Question

HEALTH INFORMATION TECHNOLOGY:

Chapter 4 emphasized the importance of good clinical documentation. For this week’s discussion post use the web to research the clinical documentation improvement (CDI) role in health information management (HIM). Post a brief summary, 200- 250 words, about your article and ask a thought provoking question related to the article. Cite 1-2 internet sources used.

Answer 1

• The clinical documentation is very important in the present world.As the patient should know about their health condition in the proper way.
• As we need to manually maintain the records of each person is difficult so we need to do the capture the data and should be documented properly in an electronic format.
• clinical documentation improvement programs facilitate the accurate representation of a patients clinical status that translates into coded data.The coded data is then translated into quality reporting ,physician report card,public health data and disease trending and tracking.
• In this clinical documentation improvement we need the effective individuals who can analyze all the documents which are in the coded data and represent it in the form of the reports that to be given to the patient.
• The clinical documentation improvement professionals come from the variety of backgrounds.Mainly from the two important types of background they are health information management and nurses.
• The health information management professionals who are good in the compliant documentation rules and regulations.
• The health information management professionals should also concentrate on the privacy,security and confidentiality.
• Nurses have a strong clinical background and so they can easily find out the mistakes that were unfortunately done by the health information management.
• The electronic health record is the one of the best way to analyze the patient in each every aspect of his health.
• A lot of improvements should be made in the clinical documentation so that every patient gets benefits as well as they can perfectly understand about their health condition.
• The clinical documentation improvement include the clinical evaluation,nursing care,diagnosing procedures.
• QUESTION:-Can the individual persons DNA gives the report of his/her health condition.By seeing and analyzing the DNA can we recognize the disease in the patient.
• LINKS USED:-https://www.ahima.org
• https://en.wikipedia.org