AHIMA Webinar

EMPOWERING PEOPLE TO IMPACT HEALTH™
The State of the HI Industry:

2023 Key Trends
Moderated by
Keith Olenik, MA, RHIA, CHP, Chief Health Information Officer @ AHIMA
Presented by
Liz Kwo, MD, MBA, MPH, Chief Medical Officer @ Everly Health
David Marc, PhD, CHDA, Associate Professor @ The College of St. Scholastica
Chantal Worzala, PhD, MPA, Principal @ Alazro Consulting, LLC
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©2023 | AHIMA.ORG ©2023 | AHIMA.ORG
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Disclaimer
• This webinar is informational and for educational purposes
only.
• It is not to be construed as providing legal advice.
• The views and opinions expressed herein are those of the
authors and do not necessarily represent the views of AHIMA.
• Every effort has been taken to ensure that the educational
information provided in today’s presentation is accurate and
useful as of date this presentation was produced.
• Applying best practice solutions and achieving results will vary
in each hospital/facility situation.
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©2023 | AHIMA.ORG
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Chief Health Information Officer
Keith Olenik has more than 35 years of

experience working with healthcare delivery
systems as a member of executive
leadership and a consultant. He specializes
in methods to streamline business
operations, evaluate, and implement
information technology solutions, and
enhance productivity through process
improvement. Prior to joining AHIMA, he
was vice president of revenue cycle for
Pivot Point Consulting, a national healthcare
technology firm. He is a well-known speaker
and writer in the industry.
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What are three key trends in the HI Industry for 2023?
1. Artificial Intelligence (AI) and Digital Health

2. Data Analytics and the Future HI Workforce
3. Information-Blocking
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Dr. Liz Kwo is a serial entrepreneur, practicing

physician, faculty lecturer at Harvard Medical School
and serves on the boards of several public and private
healthcare companies. She is currently Chief Medical
Officer at Everly Health, a company focused on home
care testing. Dr. Kwo has an MD from Harvard Medical
School, MBA from Harvard Business School, MPH from
Harvard TH Chan School of Public Health, and a BA
from Stanford University. She completed her residency
at Harvard Preventive Care and is Board Certified in
Preventive Care and Occupational Medicine.
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David Marc is an associate professor, the health

informatics and information management department
chair, and the health informatics graduate program
director at the College of St. Scholastica in Duluth, MN.
Dr. Marc has a master’s degree in biological sciences
and a PhD in health informatics from the University of
Minnesota and is a certified health data analyst
(CHDA). He served as the former chair of the AHIMA
foundation research network and as a member of the
AHIMA Council for Excellence in Education (CEE) where
he co-chaired the Educational Programming
Workgroup. Dr. Marc is an accomplished researcher
and author on topics related to the storage and
retrieval of publicly available health care data and
health informatics and information management
workforce trends.
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Chantal Worzala is an experienced policy expert who helps

technology companies, associations, provider organizations,
and patient advocates to understand and navigate the digital
health policy landscape. She has a broad range of expertise
in federal health programs, digital health innovation and
adoption, interoperability, privacy, and administrative
simplification, Medicare payment policy, health care quality,
and new models of care. Chantal previously served as vice
president of health information policy at the American
Hospital Association, where she was recognized as a leading
voice on digital health policy. Chantal also served as Senior
Analyst for the Medicare Payment Advisory Commission.
She holds a Ph.D. from the Johns Hopkins School of Public
Health and an MPA from the Woodrow Wilson School at
Princeton University.
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©2023 | AHIMA.ORG
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The Impact of AI & Digital Health on

Healthcare
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Digital MD: Revolutionizing the Future
of Healthcare
Dr. Liz Kwo, MD, MBA, MPH
Chief Medical Officer at Everly Health
Our agenda for today
Big Data and AI
The State of Consumer-Driven Wellness
Digital Health Ecosystem and Stakeholders
What Does This Mean for You?
CONFIDENTIAL
1
Healthcare leaders will need to embrace “Big Data”
• Health providers are willing to adopt digital tools if there is tangible proof they will decrease
costs, save time and deliver better health outcomes.
• Health plans keep a close eye on the digital direction of healthcare and often take measures
to keep or strengthen their competitive advantage.
So, what’s the solution?

