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IFHRO’s Strategic Initiatives 2004 - 2010 1. Background to the Initiatives 2003 - 2007 In June 2003, delegations from the Canadian Health information Management Association (CHIMA) and the American Health Information Management Association (AHIMA) met to exchange ideas about issues of shared interest. A consensus was reached that three advanced practice issues presented challenges for health record/information management professionals and their associations:
It was recognized that the importance of these issues extended beyond North America as health record/health information management (HR/HI) practice was becoming more global. It was acknowledged that change in this discipline was rapid and the delegation believed that the international HR/HI communities should work more closely to advance standard practice solutions and to learn from one another. This included both advanced practice and developing practice. It also included closer collaboration on academic curricula so that HR/HI education would be more universally recognized as an applied health informatics discipline. Mobilizing the international community to address today’s challenges was entirely consistent with the purposes of IFHRO. Five statements of need related to these three issues were then developed, which included education and the needs of developing countries . The focus areas included:
These statements of need were posted on a special IFHRO “community of practice” via the AHIMA website to facilitate a preliminary virtual discussion of the five issues among the national delegates to the 14th Congress and General Assembly (GA) to be held in Washington DC in October 2004. The General Assembly subsequently held an open forum during the GA, which generated information for the IFHRO Executive Committee to use as a basis for planning for the term of office over the ensuing three years up to 2007.
2. Moving Forward 2007 - 2010 2.1 The 15th General Assembly, 27th May 2007, Seoul, Korea The IFHRO Executive Committee 2004-2007 continued to regularly monitor progress against the five strategic initiatives derived from the statements of need discussed at the 14th General Assembly in Washington DC in 2004: The issues surrounding confidentiality, privacy, security and personal health information had gathered pace globally and on 27th May 2007 the following resolution was put to the 15th IFHRO General Assembly and was subsequently passed: Resolution : Confidentiality/Security/Personal Health Information Whereas, the principles of confidentiality, privacy, security and personal health information are global issues,
2.2 Executive Committee Meeting, 11th & 12th June 2008, Amsterdam At the face-to-face meeting of the IFHRO Executive Committee held in Amsterdam on 11th & 12th June 2008 the five key (strategic) initiatives identified in 2004 as shown above were reviewed and discussed in detail and it was subsequently agreed that ‘Privacy and Confidentiality’ was a concept within all of the IFHRO strategic initiatives and not a stand alone item. Additionally ‘Clinical Data Management’ was a concept within Education and had been embedded in this initiative through the WHO-FIC-IFHRO Joint Collaboration. It was therefore agreed that there would be three strategic initiatives for IFHRO going forward (Electronic Health Record, Education, and The Needs of Developing Countries). It was appropriate to narrow the focus and scope into specific areas that would most benefit Health Information Management in the world. These three initiatives were then debated and preliminary actions for the following twelve months were agreed as follows:
2.2.1 Electronic Health Record The IFHRO EC agreed that they could provide up to date information as to the current state of the electronic record in their home countries/regions and individuals made a series of presentations on the topic at an International Session at an EHR conference hosted by the Dutch national association NVMA in Amsterdam in June 2008. All five of the presentations from Germany, Denmark, Canada, United States and the United Kingdom together with an additional paper “EHR in poor resource settings; the case of Kenya” were then posted on the IFHRO web site for the information of IFHRO members and other visitors to the website. Other member countries were then asked to contribute information as to the status of the record system in their respective countries including those where paper-based records need improvement as it was felt that this information would also be useful for the membership. Best practice systems can and should be documented for either electronic systems or paper record systems and IFHRO member nations were invited to submit articles for the website detailing best practice systems and EHR status in their countries. It was agreed that a standardized form should be developed before the 16th General Assembly to be held in Milan and member countries will be asked to complete the form regarding national progress on the electronic record. A summary will then be compiled before the meeting and shared during the Assembly.
2.2.2 Education This strategic initiative now has the subsets of Clinical Data Management and Privacy and Confidentiality. It was agreed that IFHRO would continue the Joint Collaboration with WHO’s Family of International Classifications, which will start work on training and development of a certificate program for morbidity coders in 2009. An on-line ICD 10 training tool is being developed and it was agreed that links to the tool will be included on the IFHRO website when it is completed. It was also agreed that, subject to appropriate funding being received, a Community of Practice for Coders could hopefully be developed on the IFHRO website. IFHRO will also provide input to the work on the development of an International HIM Curriculum by a Committee that AHIMA is coordinating and there will continue to be IFHRO input to AHIMA’s annual Assembly on Education (AOE). The IFHRO Executive Committee agreed that one of IFHRO’s goals for 2007-2010 would be to work towards the production of a global map of HIM education around the world and the development of a compendium of current information following the model agreed for EHR. National Directors would be engaged to provide an update on education in their countries including types of courses, levels, titles, credentials, distance education provision etc.
