Shepheard Health Management Consultants, Australia.
Health Inf Manag. 2019 Jan;48(1):52-55. doi: 10.1177/1833358318802955. Epub 2018 Oct 7.
Philip Hoyle presents a compelling argument for the significant and highly valued role that the management of health information plays in the Australian healthcare system and the delivery of health services in this country. However, he also brings to our attention the ill-defined nature of the ethical oversight of this very information. Hoyle uses words such as "honesty," "commitment to beneficence," "commitment to equity" and "respect for variation" when describing the characteristics of ethical leadership. He singles out health information management professionals - Health Information Managers (HIMs) and Clinical Coders (CCs) - as the key professional group who need to step up and seize the initiative, get conversations going, form partnerships, do research and publish findings, so the knowledge and insights that the health information management profession has the potential to offer are not only more widely known and understood but also more useful to others working in the healthcare arena. Hoyle calls on health information management professionals to step out from behind the scenes and take responsibility for the ethical use of the information they help produce. Hoyle's words resonated powerfully with me, particularly with respect to the clinical coding workforce in Australia, which is made up of trained CCs and qualified HIMs. In a truly ethical environment, HIMs and CCs would not be asked to meet performance indicators for increased funding metrics or to change codes to avoid triggering certain indicators; they would simply be asked to ensure complete, accurate coding for every episode of care. This is what ethical leadership would look like. I am concerned about our clinical coding workforce. I am now asking, are our CCs and HIMs up to the task of taking back absolute and unchallenged ownership of their particular skill set, which makes them the keepers of the clinical coding standards and the experts in accurate and complete code assignment?
菲利普·豪尔（Philip Hoyle）提出了一个令人信服的观点，即健康信息管理在澳大利亚医疗保健系统和医疗服务提供中发挥着重要且极具价值的作用。然而，他也让我们注意到对这种信息的伦理监督的定义不明确。豪尔在描述伦理领导力的特征时使用了“诚实”、“对慈善的承诺”、“对公平的承诺”和“尊重多样性”等词语。他特别指出，健康信息管理专业人员——健康信息经理（HIM）和临床编码员（CC）——是需要挺身而出、主动出击、开展对话、建立伙伴关系、进行研究和发表发现的关键专业群体，以便健康信息管理专业能够提供的知识和见解不仅得到更广泛的了解和理解，而且对医疗保健领域的其他工作者也更有用。豪尔呼吁健康信息管理专业人员走出幕后，对他们所帮助生成的信息的道德使用承担责任。豪尔的话深深地打动了我，尤其是对于澳大利亚的临床编码人员，他们由经过培训的 CC 和合格的 HIM 组成。在一个真正的伦理环境中，不会要求 HIM 和 CC 为了增加资金指标而满足绩效指标，或者为了避免触发某些指标而改变代码；他们只需要确保为每个护理案例进行完整、准确的编码。这就是伦理领导力的样子。我对我们的临床编码人员感到担忧。我现在想问，我们的 CC 和 HIM 是否有能力收回对其特定技能的绝对和不容置疑的所有权，使他们成为临床编码标准的守护者和准确、完整代码分配的专家？