AI and Telehealth will continue to impact healthcare
delivery
• Data can create and implement better strategies to improve health outcomes and reduce the number
of readmissions and associated costs.
• Al-driven solutions and algorithms’ assistance provide support also in other medical areas such as:
• early detection of various diseases;
• virtual triage and symptom checking with the support of AI chatbots;
• drug innovation and development ;
• medical imaging processing;
• management of supply chain;
• study of medical devices, etc.
Artificial Intelligence (AI) has been “trained” to assist
and adapt to healthcare industry needs.
• Improve patient experience
• Improved healthcare costs through efficiencies
• Ultimately shapes the digital future of healthcare

Big Data Ecosystem and Stakeholders
• Our prior definition of “healthcare products”

has changed
• Digital-global connectivity has flipped the
model
• Consumer-driven healthcare system drives
business priorities
• The end goal? Lower cost, better reach
* Book release in February 2023

Digital ecosystem
Digital continuum
Digital health
company
framework
We empower members to take control of their health
Friendly reminders
Physician-reviewed results delivered to
member by mail and available online
Samples processed at CLIA-
certified and CAP-
accredited labs
Results
Clinically validated at-home Intuitive results

collection methods platform with
integrated consults
and prescriptions
Easy-to-use test kits
Result letters sent to physician

by mail and via DirectTrust Actionable next steps
Alert value calls for abnormal results

with guidance for members’ next best
steps in their care journey
At Everly Health, we want to
use AI to support traditionally
poorly served populations to
create better health outcomes.
Our at-home test kits change and save lives
We have a robust suite of at-home tests to impact HEDIS measures
At-home testing programs

can contribute to closing
~50% of open gaps
Real-time communication for members…
User-friendly digital results platform
for members to view test results and
informative clinical content
Intuitive member opt-in portal
Transactional emails
for sample tracking, result
notifications, and sample issue
resolution
Results letters mailed
Advance notice, opt-in, directly to member
and opt-out letters;
opt-in postcards
Consumers are defining wellness on their own terms
Wellness spending by category, U.S. consumers
HEALTH FITNESS NUTRITION APPEARANCE SLEEP MINDFULNESS
50.1%
20.1%
13.8% .6%
9.2%
CONFIDENTIAL
SOURCE: McKinsey & Co., Future of Wellness Market

6.3%
US consumers can be classified into 5 health personalities
Balance Seekers Direction Takers
17% 15%
19% 18% 31%
Self Achievers Priority Jugglers Willful Endurers

SOURCE: Activating the Health Personalities Segments, Right Angle Advisors, 2019
Self Achievers
Takes ownership and ready to fight for health.
The most proactive when it comes to health.
Willing to invest what is necessary toward their health

and appearance.
Task-oriented; wants measurable goals.
“I can beat this. I am getting healthy. Let’s

put together a plan of action. “
SOURCE: Activating the Health Personalities Segments, Right Angle Advisors, 2019
Balance Seekers
Generally proactive and wellness-oriented.
Open to many ideas, sources of information and

treatment options
To get action, provide the “why.”
Stress relief is important. Position as a way to achieve

balance.
“I know my body best. Explain my options. Tell me why I should choose this.”
CONFIDENTIAL
Direction Takers
View their physician as the most credible resource.
Seeks guidance and direction. Wants to be led.
Monetary/material motivated.
Values their personal routine.
“Tell me what to do next. I’ll trust your advice as long

as it fits into my routine.”
CONFIDENTIAL
Priority Jugglers
Busy with many responsibilities.
Values efficiency and family.
Does not take time to invest in their own wellbeing but

proactive when it comes to
their family’s wellbeing.
“It’s not about me. I worry about my family. Tell me how my family will benefit.”
CONFIDENTIAL
Willfull Endurers
Lives in the here and now.
Believes there are more important issues to focus on other than

improving their wellness.
Reactive, least engaged and hardest to reach.
Responds to a step-by-step approach.
“I’m living for today. On my own terms.

