Chart Correction Specialist I

As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Partners HealthCare supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.

We're focused on a people-first culture for our system's patients and our professional family. That's why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees' personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development-and we recognize success at every step.

Our employees use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.

General Summary:

Accurate management of patient clinical data integrity in the Mass General Brigham Electronic Health Record (EHR) is foundational to the care of all of the patients within the Mass General Brigham (MGB) network. The MGB patient database contains over 8 million patient records and serves as the foundation of care, patient communication and clinical coordination within the Partners network and beyond.

Under general supervision, this position is responsible for maintaining the integrity of the content of the MGB eCare/Epic electronic health record by performing in-depth investigations of questionable data entry and correcting as appropriate. The Chart Correction Specialist provides issue identification, assessment, resolution, and technical support in order to achieve desired outcomes and compliance with MGB policies/procedures and standards.

This role analyzes chart correction scenarios and performs subsequent hands-on technical chart corrections as part of daily work responsibilities. This position serves as an organizational resource for issues involving chart correction, identity, and eCare instructional support.

The Chart Correction Specialist works at the center of the chart correction process, facilitating correction of clinical information throughout all inpatient and outpatient information systems. The individual coordinates the parties and interdisciplinary teams involved in each case (i.e., finance, clinical departments, and Pharmacy) and is responsible for ensuring all necessary corrections are made in a timely manner, and each case is validated prior to closure to ensure that documentation is complete and accurate to support patient safety and continuity of care.

Principal Duties and Responsibilities:

* Corrects and resolves incorrect documentation issues within MGB entity and enterprise clinical systems such as fraudulent chart use, multiple patients' information in one health record, and one patient with two or more records/encounters in order to maintain a complete and correct legal health record for each patient. * Makes independent decisions on how best to address critical registration and documentation errors impacting patient safety and direct clinicians, ancillary & clinical departments on the necessary actions that must be taken to mitigate. * Facilitates emergent wrong registrations through the eCare Contact Move process on inpatients and emergency department patients, interfacing with and directing multiple stakeholders as to the appropriate actions to take to quickly resolve data quality issues as a result of wrong patients being registered in a manner and timeframe to minimize the impact to patient safety. * Ensures accurate correction of clinical information between patients and systems, confirming corrections with the senior members of the team. Precision and accuracy are mandatory due to high risk to patient safety. * Maintains In depth understanding of data flow between the EHR, various repositories and ancillary systems. Attain a general understanding of site level information systems both active and historical (legacy). * Develops and maintains good communication with a wide variety of internal and external professional relationships to accomplish departmental and hospital objectives. Communicate with customers throughout the chart correction process, utilizing e-mail, phone calls, in-basket messaging and Service Now updates. * Participate in analysis and correction of large scale system errors as a result of conversion, build issues and clinical system bugs. * Works with MGB/IS/eCare and MGB Site staff ensure smooth and coordinated correction to patient clinical data to ensure accuracy and prevent disruption to patient care and minimize the impact to patient safety. * Acts as a liaison between patients, clinicians, and practice/clinical staff ensure that incorrect data is identified, charting errors are communicated to the parties identified in the chart correction policy, erroneous data is corrected, and is verified that the clinical information was updated completely and correctly. Conduct patient interviews to verify clinical and demographic information to assist in record integrity corrections. * Communicates with clinicians, health care providers, and MGB IS Teams to provide critical and complex information on how to report and correct health record documentation, often in an urgent timeframe. * Processes patient requests for amendments to the clinical information in a patient's medical record, in accordance with federal (HIPAA) guidelines. Coordinates with MGB entities on multi-site corrections to facilitate a seamless (one patient, one record) patient experience. Makes addendum in the electronic record by following proper procedures and notifying all departments affected. * Documents outcomes of the chart correction process according to organizational policies. Advise clinicians, HIM staff, and other customers on HIM procedures and assist in resolution of incorrect documents and documentation related issues. * Provides feedback to PeC HIM team for changes and enhancements related to eCare HIM/Identity functionality. Assists the Pec Identity team members in preparing detailed specifications and proposals for modifying the existing system when the solutions follow clear precedence. Works with the EMPI and PeC HIM teams to review, test and implement new functionality for the EHR. * Assists in the development and implementation of policies and procedures to streamline the workflow of Chart Correction, increase productivity and maintain consistency with current practice. * Assists in training new Chart Correction employees and team members regarding Hospital and Departmental policies and procedures. * Coordinates with EMPI Operations Team or Site Data Integrity specialists when a duplicate or deactivate is identified or created during a chart correction. * Monitors and replies to all communication sent to Chart Correction team within the email box, in-basket and Service Now queue. * Performs other duties as needed. * Uses the MGB values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration * Associate degree in health information technology, computer science or business required. Bachelor's degree preferred. Bi-lingual a plus. * Two years experience in a Health Information Management department or in the administrative/business/clinical area of healthcare. Acute care hospital experience preferred. * Successful completion of basic Medical terminology course required. Basic anatomy and physiology preferred. * Knowledge of medical treatment methods, pharmacology, patient care assessment, medical documentation requirements, data collection techniques is preferred * Demonstrated knowledge of Microsoft Office suite of applications, including MS Access. Knowledge of other healthcare related computer systems including Epic a plus.

Skills/Abilities/Competencies Required:

* Strong interpersonal and customer service skills. Proven conflict resolutions skills. * Strong verbal and written communication skills * Organized, detail oriented, and work well in time sensitive situations. * Strong critical thinking, problem solving, and prioritizing skills. * Exercises independent judgment with minimal guidance and supervision to make decisions in the absence of leadership.

Working Conditions:Standard Office Environment

Participate in off-hour on-call (pager) coverage schedule is required.

Periodic travel to MGB sites as needed.

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