Tuesday, May 30, 2017

AHIMA Advocacy Summit Part 2: Right to Access vs. Right of Access - Do You Know the Difference?

This summit was very enlightening and educational.  It was a true pleasure representing OHIMA.  There were several presentations that caught my attention.  One particular presentation was by Aneesh Chopra, President, NavHealth.  Aneesh discussed the differences between Right to Access (HIPAA Compliant Authorization) and Right of Access.  The distinction between the two was not well known amongst the audience.  Right to Access is a right given under HIPAA that allows individuals and or their representatives to obtain access to their protected health information (PHI).  This right includes the ability to obtain a copy of their PHI as well as have a covered entity transmit a copy of said PHI to a designated person or entity as specified in the HIPAA compliant authorization.  The right to access exists as long as the covered entity or its business associate maintains the information no matter when it was created.  The manner in which the record is maintained (electronic, paper, onsite, offsite or archived) does not matter.

Right of Access is the ability to view the designated record set.  The  Right of Access should be granted by utilizing a separate form than that used for the Right to Access.  The form should specifically address the fact that the patient or their representative is being given the right to review their PHI or medical record.  The right is not to obtain copies but simply to review them.  In the audience there was on only one person who actually had a separate authorization for Right of Access.  It was the suggestion of Aneesh that an ROI (Release of Information) Forum be created to share this information as well as the existing authorization form.  

Watch for more information from OHIMA and AHIMA on 'Right to Access' and 'Right of Access' in the near future!

About the Author

Tonya L. Bates, RHIA is the Corporate Manager of Release of Information for University Hospitals in Cleveland, Ohio.  Tonya currently serves on the OHIMA 2017-18 Board as the Innovation Director and chair of the Advocacy Committee

Tuesday, May 23, 2017


Susan W. Carey, MHI, RHIT, FAHIMA, PMP

Norton Healthcare (NHC)

Current job title
System Director, HIM

Job duties and/or educational background
Responsible for the strategy of HIM/HIT services for all divisions (Hospitals, Norton Cancer Institute, Norton Children’s Cancer Institute, Primary Care Offices, Specialty Offices) of NHC. 

How did you progress to your current leadership position?
I progressed in my career through taking on any new projects or assignments that were available; and, my participation was approved by my leader. We all lament about how to gain experience and move up the ladder and many believe we have to change jobs to do this; well, we don’t. Taking on new work in your existing position grows your skill set and develops your leadership capabilities. Thus, when a “higher up the ladder” position opened up I met the qualifications of the position.

Part of what I did when taking on new projects and assignments was to identify what new skills I would learn, how I would expand my knowledge base, what new behaviors would I need to learn and what weaknesses I brought to the table. This allowed me to find the right challenges to help me grow! For example, early in my career in HIM at a hospital there was an opportunity to serve as the liaison between HIM and IT as part of implementing a computerized medical record system at our organization. There was no more money offered, there was not a different job title. I volunteered for this assignment although my exposure to IT at that point was minimal. However, I dove in and learned everything I could; I soon found myself with an opportunity to move into a system installer role at the corporate level. This is when I began my HIT career. I moved into project management and began to manage EHR projects. During the time I was focusing on HIT project management, the electronic health record was taking the healthcare ecosystem by storm and the traditional role of HIM Director was becoming everything but traditional.

I moved into a senior project management consultant and had the opportunity to consult as a project/change manager at NHC on the EHR implementation project. While serving in this role, the system director of HIM opened and I was able to move into the position due to my HIT background. The position at that point in time (2003) was somewhat non-traditional with a focus on aspects of HIM and HIT excluding CDI and coding.  

What are ways that you motivate and inspire your team?  Please identify what type of team you are referring to (i.e. your direct reports at work, a committee, a different organization you are part of).
The first step in motivating any team member is making accurate judgments on whether he/she is motivated by extrinsic factors or intrinsic factors. As we all know, people are different and they are motivated by different things. Some team members are motivated by the potential of a bonus, which is an extrinsic factor – it is external. Some team members are motivated by a specific challenge and the opportunity to achieve something that they have not achieved before, which is an intrinsic factor – it is internal. If you attempt to motivate someone who is motivated by extrinsic factors with intrinsic approaches you will fail. Leaders must take steps to understand what motivates each team member. Your understanding of what motivates your team members influences how you will and should manage that team member. 

