At a news conference yesterday, the American Health Information Management Association (AHIMA) unveiled its Health Information Bill of Rights, a set of seven principles designed to protect and promote patient access to personal health information.

Craig May, AHIMA public relations, called the Bill of Rights "an extraordinary stride in patient protections." He plugged the provisions at Sunday's Student Academy, mostly saying the association planned to introduce a list that was unprecedented in the industry, but kept the details under wraps. Well, here they are (abbreviated for your quick perusal, of course):

1. The right to access your health information free of charge.

2. The right to access your health information during the course of treatment.

3. The right to expect accurate and complete health information.

4. The right to know who provides, accesses and updates your health information.

5. The right to hold health care professionals and others accountable for violations of privacy and security laws, policies and procedures.

6. The right to expect equivalent privacy and security protections, regardless of location.

7. The right to seek legal recourse for violations.

Wait, you say, that sounds a lot like HIPAA, and isn't the American Recovery and Reinvestment Act (ARRA) already beefing up privacy and security? Reporters thought the same thing. But according to AHIMA, the Bill of Rights are not meant to replace HIPAA but rather serve as "guideposts" to ensure privacy and security protections remain part of health care discussions. "HIPAA was a good start, ARRA was another nice step, but we still feel more could be done," said Wendy Mangin, AHIMA past president and chair of the Blue Ribbon Committee, which crafted the provisions.

The Bill of Rights went through a significant "vetting process" to validate the meaning and applicability of each measure. According to Linda Kloss, CEO of AHIMA, upholding privacy and security while expanding consumer access to information will become even more critical in the digital age. Patients and providers across the nation will need a "common understanding" of these rights to make health information exchange not only possible, but successful. 

For more information on AHIMA's Health Information Bill of Rights, watch our video interview with Mangin and Kloss, which will be posted Oct. 21 as part of our comprehensive post-conference coverage. In the meantime, leave your comments about the provisions below. The seven principles seem pretty straightforward, but according to Sandy Fuller, chief operating officer of AHIMA, a few of them could turn out to be quite controversial. What are your thoughts? Do you see any loopholes or potential hang-ups?

Well, my feet hurt, my brain hurts and I can barely keep my eyes open at this point, but it was all well worth it. My first day at the AHIMA 2009 conference did not disappoint. Busy is an understatement, and I even got a bit of a cardio workout in-with all the walking to and from the various meetings and sessions. This place is huge!

After a brief welcome from AHIMA President Vera Rulon, MS, RHIT, CCS, FAHIMA, and some opening remarks from Grapevine, TX, Mayor William Tate and the Texas HIMA President Carol Smith, MBA, RHIA, attendees were treated to an energetic keynote address from Doug Keeley, CEO and chief storyteller of "The Mark of a Leader."

Keeley shared a number of touching and amazing stories designed to inspire and challenge the membership to "Think Big, Then Do It."

Next the AHIMA Foundation Triumph Awards were presented. These national awards recognize a number of individuals who've made a difference in the HIM profession. We'll bring you full coverage and photos in the coming days, but here's a quick recap of this year's winners:

Distinguished Member Award - Mervat Abdelhak, PhD, RHA, FAHIMA

Champion Award - Mary "Mamel" McCain, MPA, RHIA

Community Outreach Award - PHR Community Education Coordinators

Educator Award - Sue Biederman, MSHP, RHIA

Educator Award - Rachelle S. Stewart, DrPH, RHIA, FAHIMA

E-HIM Award - Marion V. Swaim, RHIA

Legacy Award - April D. Robertson, MPA, RHIA, CHPS, FAHIMA

Mentor Award - Karen Lawler, MPS, RHIA

Mentor Award - Barbara Manor, MA, RHIA

Mentor Award - Dwan Thomas-Flowers, MBA, RHIA, CCS

Pioneer Award - Melissa D. Myrick, MSA, RHIA

Rising Star Award - Megan L. O'Neill, RHIA

As for the rest of my day, it was mainly spent in the exhibit hall while the other ADVANCE staff members attended numerous sessions and press conferences. I've updated our ADVANCE 2009 Industry Buzz news page on just a few of the announcements made today in the exhibit hall, so be sure to check that out.