I can handle anything life throws at me.”
Prioritization and spending
on health and wellness are outpacing
how healthy consumers feel
65% of consumers say they could be taking

better care of themselves
SOURCE: McKinsey & Co., Future of Wellness Market; Edelman Trust Barometer 2022
Preventative
Predictive
Personalized
Prescriptive
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©2023 | AHIMA.ORG
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Clinical data exchange improves care costs, increases provider

collaboration and drives personalization
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©2023 | AHIMA.ORG
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Data Analytics
and the Future HI Workforce
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Defining the Health Information Technology

Workforce
• The HIDDIN workforce
• Dynamically changing workforce, rendering it hard to define
• Workforce occupational classifications systems
• Organize and rank occupations into groups based on defined tasks and duties
• Enable job placement, employment counseling, and career guidance
• Support standards for compensation and labor market trends
Marc, D. T., Dua, P., Fenton, S. H., Lalani, K., & Butler-Henderson, K. (2021). Occupational Classifications in the Health Information
Disciplines. In The Health Information Workforce (pp. 71-78). Springer, Cham.
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Defining the Health Information Technology

Workforce
• Over 180 countries have adopted an occupational classification system
• International Standard Classification of Occupations (ISCO)
• 3252- Medical Records and Health Information Technicians
• 4415- Filing and Copying Clerks
• 2622- Librarians and Related Information Professionals
• There are others, but they are not specific to healthcare or technology
• United States- Standard Occupational Classifications (SOC)
• 11-9111- Medical and Health Services Managers
• 29-2072- Medical Records Specialists
• 29-9021- Health Information Technologists and Medical Registrars
• 31-9094- Medical Transcriptionists
Marc, D. T., Dua, P., Fenton, S. H., Lalani, K., & Butler-Henderson, K. (2021). Occupational Classifications in the Health Information Disciplines. In The Health Information
Workforce (pp. 71-78). Springer, Cham.
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The Impact of Technology on the Workforce

• Changes in HIT careers have happen rapidly in this age of
technological development.
• Implementation of the electronic health record (EHR) has been
the largest contributor to the changes.
• The Health Information Technology for Economic and Clinical
Health (HITECH) Act of 2009 was enacted as part of the
American Recovery and Reinvestment Act (ARRA).
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©2023 | AHIMA.ORG Source: http://www.hitechanswers.net/about/about-arra/
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Defining the HI Workforce

• Job posting
data was
analyzed using
k-means
clustering
• 4 naturally
occurring
clusters
Marc, D., Butler-Henderson, K., Dua, P., Lalani, K., & Fenton, S. H. (2019). Global workforce trends in health informatics & information
management. MEDINFO 2019: Health and Wellbeing e-Networks for All, 1273-1277 ®
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Defining the HI
Workforce
• The frequency of jobs by category

differed by country
• Most common were jobs related to
health project management then
health leadership and HIT
• The US had more jobs related to
consumer engagement, clinical
documentation, and information
governance compared to other
countries
Marc, D., Butler-Henderson, K., Dua, P., Lalani, K., & Fenton, S. H. (2019). Global workforce
trends in health informatics & information management. MEDINFO 2019: Health and Wellbeing
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e-Networks for All, 1273-1277
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Data is Changing HI Careers

• A 2015 workforce study defined how health
information management (HIM) is shifting
to meet future needs and what knowledge,
skills, education, and credentials they need
to be successful.
• Anticipate a lower percentage of time on diagnosis
and procedural coding in the future
• Leadership, teaching, and informatics identified as
tasks that will increase most significantly.
Sandefer, R., Marc, D.M., Mancilla, D., & Hamada, D. (2015). Survey Predicts Future HIM Workforce Shifts: HIM Industry Estimates the Job Roles,
Skills Needed in the Near Future. Journal of AHIMA, 86(7), 32-35. Available at: http://library.ahima.org/doc?oid=107697#.Ww2ucFMvwW8
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Source: http://library.ahima.org/doc?oid=107697#.WS4bUlLMxE4
Data is Changing HI Careers
• Associate: 22.5% 61
• Bachelor’s: 44.0% 120
• Master’s: 18.2% 50
• Significantly greater
percentage of job postings
that require a bachelor’s
degree (p<0.001)
Sandefer, R., Marc, D.M., Mancilla, D., & Hamada, D. (2015). Survey Predicts Future HIM Workforce Shifts: HIM Industry Estimates the Job Roles, Skills Needed in the Near Future. Journal of
AHIMA, 86(7), 32-35. Available at: http://library.ahima.org/doc?oid=107697#.Ww2ucFMvwW8
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Data is Changing
• The Clinical segment consists of Hospitals
and Non-Hospitals (medical groups,
alternative living facilities, government
HI Careers community health centers).
• The Clinical sample includes a mix of small,
medium, and large hospitals as well as a mix
of those located in rural, suburban, and urban
areas.
• The Non-Clinical segment consists of IT
vendors, Clinical research companies,
MCO/health insurance companies, and
independent retail pharmacies.
Sandefer, RH (2018). New market research supports HIM Reimagined's call for professional adaptation. Journal of the American Health Information Management Association, 89(5), 20-23.
Available at: http://bok.ahima.org/doc?oid=302487#.WwciQUgvxdg
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AHIMA Curriculum Related to Workforce Needs
• 29% posted were in the Southeast, 20% in the Midwest, 19% in the
West, 14% in the Northeast, and 11% in the Southwest, with 7% fully
remote jobs
• Most HIM jobs require an associate degree or above.
• Many require an RHIT or RHIA credential with more opportunities in the
Southeast region and a number of jobs closely aligned with coding and
revenue cycle related careers
• Job postings did not strongly associate with the AHIMA curricular
competencies
Fenton SH, Marc DT, Kennedy A, Hamada D, Hoyt R, Lalani K, Renda C, Reynolds RB
Aligning the American Health Information Management Association Entry-level Curricula Competencies and Career Map With
Industry Job Postings: Cross-sectional Study
JMIR Med Educ 2022;8(3):e38004
What is the research telling us?
Jobs are The curricular

