regulated in a way that supports coordinated care, clinical decision-making, appropriate reimbursement, and risk management. To that end, AHDI considers the following advocacy areas to be mission-critical for the association, its members, and this sector:

Patient Health Story

The healthcare documentation industry and the professionals who work within it play a critical role in making sure patients in the US health system have an accurate, comprehensive, and secure health record. Historically, care providers have relied upon the ability to dictate the details of a health encounter and have that “story” documented either by a transcriptionist or speech recognition technology (SRT) and an editor. As healthcare delivery moves toward a nationwide health information exchange network via electronic health record (EHR) systems, the ability to preserve the full story of patient’s health will be a critical consideration. EHR systems will need functionality for receiving and processing codified narrative reports so that meaningful use criteria can be met without compromising patient health stories.

AHDI advocates for the patient health story by:

  1. Promoting public awareness of the role and value of a comprehensive health story through campaigns that teach patients how to: (1) access and understand their health records, (2) draft meaningful personal health records, and (3) “own” their own health stories.
  2. Seeking a federal requirement for EHR systems to interface with the dictation/transcription process in order to receive and integrate narrative reports into a patient’s health record.
  3. Positioning the value of innovative industry technologies that can codify narrative text through the use of natural language processing and clinical nomenclature systems so that health information generated from narrative capture can be consumed by EHR systems.
  4. Promoting adoption of Health Story Project data standards, which support information flow between narrative documents and EHR systems.

EHR Adoption

AHDI fully supports our nation’s goals for EHR adoption. Successful integration of EHRs into the DNA of healthcare delivery will facilitate health information exchange on a global scale with the goal of improving both coordination of care and public health but only if those EHRs are shaped around standards and best practices for capturing and managing patient health information in a practical, patient-centric manner. Our sector has historic perspective, expertise, and innovative solutions that address how patient health stories need to be captured, formatted, and documented. We have the unique ability to facilitate truly practical EHR adoption in a way that preserves America’s healthcare story – so that the focus isn’t just on patient health data, but rather on meaningful patient health information.

AHDI advocates for standards-driven EHR adoption by:

  1. Positioning the healthcare documentation sector as an authority in the accurate, secure capture of patient care encounters and the best source of leadership when it comes to the integration of healthcare documentation practices and standards in the evolving EHR.
  2. Contributing to the development of standards and technical specifications around EHR systems development and interoperability.
  3. Lobbying for legislation and/or policies that comply with standards and best practices for health information management.
  4. Promoting the role of healthcare documentation specialists as quality data capture experts who can provide analysis of codified narrative, setup and integration of EHR systems, and quality assurance support in an EHR-driven documentation setting.
  5. Lobbying for federal and/or state funding for workforce development programs, apprenticeship programs, and/or technical training programs designed to retool the healthcare documentation workforce toward emerging EHR roles.

Health Information Exchange (HIE)

AHDI recognizes that the success of a Nationwide Health Information Network (NHIN) will greatly depend on how quickly and to what degree health information is able to be exchanged across disparate healthcare enterprises. While many organizations are scrambling to define interoperability and build the framework for information exchange, the healthcare documentation sector has the advantage of ready access to America’s health records and innovative solutions and strategies for enabling the exchange of that health data through a secure network.

AHDI advocates for meaningful health information exchange by:

  1. Contributing to and actively promoting the development of standards for uniform data exchange, including transaction and security standards, that will facilitate meaningful interoperability.
  2. Supporting HIE efforts of alliance partners, such as AHIMA, that move the needle toward the NHIN.
  3. Promoting this sector’s HIE initiatives – immediate, ready-to-deploy solutions for establishing an interoperable network for information exchange.
  4. Supporting local HIEs and RHIOs and engaging AHDI regional and local components toward involvement with these organizations at the local level.

Health Record Privacy & Security

Safeguarding patient health information is a core value for AHDI, its members, and the healthcare documentation industry. Few objectives are more important to this sector than protecting the privacy and security of patient health information. As EHRs are developed and an NHIN is established, the scrutiny around health record access and security will only increase. Clear and practical standards, regulations, and certification processes must continue to be developed to ensure the protection of health information in a way that will meet EHR adoption goals. In addition, anyone who has access to protected health information will need to be trained, certified, and held accountable to those privacy and security standards before access to that protected information is granted.

