1. Congressional Advocacy: Hill Day Issue Set 1 Presenter: Margarita L. Valdez, Senior Director, Congressional Relations ©2015

2. Agenda Introduce the Association and Profession – AHIMA Fact Sheet and CSA Fact Sheet – CSA numbers – Take Aways Patient Identifiers – Congressional Restrictions – Uses and Functions – Unified Solution

3. What is Hill Day? Hill Day is on Tuesday, March 24 th in Washington, DC Capitol Hill Day is an opportunity to meet with your US Representative and/or US Senator to advocate for issues that are important to health information management professionals. Appointments will be made with Members of Congress who represent the congressional district where you live, and if different, the congressional district where you work. – Email: nia.bailey@ahima.orgnia.bailey@ahima.org

4. Hill Day Schedule Tuesday, March 24 th – 8am breakfast Holiday Inn Washington-Capitol Members of Congress and legislative staff will be invited to attend Participants will pick up their packets at the breakfast Participants will be asked to sit with their state delegation – 9:30am-? Meetings with U.S. Representatives and/or U.S. Senators “Down time” in between meetings can be spent in the Longworth House Office Building cafeteria

5. Why Advocate? Build name recognition for the association and profession Make valuable contacts Collaborate with other organizations To represent our professional interests To ensure that HIM professionals are a part of the decision making process ©2015

6. Introduce the Profession

7. About AHIMA AHIMA is the national non-profit association of health information management (HIM) professionals. The Association was established in 1928 – The American College of Surgeons needed an association to manage their healthcare data and improve the quality, protection, and use of medical records. The Association has chapters in all 50 states, the District of Columbia and Puerto Rico AHIMA works with nearly 300 HIM programs in higher education institutions from community colleges to graduate education – The association addresses curriculum developments (including ICD-10-CM/PCS) needed for today’s and tomorrow’s graduates. – Ensures the availability of text books and other resources, and works with others in the industry to recruit and provide opportunities for students and faculty.

8. Continued… You will be provided an “About AHIMA” fact sheet to give to legislators on Hill Day. Be a resource for federal legislators – You have the expertise, make sure your voice is heard Does your Component State Association (CSA) have a fact sheet? – Highlight your membership numbers – Educational institutions – Types of careers your HIM members have – Provide your state board of director’s contact information – Share your CSA highlights

9. MdHIMA Sample fact sheet The Maryland Health Information Management Association (MdHIMA), formerly the Maryland Medical Records Association, is the professional healthcare organization in the field of health information management. MdHIMA serves its members, the health care industry, and the public by supporting activities and providing services which contribute to quality and efficiency within the healthcare system MdHIMA was founded in 1930 and is a component state association of the American Health Information Management Association (AHIMA). MdHIMA has over 1,000 members. Over 300 student members are studying throughout 8 HIM accredited programs in the state. Contact: Jane Doe, President, MdHIMA President – Cell: 443-421-XXXX – E-mail:

10. What is an HIM Professional? HIM Professionals are dedicated to the effective management of health information, communications, and technology needed to deliver quality healthcare to the public. HIM professionals work throughout the healthcare industry, government, and education in more than 40 different employer types and 120 different job functions. – Quality healthcare can be achieved through quality information Share a personal story about your profession. You are what is unique about the meeting, you’re the person who works and lives in the district.

11. Take Aways Introduce AHIMA – 300 accredited education programs nation-wide Introduce your Component State Association – A state association in your state – How many members are in your state CSA? Mention that you live/work in the congressional district Explain what a HIM professional does – Where do AHIMA members work? What do you do? Why is it important? Where did you go to college for your HIM degree? In the state/district? Make it personal

12. Patient Identifiers

13. Unique Patient Identifier The Health Insurance Portability and Accountability Act of 1996 (HIPAA) included the call for a standard unique patient identifier among several others. “a Unique Patient Identifier,” according to the requirement, “is a required to manage the various clinical and administrative functions related to the delivery of care.”