And now, it's time to get some rest so I can do it all again tomorrow!

They say everything's bigger in Texas, and that even goes for their welcomes. Following yesterday's pre-conference events, attendees at the American Health Information Management Association (AHIMA) Convention and Exhibit were treated to a Welcome Reception at the Glass Cactus, a nightclub at the Gaylord Texan Resort. Set on the shores of Lake Grapevine, the Glass Cactus was a bit of a hike from the Convention Center, also on the Gaylord's grounds, but attendees could hop a trolley instead of hoofing it across the parking lot.

The Glass Cactus was the perfect place to wind down, with warm lights, smooth music and two floors of stone walls that evoked the open air of a hunting lodge. Despite a chill in the air, several conventioners soaked up the scenery on the outdoor deck; with 180-degree views of the lake, it was a backdrop too tempting to pass up. 

Attendees wined and dined on cheese, crackers and crudite as they discussed the events of the day and goals for the convention. Discussions ranged from recovery audit contractors to the ongoing debate about apportionment at the House of Delegates. But when inquired about the conference, most attendees had the same response: "We've only just begun."

The events--and hospitality--continued this morning with the official welcome from Grapevine Mayor William Tate. After sharing a glimpse of the town's history, Tate invited attendees to come back "real soon" and explore the golf courses, wine tours and lively downtown area Grapevine has become known for. Texas HIMA President Carol Smith, MBA, RHIA, also offered a warm welcome and urged attendees to take advantage of networking opportunities at the convention. Texas means "friendship," she said, so start making those connections. And speaking of connections, TxHIMA will be playing a major role in building the state's health information network. With such a large area to cover--and much of it rural territory--linking up will be nothing short of a challenge, Smith said. Here's hoping that hometown hospitality goes for health exchange, too.

My first day at the 2009 American Health Information and Management Association (AHIMA) Convention and Exhibit is off to a great start. I attended the Student Academy this morning, where Barbara Black, director of human resources, and Gwen Hughes, director of eHIM, Care Communications, shared the dos and donts of writing cover letters and resumes.

"Your resume should reflect your next job, not your current job," Black said. Be concise, factual and positive, she added, and focus on what your skills can do for the company, not the other way around. Instead of listing an "objective," try a "positioning statement" that summarizes your unique talents. Don't be afraid to toot your own horn, Black said, but never lie; a simple fib can come back to haunt you. Misrepresenting yourself can also land you a position you're not ready for, which only adds to stress and makes employer relations difficult down the road, Hughes added.

Addressing Generation Y in particular, Black urged students to Google themselves and remove any information online that could be unattractive to employers. Keep ringback tones and e-mail addresses appropriate, and rid your Facebook account of any incriminating photos, she said. But Black didn't forget those pursuing second careers or returning to the HIM field, either. Make sure your credentials are up-to-date, she said, and ditch the "References upon request" line at the bottom of your resume. Instead, hand potential employers a "Professional References" sheet before you leave an interview; hiring managers will be impressed with your initiative and you'll have more time to alert references that a phone call might be coming their way.

Despite the early morning start, students had plenty of energy and asked thoughtful questions throughout the session. I had the chance to sit with a few during the lunch break; they're excited to get into the field, but many said it's tough to find information about the industry. They turn to mentors, associations and other resources (hopefully ADVANCE!) to get the nitty-gritty on what it's really like to be in HIM. Career goals ranged from management to consulting, but no matter what direction they head, they'll likely encounter HIT. Luckily, they're prepared--every student at my table has worked with EHRs, and said they foresee the technology succeeding in the future.

I'm headed to Texas tomorrow and looking forward to meeting many of you attending the American Health Information Management Association (AHIMA) convention. I wasn't able to attend last year's meeting in Seattle, so I'm especially excited to get out there and mingle with so many of our faithful readers.