requiring more Many jobs competencies
technical skills, require a need to evolve
particularly Bachelor’s to align with
those related to degree or above workforce
data analytics needs
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Convergence of Disciplines
Shared knowledge concepts between HIM and HI
Gibson, C. J., Dixon, B. E., & Abrams, K. (2015). Convergent evolution of health information management and health informatics: a perspective on the future of information
professionals in health care. Applied clinical informatics, 6(1), 163. ®
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Key Takeaways
• The HI workforce isn’t fully represented in a way that

captures all the work being performed
• The HI workforce is evolving and requiring more
technical, analytical skills
• Educational programs need to fill in curricular gaps to
ensure the HI profession of the future is being trained
appropriately
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Information Blocking Overview
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Information Blocking – 21st Century Cures

• Prohibition affects:
• Health IT developers of certified health IT
• Providers (broadly defined)
• Health information networks and exchanges
• Penalties and enforcement by OIG
• Civil monetary penalties
• “Appropriate disincentives” for providers
(enforcement agency TBD)
• Final rule expected summer 2022
Culture Shift:
• ONC asked to define practices that are not
information blocking Information Sharing as
• Final rule in March 2020
• Clarifications/modifications expected late 2022
the Norm
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ONC Information Blocking Provisions

Definition: Examples:
Information blocking means a practice that—
• Restrictions on access, use or exchange
(a) except as required by law or covered by an
exception set forth in subpart B of this part, is likely to
interfere with, prevent, or materially discourage access, • Limiting or restricting interoperability of
exchange, or use of electronic health information;
and
health IT
(b) if conducted by a health information technology
developer, exchange, or network, such developer,
• Impeding innovations and advancements
exchange, or network knows, or should know, that in access, exchange or use of health IT-
such practice is likely to interfere with, prevent, or
materially discourage the access, exchange, or use of enabled care delivery
electronic health information; or
(c) if conducted by a health care provider, such provider • Rent-seeking or opportunistic pricing
knows that such practice is unreasonable and is likely
to interfere with, prevent, or materially discourage
access, exchange, or use of electronic health • Non-standard implementation practices
information.
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What is EHI?
For more detailed discussion
see:
final-ehi-task-force-report.pdf (ahima.org)
Understanding the Scope of Electronic Health Information (EHI) for the Purposes of the Information Blocking
Definition (healthit.gov)
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Information Blocking Exceptions

Not fulfilling requests to access, Procedures for fulfilling requests
exchange or use EHI: to access, exchange or use EHI:
• Preventing harm • Content and manner
• Privacy • Fees
• Security • Licensing
• Infeasibility
• Health IT performance
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The Sequoia Project Information

Blocking Compliance Workgroup
Information Blocking Compliance Workgroup Resources - The Sequoia Project
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The Role of HI Professionals in Operationalizing

Information Blocking Compliance
• Source of knowledge and experience regarding
both EHI and release of information process
• Review and update Designated Record Set policy
• Data mapping given move to electronic systems
• Build culture of information sharing
• Within organization
• With patients
• Understand role for HIM department and ROI
vendors
• Key part of cross-organizational team supporting both
HIM and IT
• Experts on navigating information requests and privacy
rules
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Health Information Sharing is the Goal:

Compliance Guidance on Information Blocking
A Webinar Series
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Goal
The webinar series will provide carefully vetted, substantive

resources and relevant information about requirements of
the Information Blocking regulations and good practices to
enhance effective and compliant organizational responses,
including the role of Health Information professionals.
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Objectives
1. Information Blocking Overview. Get answers to questions such as:
• What is information blocking?
• What is not information blocking?
• Who is covered by the rules?
• Risks, opportunities, and enforcement
2. Moving Toward Information Sharing. How organizations are achieving compliance:

• Information sharing tools: patient portal, APIs and apps, role and limits of EHR vendor support
• Sharing clinical notes
• Sharing lab results
3. Special Circumstances. Explaining the exceptions and how they are used:
• Preventing Harm, Privacy
• Infeasibility, Security, and Health IT Performance
• Content and Manner
• Fees and Licensing
4. Office Hours. A dedicated session to get your outstanding questions, and those of your colleagues,
answered by our legal and policy experts.
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Our vision is to make the right health information accessible at the right place and time
to improve the health and welfare of all.
Connected We Stand
Sequoias are among the oldest, tallest trees on earth. Individually, they cannot reach the great heights of giant sequoias. Together, their
complex, interconnected root system helps them withstand nature’s forces and flourish. Only connected can they reach great heights.
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Webinar Series Materials

• Information Blocking Summary—an extensive narrative that provides a
comprehensive discussion of:
• The legal authority for Information Blocking in the CURES Act, the ONC Final Rule,
and the OIG Proposed Rule;
• Key definitions and the exceptions.
• Compliance Planning Workbook—a comprehensive discussion of organizational

compliance and implementation for Information Blocking with checklists,
examples and suggestions (available to those registered for the full webinar
series).
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Interoperability Matters
https://sequoiaproject.org/interoperability-matters/
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®
Thank you for joining us!
Email: info@ahima.org | Website: ahima.org
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EMPOWERING PEOPLE TO IMPACT HEALTH™

EMPOWERING PEOPLE TO IMPACT HEALTH™

The State of the HI Industry:

Chief Health Information Officer

Keith Olenik has more than 35 years of

What are three key trends in the HI Industry for 2023?

1. Artificial Intelligence (AI) and Digital Health

Dr. Liz Kwo is a serial entrepreneur, practicing

David Marc is an associate professor, the health

Chantal Worzala is an experienced policy expert who helps

The Impact of AI & Digital Health on

So, what’s the solution?

• Improve patient experience

• Improved healthcare costs through efficiencies

• Ultimately shapes the digital future of healthcare

• Our prior definition of “healthcare products”

* Book release in February 2023

Clinically validated at-home Intuitive results

Easy-to-use test kits

Result letters sent to physician

Alert value calls for abnormal results

At-home testing programs

Wellness spending by category, U.S. consumers

HEALTH FITNESS NUTRITION APPEARANCE SLEEP MINDFULNESS

SOURCE: McKinsey & Co., Future of Wellness Market

Balance Seekers Direction Takers

19% 18% 31%

Self Achievers Priority Jugglers Willful Endurers

The most proactive when it comes to health.

Willing to invest what is necessary toward their health

Task-oriented; wants measurable goals.

“I can beat this. I am getting healthy. Let’s

Open to many ideas, sources of information and

To get action, provide the “why.”

Stress relief is important. Position as a way to achieve

Seeks guidance and direction. Wants to be led.

Values their personal routine.

“Tell me what to do next. I’ll trust your advice as long

Values efficiency and family.

Does not take time to invest in their own wellbeing but

Believes there are more important issues to focus on other than

Reactive, least engaged and hardest to reach.

Responds to a step-by-step approach.

“I’m living for today. On my own terms.

65% of consumers say they could be taking

Clinical data exchange improves care costs, increases provider

Defining the Health Information Technology

Defining the Health Information Technology

The Impact of Technology on the Workforce

Defining the HI Workforce

• The frequency of jobs by category

Data is Changing HI Careers

Data is Changing HI Careers

What is the research telling us?

Jobs are The curricular

• The HI workforce isn’t fully represented in a way that

Information Blocking Overview

Information Blocking – 21st Century Cures

ONC Information Blocking Provisions

Information Blocking Exceptions

The Sequoia Project Information

Information Blocking Compliance Workgroup Resources - The Sequoia Project