14. Congressional Restrictions The late 1990’s saw an increased concern on the privacy of health information. While Congress had a difficult time gaining consensus on privacy, this did not prevent the Appropriations Committee from addressing the issue in the 1999 Omnibus Appropriation Act funding HHS. “…until legislation is enacted specifically approving the standard…”

15. The Use of Unique Patient Identifiers Identifiers under the initial HIPAA rules were seen as supporting administrative purposes. In the previous decade, some identifiers used for clinical care were developed using the traits of an individual rather than a unique identification number. Further development of electronic health information record systems (EHRs), health information exchange (HIE), and other clinical purposes along with increased adoption of EHRs and HIE have changed the purpose of “unique” identifiers.

16. Continued… In recent years the development of accountable care organizations (ACOs) has increased the need for unique patient identifiers. ACOs do not represent one unique enterprise but can be made up of many with changes over time. ACOs require the convergence of member entities patient health records for clinical and administrative purposes requiring accurate matching of an individual’s records. New initiatives of Congress including bundling also require in integration of records.

17. Functions and Objectives of Unique Patient Identifiers Positive identification of the individual: Identification to access patient information for prompt delivery of care. Organization of patient care information into a medical record for both current and future uses. Linkage of various clinical records pertaining to a patient from different practitioners, sites of care, and times to form a lifelong view of the patient’s record and facilitate continuity of care. Support of HIE functions supporting clinicians and the patients themselves.

18. Continued… Support the protection of privacy and confidentiality through accurate identification Positive identification of the individual for administrative purposes Patient safety programs Claims payment and adjudication Legal reporting requirements Reduce healthcare operational costs and enhance the health status of the national by supporting patient record management.

19. Finding a Unified Solution The focus of concerns and the need for a unique identifier have changed since the 1990s. As the use of EHRs and HIE increases, the call for a more correct and efficient means of indenturing one individual from another have increased especially since information can be needed and used well beyond the individuals community. Calls for the investigation and development of a unique identifier have come from the various sectors and consumer groups in the healthcare industry.

20. Continued… However, HHS and its agencies (ONC, OCR, AHRQ, and CMS) cannot investigate the need and alternatives for an identifier due to the Appropriations restriction. Standards to improve identification, increase patient safety, and reduce inefficiencies and cost cannot be proposed when the key government agencies are prohibited from working with consumers and the healthcare and information industries to come up with a solution using 21 century technologies and knowledge.

21. Continued… While alternatives exist that can both increase patient safety while allowing individuals the ability to determine how their privacy may be maintained, little can be done to ensure a nation-wide solution due to the Appropriation language barrier. Meantime: The Social Security has call for the abolition of using the SS# for Medicare and some Medicaid patients in the next 5 years; and HIT experts indicate a barrier to progress if the identifier issue cannot be addressed.

22. The “ASK” HHS should be funded for such an effort and required to report back to Congress with a solution that will meet the original HIPAA requirement and 21 st century requirements for a unique patient health information identifier.

23. Continued… AHIMA requests members of Congress to unite and allow HHS and its agencies and offices to explore the issues, needs, and alternatives regarding unique patient identifier. Members of Congress should ask members of their Appropriations Committees to ensure that no language exists that effectively would prohibit HHS and its agencies and offices from moving forward to find an acceptable solution to the need patient unique identifier.

24. Talking Points Absence of a uniform unique patient identifier results in: duplicate records incomplete health information Incorrect health information patient safety issues incorrect quality measures incorrect billing and payment increase fraud and abuse All of these factors decrease quality and increase healthcare costs.

25. Effective Communication Know your audience – Members of Congress (MOCs) and their staff have basic knowledge on many issues, and in depth knowledge on a few issues Take broad topics and narrow them down – Use specific and relevant points – Relate your point of view to your area of expertise Where in the district do you work? And what do you do? Use laymen’s terms – Avoid using acronyms Make it personal – Share an example of how quality information can improve someone’s life

26. Hill Day Sponsor

27. Questions? Margarita L. Valdez, E-Mail: margarita.valdez@ahima.orgmargarita.valdez@ahima.org Nia Bailey E-mail: nia.bailey@ahima.orgnia.bailey@ahima.org