Question

You and your coworkers in healthcare documentation department are called to a staff meeting by your supervisor, the director of health information management, who wants to formalize HDSs' roles as risk managers. Some traditional risk management functions of the HDS include which of these?

a) Managing medical equipment.
b) Analyzing patient satisfaction.
c) Monitoring infection control.
d) Conducting financial audits.

Answer 1

Healthcare Documentation Specialists in risk management focus on quality patient care, compliance with laws, and record integrity—not financial audits. They examine documentation practices, analyze for safety and errors, and ensure adherence to regulations.

Step-by-step explanation:

Some traditional risk management functions of the Healthcare Documentation Specialist (HDS) in the Health Information Management department may include monitoring the quality of patient care, ensuring compliance with healthcare laws and regulations, and maintaining the integrity of health records. While conducting financial audits might be relevant, it is not generally considered a core function of an HDS in the context of risk management. Instead, they would focus on the following aspects:

• Assessment of record-keeping practices to ensure they minimize legal risks and protect patient privacy.
• Analysis of documentation for potential safety concerns or errors that could compromise patient care.
• Ensuring that documentation practices adhere to regulatory requirements and standards.

Addressing these elements helps balance treatment costs, patient quality of life, and privacy risks. An HDS would pose questions such as:

1. How can policies optimize the costs of treatments and diagnoses without compromising patient outcomes?
2. What measures can ensure patient quality of life is not diminished due to cost-saving practices?
3. How can the department protect risks to individual privacy while still enabling effective healthcare data usage?