It will definitely be a whirlwind trip for me, as I'm arriving late on Sunday and returning home on Tuesday evening. (Duty calls, and I must get back to the office and start working on the October issue.) Although my time there will be short, yet jam-packed with meetings, I always come away from the AHIMA conference completely energized. I'm sure this year will be no different.

It's always so uplifting to talk personally with our readers, columnists, panel members and advertisers. The ADVANCE magazine and online edition exist for you, and because of you. Many of our columns wouldn't exist without your participation, such as our Say What?? collection of funny bloopers (which always make me LOL!), our Coding Q&A and Management Q&A, and the countless other contributions you provide to this magazine.

I always come away from the national meeting with new article and column ideas, new contacts and new friends. So, if you're attending this year, please be sure to stop by and say hi! I'll be at Booth # 1907. I'd love to hear your thoughts on the magazine and the Web site, and any ideas you may have for future articles, columns or blogs. If you're not able to attend this year's meeting, be sure to follow along with our Live 2009 AHIMA Conference Coverage. And don't hesitate to comment here below with your feedback and suggestions on how the magazine and Web edition can better serve your needs.

Anytime someone mentions this year's American Health Information Management Association (AHIMA) Convention and Exhibit, I immediately think of the song, "I Heard it Through the Grapevine," because, well, the event's being held in Grapevine, TX. Problem is, I only know that single line of lyrics, and as a child of the late ‘80s, I more often associate that tune with the California Raisins than Marvin Gaye.

Motown and dried fruit. Probably not the image AHIMA was going for.

Fortunately, the convention has plenty of opportunities to give new meaning to Grapevine. My days will be filled with talk of ICD-10, recovery audit contractors and the HITECH Act--and I'll bring it all to you via blogs, daily photos and even a live audiocast from the press room. It all starts with Sunday morning's Student Academy, where I'll be learning alongside HIM's up-and-comers.

I'm eager to hear what's mentioned at this year's general sessions. Last year, AHIMA cited the Genetic Information Nondiscrimination Act (GINA) as one of its greatest accomplishments of 2008. Lo and behold, the Office of Civil Rights announced a proposed rule yesterday that will enhance genetic protections under HIPAA, in accordance with GINA. Perfect timing for a pat on the back, or at least a mention, at this year's event. And with CEO Linda Kloss' impending departure next March, I wouldn't doubt there will be some sort of tribute or award when she takes the stage.

Sadly, I won't have much time to explore Grapevine, but the Gaylord Texan Resort and Convention Center will be a sight to see in itself. A sprawling, fountain-filled hotel, it's the perfect place to rub elbows with HIM's elite. Attendees can schmooze at the annual Welcome Reception and President's Premier Celebration, plus some alums have the additional chance to meet-and-greet at receptions sponsored by their alma maters. Of course, I'll be there to snap some shots for our Web site, so don't be shy!

Enjoy our live coverage now and make sure to check back Oct. 21, when we bring you comprehensive post-conference coverage, including articles, photos and video. Feel free to share your reflections in the comments sections!

Greetings! My name is Rob Senior, and I am the newest member of the editorial staff at ADVANCE for Health Information Professionals.

For the past eight years, I've worked at ADVANCE in a similar role for the Physical Therapists and PTAs magazine. In my new assignment, I'm learning about the "other" side of health care--the people developing, processing and correcting the medical records of the patients seen by physical therapists and other practitioners. 

Next week, I'll be attending my first HIM event--the AHIMA conference in Grapevine, TX. This is where I need your help--what issues pertinent to the profession would you like to see covered in ADVANCE? What advice do you have for someone just starting to cover your profession? Most importantly, what should I know about covering HIM?

I welcome any and all of your thoughts and opinions. I look forward to working with and writing about each and every one of you!

With all the prep for next week's American Health Information Management Association Convention and Exhibit and our HIM Team of the Year coverage (Yes, we have a winner!), I've been neglecting my Google Alerts. Well, I found some time this morning to browse the news on electronic health records (EHRs), and there's a whole lot of good, bad and ugly.

