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Introduction

Planning, designing and implementation of a strategy to any department plays a significant role in strategies of a place or department. The document below is a plan for designing Health Information Management in the radiology department.

EXECUTIVE SUMMARY

What is this document?

This document is the early version of ways for use by the radiology department to help in maintaining and caring for health records through the traditional and electronic means.

What is it designed to do?

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It is designed to help hospital departments to keep records according to the standards required by the American Health information Management Association.

What are the guiding principles?

There are several guiding principles defined in American Health Information Management Association document that help to design, plan, and implement the health Information Management system in a radiology department.

Health information management should be characterized by a) Agreement among stakeholder b) definite incremental efforts directed in achieving the departments long-term goals c) Accreditation.

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Who should use this document?

At the highest level, users of this document are the Radiology department Health Information Management managers because they have to ensure that the system meets the necessary ethical, legal, and medical standards. The other users of these systems are the medical records and health information technicians. They have to ensure that the patients' records are arranged according to diagnosis, medical history and their personal characteristics. They also have to ensure that data is stored correctly in the system and that this data is accurate.

How should I print the Document?

It is advisable to print using color. It should be double sided and printed on an A4 paper. It should have distinct lines to separate the modules, steps and the appendices.

What is the process for HIM's strengthening?

The process for designing and strengthening the HIM is done in three phases

Phase 1 is coordination and leadership assessment. This involves setting up working groups and designing committees. It also involves reviewing the current HIM system and analyzing its shortcomings.

Phase 2 is priority setting and planning. This involves using the results of the assessments in phase 1 is to direct the attention of the working group on the performance gap and difficulties that deserve priority. It also involves generating suggestions that strengthens the HIM priority systems. The implementations of these interventions are then planned over the medium-term period, cost and described for approval and implementation by the stakeholder.

Phase 3 is implementation of HIM strengthening activities. This involves implementation of time phased priorities while monitoring and re-planning at different stages take place.

How is this document organized?

This document is organized in three modules. The twelve steps of phase two are spread across the three modules. Each module begins with an overview and then the outcomes. The steps and materials required for that module are then described.

This document presents phase 2 as consisting of three modules.

They include Module 1, which is preparing for HIM's strategy design, and planning, Module 2, which involves HIM's strategy planning, and Module 3 which involvesdetai9led HIM'S planning and costing.

PLANNING MODULE I - PREPARING FOR HIMS STRATEGY DESIGN AND PLANNING

This module involves channeling efforts of the core team to assessing the HIM program in the radiology department. It also involves analyzing the priority components with an intention define its problems and to find solutions to these problems. It also involves assessing successful HIM components already under implementation or planned and to assemble any relevant additional information needed in this design process.

Step one - REVIEW HIMS ASSESSMENT RESULTS

Health Information Management is caring and keeping of patients' health records.

Records that are kept in this system include a) Patient health record, which is the document that records all the health services that a patient receives. b) Primary patient record is the document used by health care professionals while providing care to patients. c) Secondary patient record is a document that has some data derived from the primary patient record. This document provides information to be used by the non-health professionals in analyzing and recording information, in the health systems.

In this step, the working group and the committee have to define the HIM components and analyze their effectiveness over time. The HIM components are a) resources: the radiology department has to update the system that provides information on the record of patients in the department. The computers and other data keeping materials are assessed and reviewed to see if they have been effective over the years. Machines like X-ray machines should also be reviewed to see if the information provided on patients is accurate.

b) Indicators are identified for the department carrying all scores of their efficiency. These indicators are reviewed and analyzed on a regular time basis.

c) Data sources are also assessed. These include information on radiology, for example, how many patients were scanned for tumors. Their details are then stored in the system. How accurate was the information retrieved from patients' records is another question that the team can use to analyze data sources.

d) Data management involves written set of procedures for data management that include cleaning, quality control and storage. It involves data from all sources of patients' previous records.

Step two - REVIEW HEALTH SYSTEM DEVELOPMENT PRIORITIES AND DEFINE HIMS PROBLEMS

The first step is for the core team to assemble all the information required to plan, design and implement the current radiology department's objectives, policies and priorities. This reviewing of priorities involves using key questions in analyzing current HIM problems. Indicators are analyzed using questions. The low-scoring indicators then forms the basis for current HIM problems. The indicators for HIM are a) report turnaround time b) availability of folders c) waiting lists d) waiting times and e) examination times. These are the indicators that determine whether information management is efficient or not. The team can also use results from other data sources in order to fully design the HIM problems. This information is relevant because it will be used in module two.

The reason for this stage is to identify HIM problems. The list then becomes the key element in designing strategic interventions to be used in planning module two.

Step three - INVENTORY OF ON-GOING HIMS STRENGTHENING EFFORTS

A considerable amount of information is required in planning module two. It is part of formulating the gaps and problems to be planned for in module two. It is increasingly significant to gather on goings and planned HIM strengthening efforts and analyzes technical and financial resources that will be used in planning module two. It is also beneficial to assemble all other relevant materials to be used in this stage, for example, assembling other reports that might be necessary in planning.

PLANNING MODULE II - HIMS STRATEGIC PLANNING

Completion of module one assessment provides the foundation for HIM formulation.

In planning module two, the working group reviews and analyzes the problems that are presented in module one. The future vision for HIM is then formulated.

Step 4 - PRIORITY HIMS COMPONENTS AND PROBLEM

This stage links the first module to the second module. This step provides the working group with the opportunity to discuss the problems that were presented in module one. The problems are then analyzed and their indicators are also analyzed.

