SRU professor talks about health information management in the pandemic
From telehealth to the rollout of the COVID-19 vaccine, health information management professionals are playing a key role in the health care industry during the pandemic, according to the director of Slippery Rock University’s health information management program.
Dec. 16, 2020
SLIPPERY ROCK, Pa. — As Americans await the arrival of a COVID-19 vaccine, the immunization effort will be a collective effort that the U.S. has never experienced, both in terms of scale and urgency. One group of professionals involved in the process will be those who work in health information management, a field in which Slippery Rock University is preparing students to enter through academic programs within SRU's Health Care Administration and Information Systems Department.
Health information management professionals work across a variety of practices in health care related to finance, quality, billing services, information systems, education programs and standards and policy development. Their work joins clinical, operational and administrative roles in health care, from classifying diseases and interventions to financial and legal compliances for public and private insurance benefits. Simply put, they help link health care providers to patients using technology -- and their role has only increased during the COVID-19 pandemic.
"The response to the virus is speeding up all the technology," said Abel Gyan, associate professor of health care administration and information systems and director of SRU's health information management program. "What you would typically take 10 years to change in terms of technology started occurring this year due to the pandemic, everything in terms of health records and telehealth."
Telehealth, which is the remote delivery of clinical health services via the use of two-way telecommunications technologies, has increased dramatically. Doctors "visit" with patients using computers, smartphones and other devices to avoid potential exposure to or transmission of the coronavirus. According to FAIR Health, an organization that maintains the nation's largest database of privately billed health insurance claims, the percentage of telehealth claims increased to 7.5% in March 2020 at the onset of the pandemic, compared to just 0.17% in March 2019.
Meanwhile, there has been a litany of legislation from the state and federal governments to expand insurance coverage and access to telehealth by changing policies and regulatory waivers. These include actions from agencies such as the Centers for Medicare & Medicaid Services, known as CMS, and even the Federal Communications Commission.
"Telehealth was not well recognized before the pandemic but the government approved some diagnoses to be treated using telehealth," Gyan said. "When that happened, health information management professionals worked with the medical doctors to establish clinical codes that are used when diagnoses are made. The doctors use those codes when entering them into computer systems when diagnosing various types of diseases associated with the coronavirus."
The World Health Organization maintains more than 70,000 disease codes on its list of International Classification of Diseases. An ICD code is found on a patient's medical records and billing summaries for reimbursing medical expenses and standardizing the delivery of medical treatment. For example, "E10.9" is Type 1 diabetes. Earlier this year, WHO issued an emergency ICD code, U07.1 COVID-19, but there are other codes for suspected, possible, probable or inconclusive COVID-19 diagnoses. Additionally, there are codes for exposures, screenings and types of symptoms for COVID-19, as well as acute respiratory illness due to COVID-19, such as pneumonia or bronchitis.
SRU students learn about these in great detail in Gyan's class, Health Information Vocabularies and Clinical Terminologies, which is part of the master's degree program in health information management.
There are also Current Procedural Terminology codes, which are assigned to every task and service a medical practitioner provides to a patient, including medical, surgical and diagnostic services. CPT codes are already prepared for the various coronavirus vaccines from pharmaceutical companies such as Pfizer and Moderna. Health information management professionals will be involved in the work flow once the vaccine is distribution, even though CMS will pay for all COVID-19 immunizations.
"The government is planning to pay for the cost of the vaccine, similar to how Medicare and Medicaid are handled, while insurers pay for the cost of administering it," Gyan said. "HIM professionals will also work with those who are providing the vaccine to code electronically, and the systems are in place. You'll get your vaccine and then it will be between the provider and the 'payer,' which can be CMS, insurance companies, individuals or anyone who pays for health services. The bill will go to the payer for reimbursements to the provider."
Even after the pandemic, there will be a greater need for professionals in the field of health information management, according to Gyan.
"The need for these types of professionals will always be there as long as we are using technology to manage information," Gyan said. "There are all types of complex data management needs in the health care industry and in financial management. They will be in demand for jobs."
For more information about health care administration and information systems programs at SRU, visit the department's webpage.
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