Boston researchers have identified yet another benefit of EHRs: flagging domestic abuse. According to the Boston Globe, the researchers examined 6 years of hospital admissions and emergency room visits, looking for cases that involved risk factors like injuries, poisoning and alcoholism for women and depression and psychosis for men. Using that data, researchers identified domestic abuse victims an average 2 years before the diagnosis was listed in a patient's chart, the report said.

The researchers developed an EHR-friendly module that could alert physicians when signs point to abuse. The screening tool could also be adapted to assess risk for other conditions, like diabetes and depression, all in the effort to provide what researchers called "predictive medicine." It doesn't guarantee a problem exists, but puts providers on alert in case one develops.

While the Boston study is all about keeping tabs on records, some patients may be looking to wipe theirs clean. The American Recovery and Reinvestment Act requires providers to participate in a national HIT network, but patients will determine which information doctors can access. Abortions and sexually transmitted diseases (STD), for example, could be withheld, according to Rep. Patrick Kennedy. "This is totally going to be up to the individual," he told CNS News.

Given the social stigmas, it's understandable patients could want to keep such conditions under wraps, but all politics aside, is that best for delivery of care? Coordination of care depends on having complete information-just ask a cardiologist waiting for hospital discharge notes-so if something as critical as an STD is left off the record, doctors might not deliver the most effective care.

And speaking of coordination, take a look at this communication debacle. The Tennessee Department of Human Services (DHS) is attempting to save face after a caseworker sent the wrong fax number to 100 providers who submit information for disability determination. So where did all of those social security numbers and private health details go? To a solar-powered fan manufacturer in Indiana, where the owner told reporters he's been receiving medical records for years.

Tennessee DHS owned up to the recent mix-ups, but said past problems are due to the department and manufacturer having similar fax numbers. The department's fax number is owned by the Social Security Administration, so Tennessee DHS can't change it, the report said.

One IT buff said it's a case for EHRs. Sure, digital systems would eliminate fax flubs, but it's probably just as easy to misdirect information with the click of a mouse. (C'mon, like you haven't sent an e-mail to the wrong person?) And let's face it, making all those operations paperless would be pretty darn expensive.

How expensive? Well, North Shore-Long Island Jewish (LIJ) Health System is spending a whopping $400 million to install inpatient EHRs at its 13 hospitals and partially subsidize costs for community and hospital-based physicians who go electronic. I frequented a North Shore-LIJ hospital as a kid (OK, not so much frequented as was born there and got stitches in the emergency room), so it's nice to know family members will be getting high quality care--or at least that's the hope. And with that multi-million dollar price tag, I'm sure executives are looking for a big payoff.

The launch comes to my editor's and friends' relief, I'm sure. I've sufficiently chewed their ears off about Facebook, Twitter and "Oh hey, did you check out that blog I mentioned yet?" But in all fairness, the coverage arrives at a pretty opportune time. People are tweeting from health reform rallies and joining Facebook groups to promote their professions. (While you're at it, why not take the ADVANCE Facebook Tour and become a fan?)

According to a recent report, "The Social Life of Health Information," by Susannah Fox, associate director of digital strategy for the Pew Internet and American Life Project (she also presented her take on privacy and security issues at the latest HIT Policy Committee meeting), 61 percent of American adults go online for health information; 60 percent of those people use social media as a resource and 12 percent post updates about their health or track others' conditions via Twitter. (OK, a tweet might not be the most credible source, and far more trawlers flock to WebMD for self-diagnosis, but 12 percent's still pretty impressive.)

Now, I could use this post as an opportunity to blog about blogging (how meta!), but I left the philosophical waxing to our other ADVANCE bloggers. (Read "The Benefits of Blogging.")

Instead, I'm handing this virtual soapbox over to you to share some of your best social media tips. It is all about networking, after all, so post your input in the comments section below!

I'm wrapping up an extensive print and online package about social media for our September issue (Look for it next week!), and with all the reading, interviewing and, yes, tweeting I did to research the phenomenon, I thought I'd heard everything.