The working group then develops a list of priority problems to be tackled first. The team must also ensure that a consensus is reached on the problems to be analyzed that is which problem comes before another one. Common problems in a radiology department include fixing schedules for radiologists to attend to patients. It also includes recovering patients' previous records..

Step 5 - THE HIMS VISION

The reason for stage five is to develop a vision for HIM implementation. The topics for the HIM vision can be discussed in the first module. It is advisable to formulate the vision of planning before the group embarks on planning and designing the HIM.

Vision can be in terms of what the group has in store for the department. The working group can have visions such as to create efficiency and accuracy in maintaining and caring records in the radiology department.

The radiologist has to be accurate in analyzing the patients' records. It is therefore necessary that the working group develop a vision for the department.

STEP 6 - CURRENT AND PLANNED HIMS STRENGTHENING EFFORTS

In this step the working group analyzes the planned HIM strengthening efforts.  The step requires the working team to analyze the need for and sources of any other relevant information. A consensus is reached on analyzing the positive and negative sides of HIM. The team will then update the inventory on ongoing and planned strengthening efforts. They should also agree on how to add the HIM strengthening efforts known to them. The team will suggest a procedure to use to frequently update the strengthening activities of HIM.

At the end of this step the team must ensure that there is a product achieved by the planning group. The group at the end must have a list of strengthening activities and with the indications of which activities address the priority HIM components and problems. The team should also list strengths, weaknesses, opportunities and threats which are crucial to HIM priority components. The team develops procedures to be used in updating the inventory on HIM strengthening activities.

Step 7 - HIMS OBJECTIVES AND INTERVENTIONS

Step seven requires that the team develop crucial HIM objectives and provide solutions to problems already identified. Problems that the HIM can face are critical turnover of vital HIM staff, problems related to data inaccuracy, long queues because retrieving of patients records take a long time. These are some of the problems that HIM face and therefore the team must intervene on these problems. The team comes up with ideas that are possible in solving the HIM problems that were identified earlier.  The team gives suggestions on objectives that will help define implementation of HIM. The working team is broken into subgroups. These subgroups are each given a HIM problem that has been already identified to analyze and discuss possible solutions. The sub breaking of problems ensures that the group discusses each problem and tries to give solutions to them. It also saves on time because several problems are discussed at the same time. The groups identify the most possible solutions to these problems. The groups are supposed to identify intervention measures that can be easily put to use. They should not give measures that might take a long time before they are implemented. At the end of this step the working group should have a list of objectives and interventions that have been agreed.

Step 8 - INTERVENTION IMPLEMENTATION PHASING

This phase will include not only the working group but also other implementation offices. For example in the radiology department offices that register patients, those which issue records and those which prepare the schedule for appointments with the radiologist. It is also necessary that the implementation process is spread over a given period of time. That is the team should come up with solutions that will be implemented first and those which will be implemented later. The subgroups discuss the relationship among the interventions they gave. This will then pave the way for similar interventions to be implemented at the same time.

The group then gives a list of achievements in the possible intervention schedule. The various offices are then assigned work that needs to be implemented. The phasing is organized that is to say which implementations take place in the first, second or third phase. At the end of this step the working group must have devised the phases which different implementations will take place.

PLANNING MODULE III - DETAILED HIMS PLANNING AND COSTING

After the second module detailed planning and costing strategy is then arrived which makes up the third module.

Step 9 - DETAILED STRATEGY DESIGN AND ACTIVITY IMPLEMENTATION PLANNING

The working group in collaboration with several technical groups sets up a plan for the implementation of the strategies that have been discussed. The technical group points out the chief plans that are necessary for implementation of the interventions already formulated. The technical working group devises a table in which each activity that has to be implemented is fed to it. The group also fixes the start and the end date for each implementation strategy. The table will also include the responsible office and officer for each implementation strategy. Additional resources that might be required in the implementation strategies are also incorporated into the table. The group is required to discuss the activity plans for each strategy implementation with the other working groups. The implementation plan is checked to ensure that all the activities have been incorporated in the plan. This is done through consulting other groups that had been given the task of analyzing the interventions.

STEP 10 - HIMS STRATEGY COSTING

The core team then comes up with the costing activities. A table showing the activity, office and officer in charge is prepared. The activities are analyzed. The activities that require additional resources are then noted. The cost factors are assembled for analysis. These cost factors are incorporated in the table along with the activities which are responsible for these cost factors. The remaining cost factors are projected. The output of this step is that each intervention activity is aligned which its cost elements and additional resources required are also assembled in the table. This stage is necessary and information on cost should be provided keenly. It is the stage that will determine how efficiently the strategies are implemented. This is because if there is no enough money and resources for implementation the process might take long.

STEP 11 - HIMS STRATEGY MONITORING AND EVALUATION (M&E)

This step allows the technical group to review all the activities that pertain to their sub system. The group will also review which of the monitoring and evaluation indicators are most appropriate for routine and periodic evaluation. This ensures that the group puts into place those activities which are most appropriate in monitoring and evaluating these implementation activities. The group will then choose those indicators that are appropriate to be incorporated into the monitoring and evaluation framework. The core team and the working group will then come into consensus on the methods and procedures that they will adopt for reporting their results in monitoring and evaluation.

STEP 12 - THE HIMS STRATEGIC PLAN DOCUMENT

This final step is the activity that prepares the HIM strategies into a document that will be reviewed by the committee and the stakeholder. The product of this stage is a planning document that outlines the strategies and their cost. The working group outlines the authors of this document. The document is then distributed for discussion and reviewing.

Conclusion

A brief conclusion is given to the reader on the relationship between the significant linkages between the HIM strategies and the performance of health systems.

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