What is Health Information Technology?
Health Information Technology (HIT) is the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of healthcare information, data, and knowledge for communication and decision-making.
What’s it like to work in this field?
For this article on Health Information Technology, we spoke with two medical professionals who rely on innovative tools and data to inform the solutions they provide for their patients. The first is Dr. Katrina Miller Parrish, a researcher, author, and Chief Quality and Information Executive for L.A. Care Health Plan. In her distinguished career, she has held leadership roles in prominent health organizations, received noted fellowships, and lectured at prestigious institutions, including USC’s Keck School of Medicine. She received her bachelor’s in biology from Reed College and her M.D. from Eastern Virginia Medical School.
Dr. Parrish began in family medicine as a physician but was quickly drawn to Health Information Technology and Informatics because of her interest in analyzing clinical data and her love of business. Sensing that she could do much more than care for one person at a time, she began to see working in population health as a way to positively impact millions of people’s lives.
However, working in this field is more than just about analyzing data. Dr. Parrish explained that as part of her effort to make a difference, organizations as large as the one she works for must abide by demanding regulations.
L.A. Care Health Plan, where she works, is a public health entity and receives its authority directly from the State of California and the County of Los Angeles. That means that while a board approves everything they do, it also receives oversight from multiple regulators at the state and federal levels. “Every day is spent ensuring we’re adhering to all of the rules,” she says. Like similar health-related entities, L.A. Care may be required to develop a corrective action plan in response to an audit. That task is necessary but can affect their tactical capacity. Dr. Parrish thinks that part of working with a public health authority or a government entity is just knowing that’s the case. “You understand that you have certain requirements. Part of my world is about figuring out how to go through all those processes as quickly and efficiently as possible—asking what we can do in parallel. What has to be contingent upon something previously done? Then trying to make it happen as quickly as possible, without sacrificing quality.”
ELECTRONIC MEDICAL RECORDS
Efficiency is one reason Dr. Parrish favors interoperability with electronic medical records. At L.A. Care, it’s essential to get as much data in their door as possible, especially for population health management. “The more data we get, the more we understand about our member population and the provider network,” she explains. “We’re interested in having access to as much data as feasible.”
Yet the remaining challenge is navigating the marketplace of products in her industry. In the L.A. Care network, they work with more than 20 different medical record systems. The top five systems represent most of the population, but Dr. Parrish and her team have to figure out how they’ll potentially work with the rest of them, which is why they lean on health information exchanges. Their “Health Information Ecosystem” strategy recognizes industry limitations and is partly about working well with whomever they can, getting as much good data as possible and processing it efficiently and on time.
Health Informatics leverages A.I. and big data strategies to analyze populations and improve overall health outcomes. However, the quality of the data sets may have the potential to influence and produce unintended results. One way that informatics professionals address this issue is by assigning quality assurance resources to more closely monitor their analytics and ensure they understand their data from different angles.
“One of the things that we try to do,” Dr. Parrish tells us, “in the case of claims, encounters, and population data, is to develop risk stratification insights. That information can sometimes help us see whether a particular group has a higher risk for severity of illness and how it can be addressed differently than in a lower-risk population.”
Big data analysis tools also help organizations like L.A. Care pinpoint fraud. They have a Special Investigations Unit, or SIU, committed to discovering corruption, and Dr. Parrish is the Credentialing and Peer Review Committee chair. With the committee’s guidance, professionals at L.A. Care can use their technology to identify patterns through algorithms and carefully analyze payment integrity and pharmacy data. For example, when they identify providers who are writing excessive prescriptions for a particular medication and find out the patients whose names are on the prescriptions never received them (and don’t even have a diagnosis matching them), it raises a red flag, and they take action.
Still, Health Information Technology leaders must prioritize who they put under the microscope because they can’t go after every single problem or provider. Dr. Parrish says that’s how they also approach their strategy for population health management. They first have to figure out what the priorities are, then decide where to use their resources.
Butt Health Information Technology isn’t just giving an advantage to large organizations like L.A. Care. Three states over from California, in the little town of Lakeside, Montana, it’s making a difference in the lives of Dr. Benjamin Bushnell’s patients. The doctor established his dentistry practice there in 2005, shortly after graduating from the University of Nebraska Medical Center. He says technology has fundamentally transformed his practice and the industry, and he uses computers to support the administrative side of his business and as an essential part of his treatment plans.
When he started in the field, the amount of technology in the typical dentist’s office paled compared to the tools he now uses daily, including cone beam computed tomography and computerized milling systems for same-day in-house crowns. Without these advances, he says it’s hard to imagine running his business as efficiently. And for the most part, Dr. Bushnell didn’t acquire the training to use his sophisticated machines in medical school—he had to take the initiative and seek out training from vendors and continuing education resources.
“As far as computer training goes, there wasn’t much of that I got in dental school,” he tells us. “Pretty much everything I learned about technology was after dental school. Since then, I’ve seen dramatic improvements in the modeling accuracy.”
But while cutting-edge technology is now standard in many medical offices, having a background in working with those machines isn’t a requirement for Dr. Bushnell when bringing on new staff. “Most everyone can learn the basics of these tools and train up in today’s world, although the software we use for our charts can sometimes take months to master. But my philosophy is that I hire for the person. I can train anybody.”
Anybody who has visited a dental office lately and undergone a significant procedure like a root canal, getting a crown, or an implant should be grateful for this new technology and the people who use it to improve our oral health. And that innovation we see in our local dentist office has been global, with some of the latest crown technology coming out of Germany and implant advances from Switzerland. It’s made some procedures more expensive, but ultimately worth it to most patients.
However, Dr. Bushnell notes that tech still has a long way to go. For example, some companies are trying to use A.I. to diagnose and predict tooth decay. But despite promising early results, doctors have learned that some of those tools tend to overdiagnose. That’s why Dr. Bushnell feels that, in medicine, the human element is so necessary. Doctors are always better positioned to monitor a patient’s health status and diagnose certain conditions. “I’m a firm believer that you need a human side. The clinical judgment of a doctor who can observe things over time is such a critical factor. Humans are not black and white. There’s such variability.”
And there’s as much diversity in the types of jobs in Health Information Technology as you’ll see in the section below. Whether you’re working in population health at a major insurance carrier or in a small but innovative dental office, there are all kinds of opportunities to combine your love of science, healthcare, and people.
What kind of education might you need?
Health information technicians usually need a college degree to compete for jobs, and colleges require a high school diploma or GED for admission. Taking classes like statistics or human anatomy in high school may be helpful. At a minimum, most employers want candidates to have an associate degree in this field. You may find that a bachelor’s degree will make you more attractive to employers when you enter the job market. While certification isn’t required by law, many employers seek candidates with a Registered Health Information Technician (RHIT) certification. This credential tells others that you have deep knowledge of health information technology.
Learn more about exciting careers like those in Health Information Technology in the new book, Tomorrow’s Jobs Today, available on Amazon and at Barnes & Noble.