Well, this morning I came across this blog, which references another blog (isn't linking great?) about a sticky situation involving HIPAA and Twitter. Sure, nurses and other hospital staff have begun tweeting from the operating room, but what about a patient who tweets her own trauma--and makes accusations in the process?

According to the blog, after suffering a "serious spinal fracture," tech consultant and blogger Sarah Cortes sent tweets from the Pennsylvania hospital that was treating her, seeking a second opinion from doctors back home in Boston.

Tweeting about her condition was fine and dandy, but Cortes now claims the posts saved her from unnecessary surgery. According to her account, the hospital pressured her to get reconstructive spinal surgery, an expensive procedure that could improve the hospital's accreditation status. After tweeting and talking via cell phone with a doctor from Beth Israel Deaconess Medical Center (BIDMC) in Boston, Cortes declined surgery and sought care at BIDMC, which used a non-surgical approach to treat her back.

Cortes has since deleted the tweets she sent during her medical escapade--she even admitted they were "urgent-sounding"--but she sticks to her guns that the Pennsylvania hospital had ulterior motives. But here's the real kicker--the hospital can't respond. HIPAA bars doctors, nurses and hospital spokespeople from discussing Cortes' case, like the severity of her injury or what treatment was advised. The hospital denies that it pushed unnecessary surgery for financial gain, but it can't offer much more defense than blanket statements about honesty, integrity and patient care being No. 1.

The case has the stuff of courtroom dramas--accusations, greed, deception--and it's all being broadcast across the blogosphere. But the story also touches upon many of the same health care issues lawmakers are trying to solve. According to Cortes, the Pennsylvania hospital opted for excessive care, which experts say is a leading cause of rising health care costs. On the other hand, Cortes commended the BIDMC doctor for being accessible and responsive even late at night--traits that could become more common as health reform calls for greater quality and better coordination of care. And, as hospitals are learning, they'll have more than just privacy concerns to worry about as patients become more active decision-makers regarding their own care.

What do you think about this case? Cortes felt free to publicize her treatment, so should the hospital be released from HIPAA constraints? Is the Internet an appropriate place to discuss treatment or criticize a facility's approach?

The government's "Cash for Clunkers" program was a clever idea--and a pretty successful one to boot. Dealerships swelled with drivers ready to trade in their rag-tag autos for a sleek new ride. Salespeople moved inventory, the environment got some smog relief and buyers got a few Gs of credit. Automakers even joined the trend, offering their own cash back options.

Then funds ran out. A little too quickly for some who were saving up for a trade in, say, next month. It's not clear yet whether the program has long-term benefits, but the concept is already spreading.

On Sept. 1, MedPlexus, a practice management and EHR supplier, launched its own version of "Cash for Clunkers." Physicians who "trade in" their outdated practice management or EHR system for a MedPlexus integrated platform will earn $3,000-5,000 in cash payments. The company's products are CCHIT-certified, which--as of now--is the only certifying body that ensures alignment with "meaningful use" requirements. Doctors who effectively deploy certified systems can qualify for up to $64,000 in EHR incentive payments.

It's a tempting offer, especially for small practice physicians struggling to scrounge up the dough for a quality system. The press release is short on details; it's not clear how exactly to qualify, what determines the amount a doctor receives or how those payments will be levied. But contractual clauses and fine print are probably left for the wheeling and dealing once you sign on.  

The gimmick may work, or it may flop. Like everything about EHRs these days, it all depends on physician response. If they're not ready to upgrade, a few thousand bucks won't send them shopping. But hey, if they just cashed in on the government program, maybe they'll dump their junk in one swoop.

The ADVANCE team likes to be inquisitive (it's part of our job, ya know). Sure, we've met you at conferences, chatted you up on the phone, but we want to know what really goes on in that head of yours. Thus, we introduced "What Makes HIM Professionals Tick," a series of 10-question surveys about anything from your first job to your favorite cuisine. We asked and you delivered, and today we present the results of our second installment in the series (Check out the results of our first survey here). 

A shiny new set of questions is now up and ready for your input. Click here to fill out the newest "What Makes HIM Professionals Tick" Survey.