How do you select a mentor?  What traits do you look for?
It is important to understand the role of a mentor before you make efforts to select one. A mentor is someone who can serve as a sounding board; someone who can provide career advice; and, most importantly a mentor can provide you with honest, objective and constructive feedback. There are several considerations as to how to select a mentor. Who you select as a mentor is influenced by the stage of your career, your current position and/or your focus.

You may be at the point in your career where a mentor who is very versed in your industry and is a recognized leader in the industry is your selection. This type of mentor can provide expert knowledge and networking within the industry. You may be at a point in your career where you need someone who is a visionary within the ecosystem of your industry. This type of mentor can help you navigate outside your comfort zone.

You may select someone is not even involved in your industry. You may want someone to help you see things in non-biased approach. Understand the purpose of a mentor and what you feel is most important to you and then identify potential mentors. 

What professional organizations are you associated with?  Has your participation in these organizations enhanced your leadership capabilities?  If so, how?
I belong to the American Health Information Management Association (AHIMA), Kentucky Health Information Management Association (KHIMA), Healthcare Information Management Systems Society (HIMSS), Bluegrass Healthcare Information Management Systems Society (BGHIMSS) and Project Management Institute (PMI).

Part of being a leader is being knowledgeable and versed in all aspects of your industry and building a network of resources. Participating in these organizations keeps me current with HIM/HIT and project management. My participation also helps me build my collaboration and negotiation skills. When you participate in or are a member of a volunteer or member organization you must rely on referent power to influence decisions, come to agreement, etc.; referent power is the ability to influence others based on interpersonal relationships and the ability to build loyalty. 

What advice would you give someone aspiring to be a leader?
I would quote John Maxwell first and foremost “Leadership is the capacity to translate vision into reality.” Next, I would caution someone aspiring to be a leader to not assume “leader” is synonymous with “boss.” I would encourage someone aspiring to be a leader to understand that well developed leadership skills is what equips you to lead. So, focus on acquiring and honing your leadership skills, your role as a leader will soon follow. Finally, I would advise an aspiring leader to be a servant leader and not a self-serving leader. 

Wednesday, May 17, 2017

AHIMA Advocacy Summit: Part 1

“The meaning of life is to plant trees, under whose shade you do not expect to sit.” This quote by Nelson Henderson, underscores AHIMA’s goal to prepare the Health Information Management (HIM) workforce for the future.

AHIMA’s Advocacy Summit took place in Washington, DC on March 27-28, 2017.  Continuing to Inspire, Innovate and Lead, the HIM Summit participants were provided an AHIMA update, encouraged to think about yourself differently – you are not “Just a…….”, challenged to re-imagine healthcare, and presented with information to prepare for congressional staff visits.  It was a packed agenda with thought provoking presentations by Aneesh Chopra, President, NavHealth who invited a new way of thinking for interoperability of consumer directed exchange (there is interoperability for music, but not in healthcare) and Whitney Bowman-Zatzkin, Managing Director, Flip the Clinic, who uses system thinking design to provide outcomes that matter.  Check out Fliptheclinic.org for tools and ideas.

Cora Han, Senior Attorney, Division of Privacy and Identity Protection, Federal Trade Commission addressed privacy and security challenges associated with non-HIPAA covered entities and business associates.  FTC.gov is a good resource for security business guides, including information for mobile app developers.

Deven McGraw, Deputy Director, Health Information Privacy, office for Civil Rights (OCR) provided information for the Right of Access vs. authorization. (to be covered in more detail in next blog).  The OCR has monthly newsletters you can sign up to receive addressing such items as cyber security.

All the presentations provided meaningful information preparing us to speak to congressional staff regarding the 21st Century Cures Act which included language requiring the US Government Accountability Office (GAO) to evaluate ways in which the Office of the National Coordinator for Health IT (ONC) could improve patient matching methods.  AHIMA’s request to congress in 2017 is to clarify the current prohibition for the use of appropriated funds by the US Department of Health and Human Services (HHS) of the 1999 Omnibus appropriations Act, to promulgate or adopt any standard for a unique health identifier until legislation is enacted specifically approving the standard, doesn’t hinder the ability of HHS to assist private-sector led initiatives focused on developing a coordinated strategy to improve patient matching.

