Course Number and Title: HIM 225 Technical Practicum
In this course, students apply concepts in a healthcare facility or in the health information management lab. Emphasis is placed on data collection, data verification, filing, abstraction, professionalism, legal issues, Health Information Portability and Accountability Act (HIPAA), release of information, documentation guidelines, electronic health records (EHR), record storage and imaging, the master patient index (MPI), and database usage.
Allied Health/Science Department Program Student Policy Manual Instructor handouts
- Use a healthcare facility’s organizational chart to classify the ownership, level of care, and role of the facility in the healthcare delivery system. (CCC 2, 4; PGC 5)
- Demonstrate skill in accurate collection, storage processing, and retrieval of health record information. (CCC 2, 4, 6; PGC 2, 3, 4)
- Perform quantitative and qualitative analysis of the health record content. (CCC 1, 2, 6; PGC 2, 4)
- Abstract information from the health record into a registry. (CCC 2, 6; PGC 2)
- Apply privacy strategies to health information (CCC 1, 2, 4; PGC 3, 4, 5, 6).
- Apply security strategies to health information. (CCC 1, 2, 4; PGC 3, 4, 5, 6).
- Identify compliance requirements throughout the health information life cycle. (CCC 2, 3, 4; PGC 2, 3, 4, 5, 6).
- Apply legal processes impacting health information. (CCC 2, 4; PGC 3, 5)
- Demonstrate compliance with external forces. (CCC 2, 4; PGC 5)
- Identify the components of risk management related to health information management. (CCC 2, 4; PGC 3, 5, 6)
- Identify the impact of policy on health care. (CCC 2, 4; PGC 2, 3, 5, 6)
See Core Curriculum Competencies and Program Graduate Competencies at the end of the syllabus. CCPOs are linked to every competency they develop.
Upon completion of this course, the student will:
- Use a healthcare facility’s organizational chart to classify the ownership, level of care, and role of the facility in the healthcare delivery system.
- Locate the facility and departmental organizational charts.
- Compare and contrast the various roles of healthcare professionals throughout the continuum of healthcare services.
- Compare and contrast the American Health Information Management Association (AHIMA) Code of Ethics with the code of ethics of another healthcare profession.
- Demonstrate skill in accurate collection, storage processing, and retrieval of health record information.
- Use a health information database to retrieve records or generate a report for a specified purpose.
- Generate and interpret a report detailing a patient’s recent discharge.
- Describe how the patient record and other patient data not yet part of the record arrives in the health information management (HIM) department and in the patient’s chart.
- Determine how data entered electronically in one part of an organization becomes a part of the official/legal and interoperable health record.
- Use a database tool and data elements for a specified time period and population to create a working index.
- Identify examples of external databases that support specific clinical or administrative work in a given setting.
- Perform quantitative and qualitative analysis of the health record content.
- Apply accreditation or licensing standards to determine the organization’s compliance with documentation standards.
- Identify the professional credentials of each contributor/provider.
- Conduct record analysis to ensure that documentation supports the diagnosis and reflects the progress, clinical findings, and discharge status.
- Inspect the accreditation certificates and licenses for a given facility.
- Review the process for developing facility-specific documentation guidelines.
- Identify procedures for reporting, tracking, and completing documentation deficiencies.
- Abstract information from the health record into a registry.
- Identify the types of registries used in a given setting.
- Determine the current case definition for a particular type of registry (i.e., a tumor or diabetes).
- Identify the hardware and software used to support a given registry.
- Identify the data elements applicable to a particular registry.
- Abstract data from cases, and correctly enter these data into a registry.
- Apply privacy strategies to health information.
- Review various authorizations (i.e., court orders, subpoenas, insurance, and legal) for release of information.
- Apply and follow existing organization policies for the control, use, and release of medical information.
- Identify the key federal laws that apply to healthcare.
- Explain the difference between tort law and criminal law.
- Describe the role of advanced directives in treatment and end-of-life healthcare decisions.
- Identify the components of a valid subpoena.
- Discuss the various types of requests for access, use, and/or disclosure of patient information and steps for handling the requests.
- Request for restriction.
- Request for amendment.
- Request for accounting of disclosure.
- Requests for confidential communication.
- Business associate agreement.
- Disclosures for law enforcement.
- Subpoenas, court orders, and search warrants.
- Patient request for release of information.
- Release with and without patient consent.
- Describe the process for disclosing health information for federal and state disability determination.
- Explain the various types of consent forms.
- Explain patient verification procedures.
- Describe the Notice of Privacy Practices.
- Explain patient rights and responsibilities.
- Describe retention and destruction policies for health information.
- Apply confidentiality, data privacy and security measures, and policies and procedures to protect the internal and external use and exchange of electronic health information.
- Apply policies and procedures surrounding issues of access and disclosure of protected health information.