I've been itching to kick off this Labor Day weekend. I'm taking my first real vacation day--OK, I took off a Friday for my sister's wedding, but dealing with last minute details is so not a vacation--and I'll be spending it lakeside. And it looks like I'm in good company; 53 percent of you had plans to jet off--or maybe just staycation--this summer. Nearly a third of you decided to forgo a trip this year, and 16 percent of you never take a summer break (someone has to hold down the fort, right?). 

We can see why you'd need a vacation; times are stressful, and many of you are dealing with less-than-favorable changes at work. The majority of you (58 percent) have added minor cost-cutting measures, like reducing paper use, to your routine. About one quarter of respondents have been hit with layoffs, 16 percent lost their 401K match and 10 percent saw benefits cut. About 8 percent had pay cuts and nearly 7 percent took unpaid furloughs. Amazingly, more than a quarter of respondents said they haven't been affected by cuts. (You lucky ducks!)

If you didn't give yourself a real respite this season, we hope you at least took a few breathers at work. Fortunately, when the pressure builds, most of you take a step back. Eighteen percent of respondents take frequent, short breaks throughout the workday, but 23 percent said you plow straight through the day. The majority of respondents (58%) find a happy medium, taking a few trips to the water cooler or down the hall each day.

In fact, HIM professionals are all about moderation, according to results. When it comes to your workspace, 16 percent are neat freaks, 7 percent are packrats, but a whopping 77 percent keep it just right. In the garden, about 54 percent of you admitted to being so-so. Only 13 percent of respondents were blessed with a green thumb, while a third are just all thumbs around garden tools (my wimpy herbs sympathize). With all that activity, you need to stay hydrated. Thirty four percent of you gulp the recommended eight glasses of water per day, 55 percent stick to a more reasonable bottle or two, and 11 percent of you rely on coffee for your fluid intake--we just hope it's not a 32 oz. jolt of joe.

We know it's tough to land your first job; it's probably our most frequently asked question at ADVANCE. Responses were across the board about what factor played the biggest role in getting a foot in the door. Nearly one third said a good education made the difference, while 22 percent attributed it to diverse skills. Twelve percent relied on persistence, but 16 percent said they just lucked out, and 19 percent said it's all who you know--they networked their way to employment.

Of course, even when you're out of school and have a job, there's always room to learn. When it comes to training, 22 percent of you embrace the e-learning approach. Nearly the same amount prefers in-person presentations, while about 9 percent like the "gimme a book" method. The majority of you, however, like to dive right in for some trial and error--48 percent claimed to be hands-on learners.

Whatever your learning style, many of you will be applying it in the switch to electronic health records (EHRs). Only 5 percent of respondents said EHRs won't work, but the rest were split between complete optimism (46 percent) and more moderate expectations about EHR initiatives (49 percent).

Finally, after a long day of abstracting data, auditing charts or reminding physicians to stop dictating in the car, you need to kick back at the movies. So what tickets do you Fandango? More than a third of you like action/adventure, but comedies are right behind with 31 percent of the crowd. Thirteen percent of respondents choose a cheesy romantic comedy, while about 10 percent pick a chick flick. According to the results, kids movies (7 percent) and horror films (2 percent) usually aren't your thing.

For data purists, full results sans-commentary are below (some do not total 100% due to rounding or multiple select options). Once you've satisfied your curiosity, feed ours by taking the next survey installment, which can be found here.

1. Are you planning to take a summer vacation this year?

53% I'm counting the days.

31% No, I never do.

16% No, I chose not to this year.

2. What do you think of President Obama's efforts to promote the use of EHRs?

46% It's a great idea.

5% It'll never work.

49% It might make more physicians adopt EHRs, but not all physicians will use the technology.

3. What type of movies do you run to the theater for?

10% Chick flicks (You like the feel good films!)

13% Romantic comedies (You know how it ends, but enjoy the ride.)

2% Horror films (And you don't even cover your eyes at the scary parts.)

36% Action and adventure (The only way to watch is on the edge of your seat!)