Tonya Bates, Krystal Phillips and Sandy Seabold met with their respective legislative aides and spoke with Senator Sherrod Brown in the hallway.

Washington DC was quite the scene, with the Cherry Blossoms blooming, Advocacy representatives from many groups and “activity on the Hill”, as locals say. 

Thank you for the opportunity; we were proud to represent Ohio and the HIM profession!!


About the Author

Sandra Seabold, MBA, RHIA is the Data Integrity Manager, Coding at the Cleveland Clinic and currently serves as the OHIMA 2016-17 Board President.  

Tuesday, May 9, 2017

Thriving at OHIMA 2017: First-time Presenter Shares Her Thoughts


In 2016, I was doing some reflection (what I call: Personal True North Metrics) and was mulling over the ways to accomplish the “next level” professionally.  School or certifications was always my path before… but now… how could I share my training and experiences? 

How could I achieve the next step in my professional life and encourage others to do the same?

After evaluating what I did well at work and what was authentic to my personality and strengths;  I came up with a list of topics and ways to have fun with this new challenge.

     Exploring new concepts
     Challenging  others to different thoughts
     Sharing what I know

After reviewing my skills along with the desire to stretch myself in a new way.  I deemed one of my personal goals to become a; “Public speaker on a Lean topic of my choice by the end of 2017.”

(Note: The other career goal was publish/write an article- so I am “done” for now! #PersonalTrueNorthMetricsWorks)

After the goal was written and my mind was set… I had the easy choice of going back to my comfort zone and making some excuses on why it would not work (travel, work, family) or ACTING on it…in hopes of self-development and sharing a positive message that may help others meanwhile helping myself grow.  (Howto Get Everything You Want- TED Talk)   

At the root of all the logical excuses was the fear of not being good at this… I had to somehow overcome the ever elusive Imposter Syndrome.  If you never heard of it, check out the link- I am sure you can relate to the mental chatter of; “I am not a veteran in my field, why would they listen?” “Heck… I don’t have a PhD, so what could I possibly speak on that would be worthy of their time?”  I think this is why women, youth and really anyone that is not an extroverted extremist, with an ego the size of Texas simply don’t go for engagements like this. 

I challenge you at this moment to think about sharing your expertise somewhere, (ideally the next OHIMA conference).  

We can all benefit from new ideas and experiences!

So here are the details of what to expect if you take on the challenge of speaking:

OHIMA made the process easy- 1 paragraph/teaser on content/message to audience and a title.  A few weeks later I was notified of being selected and then after signing a speaker agreement- I was given a timeslot and it was all set!

The next few months I made sure to work a few hours a week on the slides and make sure it was well rehearsed.  All in all- 30-40 weeks of effort (easily done- spread across 2-3 months) and it is something I can use for personal development and my leadership goals at work.  I heard from the audience it was something they would use at work and it was encouraging to hear the positives we were doing at Knox Community Hospital.  

I may not be the #1 expert in the whole world (really...who is?) but I have some strategies to share… and I know how to address an audience.  Speaking at OHIMA gave me the opportunity to grow in a new way that I was seeking while empowering and reaching other professionals in the field.  Very positive and engaged audience who I felt were supporting me and very much interested in the topic.  Overall, I accomplished my goal and hopefully inspired some new ways of thought.  Continuing the mission to personal improvement and growing professionally in a pretty powerful way.  Hope you found this helpful, insightful, and ideally you will take some ACTION and start improving!

Are you interested sharing your expertise at an OHIMA or Regional HIM Association event?  OHIMA is currently accepting presentations proposals for the OHIMA 2018 Annual Meeting (submit by August 31, 2017)!  Or if you would prefer to present at a smaller, local event - consider submitting your presentation proposal to the OHIMA Speakers Bank!   When planning events, Regional HIM Associations in Ohio will access presentations in the Speakers Bank to develop content for their meetings.  To learn more about Ohio's 5 Regional HIM Associations, see the OHIMA website.


About the Author

has an undergraduate degree in Interpersonal Communications and Health Information Management & Systems from The Ohio State University and a masters degree in Business Operational Excellence from Fisher College of Business. Sara is currently the Performance Improvement Director at Knox Community Hospital where she facilitates lean improvement initiatives and strategic development in a continuously improving culture of healthcare excellence.