- Discuss the issues surrounding ownership of health information.
- Distinguish express and implied consent.
- Explain the various privacy issues related to minors when parent/legal guardian authorization is required.
- Discuss the obligations of the healthcare workforce regarding access to and disclosure of health information.
- Explain the issues surrounding the access, use, and disclosure of genetic information.
- Explain access and disclosure rights regarding adoption information and adopted individuals.
- Explain access and disclosure rights of competent and incompetent adult patients.
- Discuss the reimbursement and fee structure for copying health information.
- Summarize the issues related to managing the release of information in terms of verification of requester, determining if the request is legitimate, accounting for disclosures, and refusing to disclose information.
- Discuss the statutory requirements that provide employees’ rights to their safety and health records.
- Use software in the completion of HIM processes.
- Describe the requirements for maintaining user access logs for electronic versus paper-based systems.
- Describe the methods for maintaining user access logs and disclosure of identifiable patient data.
- Demonstrate how to maintain user access logs/systems to track access to and disclosure of identifiable patient data.
- Apply security strategies to health information.
- Discuss computer security terminology.
- Identify security threats, vulnerabilities, and countermeasures.
- Explain the role of government in information security and information secrecy.
- Identify compliance requirements throughout the health information life cycle.
- Produce a series of documents to address HIM processing / workflow issues presented.
- Relate policies and procedures for the use of data required in healthcare reimbursement.
- Appraise the revenue cycle management processes.
- Review policies and procedures to ensure organizational compliance with regulations and standards.
- Demonstrate collaboration with staff in preparing the organization for accreditation, licensure, and/or certification.
- Demonstrate adherence to the legal and regulatory requirements related to health information management.
- Review current regulations and established guidelines in clinical classification systems.
- Apply legal processes impacting health information.
- Interpret compliance with local, state, and federal labor regulations.
- Demonstrate adherence to work plans, policies, procedures and resource requisitions in relation to job functions.
- Distinguish cultural competence, including assumptions, biases and stereotypes.
- Identify behaviors that support a culture of diversity.
- Demonstrate compliance with external forces.
- Describe the purpose and goals of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules.
- Explain the impact of the Health Information Technology for Economic and Clinical Health (HITECH) Act on HIPAA Privacy and Security Rules.
- Discuss state and federal laws designed to protect sensitive health information related to behavioral healthcare, substance abuse, and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS).
- Relate with staff in preparing the organization for accreditation, licensure, and/or certification.
- Demonstrate adherence to the legal and regulatory requirements related to the health information management.
- Identify potential abuse or fraudulent trends through data analysis.
- Appraise a breach of protected health information as it applies to access and disclosure of health information.
- Identify the components of risk management related to health information management.
- Describe the purpose of ‘legal hold’.
- Illustrate the relationship of risk management to the HIPAA Privacy and Security Rules.
- Given a scenario, describe the administrative, physical and technical safeguards required to ensure the confidentiality, security, integrity and availability of protected health information.
- Identify the impact of policy on health care.
- Given specific scenarios, relate how healthcare policy impacts the delivery of healthcare and health information.
- Prepare a training document for a new HIM employee that encompasses the key healthcare policies impacting the practice of health information management.
The grade will be determined using the Delaware Tech grading system:
Students should refer to the Student Handbook for information on the Academic Standing Policy, the Academic Integrity Policy, Student Rights and Responsibilities, and other policies relevant to their academic progress.
Calculated using the following weighted average
Percentage of final grade
Professional/clinical site/meeting written assignments (3) (summative)
Presentation (1); Written Assignment (1) (summative)
Professional Behavior Assessments/Written Assignments (summative)
- Apply clear and effective communication skills.
- Use critical thinking to solve problems.
- Collaborate to achieve a common goal.
- Demonstrate professional and ethical conduct.
- Use information literacy for effective vocational and/or academic research.
- Apply quantitative reasoning and/or scientific inquiry to solve practical problems.
- Synthesize knowledge of medical sciences, clinical classification systems, vocabularies, and terminologies to effectively use, apply, and interpret health data.
- Consistently demonstrate leadership through the appropriate interpretation and evaluation of professional behaviors and ethical standards.
- Interpret regulatory, coding, legal, and clinical documentation standards to develop, implement, and evaluate compliance.
- Synthesize knowledge of health data and payment methodologies to evaluate the efficiency and effectiveness of revenue cycle processes.
- Apply legal, regulatory, privacy, and security standards to employ policies and procedures for health information collection, access, and disclosure.
- Analyze data to identify trends through the use of health information technologies.
The College is committed to providing reasonable accommodations for students with disabilities. Students are encouraged to schedule an appointment with the campus Disabilities Support Counselor to request an accommodation needed due to a disability. A listing of campus Disabilities Support Counselors and contact information can be found at the disabilities services web page or visit the campus Advising Center.