7% Stuff the kids will like (You know every single word to all of the High School Musical movies.)

31% Comedies (Everybody likes to laugh!)

4.  Your work area is:

16% Pristine, with each and every paper clip in its place.

7% A wreck. Is the cat under there somewhere?

77% In between. You can find what you need, usually, and that's the most important thing.

5.  How often do you take breaks at work?

59% A couple times a day, just to clear my head.

18% I take frequent, short breaks.

23% I haven't taken a break since side ponytails were all the rage.

6. What kind of cost-cutting measures has your employer implemented? You can select more than one.

58% Little things, like saving paper here and there.

7% Mandatory unpaid furloughs.

10% Cutting back on benefits like health care coverage.

16% Taking away the employer match to the retirement plan.

8% Pay cuts across the board.

26% Laying off employees.

26% None of the above, luckily.

7.  How do you prefer to get training for work?

22% Over the computer, in Webinar form.

21% In-person presentations work best for me.

9% I can read about whatever's coming and pick it up pretty well.

48% I'm a hands-on learner, and I learn best by doing.

8.  How green is your thumb?

13% My garden's in this month's issue of Better Homes and Gardens.

54% I dabble in gardening, but only have a 50 percent success rate.

33% If I even look at a plant, it's as good as dead.

9.  What proved most important in landing your first HIM job?

19% Networking

12% Persistence

16% Luck

22% Diverse Skills

31% Education

10.  How much water do you drink a day?

34% Eight 8 oz. glasses.

55% A bottle or cup here and there.

11% Does coffee count as water?

For the past 2 months, I've been collecting entries for our 2009 HIM Team of the Year contest, and it can be...inundating. (Not that I wouldn't love to see a dozen more entries!) A copy for each judge, plus one for our files-it's a whole bunch of printing and stapling, and it gives a computer junkie like myself a new appreciation for all you form-juggling professionals.

Now, as much as I pride myself on a well-coordinated contest, it's not quite the caliber of, say, reporting H1N1 data. With health experts predicting another spike in swine flu cases this fall, hospitals are scrambling to keep tabs on who's at risk. Scientists have developed a two-step H1N1 vaccine, and administration is expected to begin soon. Before each shot, patients will be required to sign a medical consent form, and that means a whole lot of paper swirling about. HIM departments will have to stay on top of those forms and put them into electronic format for reporting to government agencies and insurers.

Electronic health records (EHRs) usually give HIM departments an advantage, but they'll still have to integrate the paper forms into the system. Recognizing this need, one Maryland-based document management company is already stepping into the new niche. Through its H1N1 Flu Vaccine Forms Processing Service, Quality Associates Inc. will design forms, scan completed sheets and send the information back to providers for reporting purposes. No doubt other scanning and imaging companies are looking for ways to capitalize on H1N1 prevention, but hey, when life gives you swine flu, look for the bacon.

Paperless hospitals may have to go old-school with consent forms, but they'll be all-electronic for flu tracking. According to Government Health IT, the Department of Health and Human Services (HHS) will use its HAvBED online system to monitor the H1N1 outbreak. HHS will collect data weekly to determine the number of beds available at hospitals across the U.S., so officials won't be caught off guard if facilities reach capacity.

Now, I'm not convinced the outbreak will be that bad, but I'm certainly part of the "better safe than sorry" camp. So monitor away. And if you're the one stuck managing those consent forms, let me know how it's going.

We're back for the third installment of our "Difficult Personalities" series. So far, we've escaped the needy co-worker's grasp and busted the "ghost" employee's vanishing routine. This time, we'll scale the know-it-all's mental pedestal to get a better perspective on this difficult personality.

Always Right, Even When Wrong

Ever see that "Saturday Night Live" sketch with the woman who has a story that tops everything? If someone went skiing, she survived an avalanche; if someone got a dog, she raised a flock of eagles by catching worms with her teeth. (OK, those aren't from the actual sketches, but you get the point.) Well that's a know-it-all, and there's one in every department, according to Cathy Jensen.