AHDI advocates for health record privacy and security by:

  1. Promoting best practices in regulatory compliance to all industry stakeholders, especially those with direct access to protected health information.
  2. Developing health record privacy and security best practice guides, training, and preparatory materials to educate and prepare the healthcare documentation workforce for regulatory compliance.
  3. Promoting mandatory credentialing of all healthcare documentation professionals to certify to healthcare delivery that our workforce is trained and held accountable to regulatory compliance policies and practices.
  4. Lobbying for legislation and/or policies that support health record privacy and security standards and accountability for access to patient health records.
  5. Contributing to the efforts of the HIT Policy Council and other committees around health record privacy, security, and confidentiality.

Workforce Development

A number of internal and external factors are generating workforce challenges for this sector. An aging and retiring traditional transcription workforce, compensation challenges, the competitive nature of a global marketplace, and emerging technologies like SRT and EHRs – all are contributing to critical gaps in our once robust workforce. The number of educated, trained, and technologically savvy specialists in this sector is presently insufficient to meet the needs of a burgeoning healthcare delivery system, where documentation demands are only expected to increase. Commoditization of service delivery has had a negative impact on both billing and compensation for the sector, making it harder than ever before to recruit workforce candidates into the profession. Recruitment, training, and deployment of a next generation healthcare documentation professional will be critical to this sector’s longevity, which must include an investment in current workforce candidates to retool and repurpose the tacit knowledge and skills of those candidates toward other emerging HIM, EHR, and documentation roles.

AHDI advocates for workforce development by:

  1. Lobbying for federal and state funding for workforce training programs.
  2. Lobbying for scholarships, loans, and grants to fund education and training for qualified workforce candidates.
  3. Working with the Department of Labor to develop a school-to-work, apprenticeship model that will successfully transition graduates to contributory employment with industry employers.
  4. Applying for federal grants designated for training in emerging EHR roles.
  5. Lobbying for legislation, policy, and funding that supports HIM/HIT workforce training and development.
  6. Developing advanced training programs for emerging roles, such as SRT editing and NLP editing/abstracting, to strengthen the healthcare documentation career lattice and create a safety net of career options for our workforce.

Value of the Healthcare Documentation Knowledge Worker

Accurate, high-integrity documentation of a patient’s health story does not happen in a vacuum, nor can it be accomplished by placing that documentation burden solely on the shoulders of the patient’s care provider. Preserving America’s healthcare story (See #1 above) will continue to require a partnership between physicians and the documentation team – highly skilled, analytical quality assurance specialists who provide risk management support in capturing healthcare encounters and making sure they are documented and formatted in a way that promotes clinical clarity and coordinated care. Even in settings where narrative capture may not be enabled, someone needs to be positioned to ensure accurate documentation of those care encounters and identify gaps, errors, and inconsistencies in the record that may compromise care or compromise compliance goals (ie, meaningful use, core measures, PQRI criteria, RACs, etc.). Beyond traditional transcription and speech recognition editing, which are likely to continue for some time, healthcare documentation specialists are a best-fit, ready-made solution to the need for quality monitoring in EHR-enabled settings. It is AHDI’s strong position that the tacit knowledge of this sector’s workforce should be deployed in any setting where healthcare encounters are being documented to preserve the integrity of health information. A great deal of visibility around the contributory value of our workforce still needs to be generated so that decisions and standards around health data capture and documentation are made with the expertise and guidance of this sector.

AHDI advocates for the value of the healthcare documentation knowledge worker by:

  1. Positioning the role of our workforce in all public policy statements, advocacy documentation, and official comments submitted to policy and standards-setting organizations and federal committees related to EHRs, health IT, and information exchange.
  4. Promoting mandatory credentialing of all healthcare documentation professionals to certify to healthcare delivery that our workforce has the training, expertise, and professional credentials to be valued among the allied health and HIM delivery teams. .
  5. Engaging healthcare documentation specialists in proactive advocacy at the regional, state, and local levels to promote pervasive visibility of this sector and its purpose in healthcare delivery.
  6. Engaging healthcare documentation specialists in every aspect of association advocacy work, best practices initiatives, standards-development, and workforce development efforts.

AHDI and its partners believe that focused and coordinated attention to these six advocacy areas will yield greater visibility for this sector, increased opportunity for engagement in and contribution to the development of regulatory standards and specifications around health information management, and greater oversight and control over the evolution of this sector and its future.

Download this agenda in full-color .pdf format here.

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