2.2.3 The Needs of Developing Countries The IFHRO Education Modules were reviewed by the Executive Committee and it was agreed that they were still current and relevant. These Modules will be supplemented in due course by documentation/guidelines under development by WHO-FIC-IFHRO entitled “Documentation requirements to promote superior data capture” and two further documents on mortality and morbidity, which would have a focus on developing countries. On completion, the various documents will be posted on the IFHRO web site as an additional resource for practitioners around the world. A “Manual for Teachers” exists to accompany the Education Modules and it was agreed that this would be reviewed by the Executive Committee, updated where necessary and posted on the IFHRO website as an adjunct to the Modules. It was agreed that certification is important and how it is done is crucial to the advancement of the profession in countries such as Kenya. It was noted that distance learning and a generic curriculum will also be very important for such countries.
2.3 Executive Committee Meeting, 4th & 5th April 2009, Mannheim, Germany At the face-to-face meeting of the IFHRO Executive Committee held in Mannheim, Germany on 4th & 5th April 2009 the three strategic initiatives agreed upon in 2008 and outlined in section 2.2 above were reviewed and discussed in detail:
2.3.1 Electronic Health Record Discussion took place about the development of another, new IFHRO Education Module on the Electronic Health Record. This will be basic initially and will emphasise the importance of interoperability. The Regional IFHRO Director for The Americas will undertake preliminary work on this module with the help of the Canadian Health Information Management Association (CHIMA).
2.3.2 Education WHO-FIC-IFHRO Joint Collaboration activities continue with major issues being the ICD-10 web based training tool, which is due for release during 2009. There is an urgent need to obtain funding to sustain the Certification process for mortality coders, to support the development of information sheets for key areas, continue the pilot project and to start work on possible testing methodologies for morbidity coders. There will be meetings of the Joint Collaboration in the fall of 2009 in Seoul, in spring of 2010 in Cologne, and in the fall of 2010 in Toronto. IFHRO is cooperating informally with the Royal College of Physicians, London to promulgate the College’s Standards for Record-Keeping and Guidelines for Clinicians. A link to the standards and the guidelines has been posted on the IFHRO web site and there was a meeting with representatives of the Royal College on 29th April 2009 to explore further cooperation. An article about the standards and the development mechanisms was published in the June edition of IFHRO Global News. IHRIM, the UK national association has developed a new suite of examinations and qualifications specifically for overseas students at Foundation, Certificate and Diploma levels. (See 2.3.3 below “Needs of Developing Countries”).
2.3.3 The Needs of Developing Countries The IFHRO Education Modules were reviewed by the Executive Committee and it was agreed that they were still current and relevant and the “Manual for Teachers” will also be reviewed by the Executive Committee, updated where necessary and posted on the IFHRO website as an adjunct to the Modules before the end of 2009. It was agreed that certification for practitioners is important and how this is done is crucial to the advancement of the profession in countries such as Kenya. Robert Wamalwa, Regional IFHRO Director for Africa is trying to initiate discussions with the WHO Regional Office regarding the provision of HIM education in Africa. The Institute of Health Records & Information Management (IHRIM), which is the UK national association, asked Lorraine Nicholson, President of IFHRO, to lead the development of a new suite of examinations and qualifications at Foundation, Certificate and Diploma levels specifically for overseas students, many of whom could be in developing countries. She was assisted by a reference group of Mauritian Health Record Practitioners all of whom were qualified by IHRIM having studied for and passed the examinations of the Institute at the different levels. It was agreed that the study materials for the new IHRIM Overseas Certificate would be based on the IFHRO Education Modules, which are generic, and therefore not focused on healthcare practices and procedures specific to any one country, and they also reflect accepted professional best practice having been reviewed by an international panel prior to publication. The Education Modules are supplemented by IHRIM study materials on Medical Terminology, which will be available free of charge to Overseas Students during 2009/10. The IHRIM Education Strategy Panel, which met recently, reviewed and approved the overseas syllabus and the Panel believes that it will provide a more equitable and cost effective examination and qualification structure for overseas students, which will better meet their own professional needs and also the operational needs of their employing organisations. Students from anywhere around the world could take the IHRIM Overseas Certificate examination using the freely available IFHRO Education Modules subject to registration by the required date and payment of the requisite examination fee. This would go some way towards addressing the issues relating to certification of practitioners discussed in 2.2.3 above.
4. Monitoring Progress Against IFHRO’s Strategic Initiatives and Taking Them Forward The Executive Committee will continue to keep the strategic initiatives under close review and they will be updated as appropriate at the next face-to-face meeting of the EC scheduled for February 2010 in Cologne, Germany. At the 2009 face-to-face meeting the EC felt that a merger of issues 2 and 3 relating Education and the Needs of Developing Countries may be a possibility and are planning discussion groups at the 16th General Assembly of the Federation scheduled to be held in Milan, Italy in November 2010. The discussions will focus on the initiatives and how they are to be taken forward to more closely involve national IFHRO Directors, to increase their participation in the Assembly and to provide a clear direction for IFHRO for the next term of office.
Lorraine Nicholson, |
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