"If you've done it, they've done it and they've had a better experience at it. They've done it for longer or know more about it. There isn't any topic brought up that they don't have a wealth of knowledge on," said Jensen, an HIM professional who's had her share of difficult co-workers.

The problem with know-it-alls is they don't actually know it all, but they sure as heck won't admit it. Evidence could be mounting against them, but they'll stand by whatever position they take. It appears know-it-alls have utter confidence in what they say, but Jensen wonders if there's insecurity behind the cocky façade. At any rate, she doesn't bother to call them out. "What's the point?" she noted. "You can't argue with a know-it-all."

Know-it-alls don't pose an immediate threat to patients, but they can be troubling if they're in quality assurance (QA) or education. A misinformed know-it-all may teach improper practices, but it's hard to correct a superior. The dilemma gets even worse when the know-it-all's checking your work. "If someone's going to correct something I have down right and make it wrong, then I don't want my initials at the bottom of the report," Jensen said.

QA issues will become even more prevalent as patients get more involved in care. Errors made by a know-it-all who was oh so sure of the correct way to document may put them in hot water with patients and physicians. Medical records are much more accessible than they used to be, Jensen said, so employees will need real knowledge, not just feigned confidence.

Pursue or Retreat?

"It's one of the toughest things about work, the fact that other people work with us and we have to maintain some level of friendliness, professionalism and also do our jobs at the same time," said April Callis, an organizational development consultant and principal of Springboard Consulting, East Lansing, MI.

Her advice for dealing with know-it-alls? Proceed with caution. Whether know-it-alls flaunt their knowledge to get attention or mask insecurity, they don't like being corrected. "If you go head-to-head, you'll always lose," Callis said.

Instead of arguing, listen to the know-it-all's side--and then agree. Ask for more detail: How would they go about executing their plan? What's one specific solution? The know-it-all will eventually falter and look for help, Callis said. That's when you can contribute your ideas.

If the know-it-all is your superior or instructor, be smart in your approach. Calling out a know-it-all in public could trigger a fight and jeopardize your employment or academic standing. Wait for an opportunity to talk one-on-one with the individual, Callis advised. "If you're alone asking these questions, not in a confrontational way, but in an inquisitive way, it can really work wonders," she explained.

Know-it-alls who make up things just to have something to contribute will typically back-pedal once they're caught and admit they're "no expert." Sticklers who are convinced they're correct may be harder to crack. At that point, Callis said, it may just be easier to smile, nod and move along. The brush-off won't win favor with your co-worker, but it'll get the point across.

And if the know-it-all is a friend? It's tough to leave them high-and-dry after they've volunteered helpful (at least in their opinion) input, but listening to them yammer on isn't healthy for your friendship, either. Your best bet is to politely raise attention to their know-it-all ways. If they're constantly telling you what to do, thank them for the help, but reassure them that you're confident in your performance, Callis advised. If the unsolicited advice continues, ask why they feel a need to tell you what to do. They'll likely try to search for a reason, and realize they don't have one.

Pst. How's your salary looking? Did you finally get that raise, or is your facility paying like it's 1999? Our National HIM Salary Survey is back to help gauge your weight on the payment scale.  

With the rough-and-tumble economy, we're curious to see how the HIM sector panned out. Did budget cuts lead to an overall slash in work hours? Have employers turned to alternative perks, like a paid birthday off or parking reimbursement, in lieu of a bonus? We know you're itching to find out, too. Well, ye who giveth shall receive. In other words, we need your input! Click here or visit www.advanceweb.com/him and click on "How Much Do You Make?" to complete our 2009 Salary Survey. It only takes a few minutes, and by clicking "Submit" you'll be entered for the chance to win a $100 Healthcare Shop gift card! (Have you seen the great stuff we have there?)

We'll publish key findings from our survey in the December 2009 issue of ADVANCE, and full results will be available online at www.advanceweb.com/him on Dec. 16. Make sure to check out all the data, and leave a comment to let us know how you compare.

In the meantime, you can review our 2008 results here. What changes do you expect to see in the 2009 results?