< + > Improving Operational Efficiency with Back Office Health IT Systems

As we try to combat healthcare burnout, improving operational efficiency is a big part of that. Like everything in healthcare, there are plenty of ways to approach an issue, so today we are going to narrow that down to back office health IT systems. We reached out to our incredible Healthcare IT Today Community to ask — how are back office health IT systems improving operational efficiency in areas such as finance, human resources, and supply chain management? The following are their answers.

Chris Luoma, Chief Strategy Officer at GHX
In the healthcare supply chain, we are seeing systems move beyond static reporting toward dynamic, decision-oriented models. This shift is helping to break down what I refer to as workflow debt: the fragmentation across systems, processes and trading partners that has long held healthcare operations back. By embedding intelligence directly into operational workflows, these platforms surface relevant signals and suggest next steps within the context of everyday decisions, turning disconnected data into coordinated action. The result is a more connected operational environment where supply chain functions are no longer reacting to yesterday’s problems, and instead they’re anticipating tomorrow’s.

Lou Fierens, Former Executive Vice President of Administrative Services at Trinity Health, and Advisor at AssistIQ
Some of the biggest supply chain efficiency gains in health systems are hiding in plain sight, but the industry is still focused on the wrong part of the problem. Procurement and inventory management tend to get most of the attention. But the harder, more foundational issue is data accuracy at the point of use, and the highest-cost items (implants, tissue, high-value disposables) are the hardest to keep accurate in the item master.

In the OR and procedural areas, documentation of what was actually consumed still relies heavily on manual capture. Intraoperative documentation error rates can be as high as 17%, rising to 38.4% when recording is delayed. And once that gap exists, every downstream system inherits it.

The lack of real-time recognition creates double and triple work across Clinical, Revenue Cycle, Accounts Payable, and Supply Chain. Each team ends up reconciling the same missing or inaccurate data from a different angle. The health systems making meaningful progress are the ones applying computer vision and AI to close the distance between what happens in the room and what the back office knows.

Denis Whelan, CEO at Documo
The real operational drag happens in what I call the “murky middle” of the back office. Nearly 70% of healthcare communications still rely on unstructured data—think paper, PDFs, and fax chaos. When your staff is bogged down by manual data entry and fragmented workflows, it creates tough bottlenecks. However, today we are seeing a massive shift.

Back-office Health IT is evolving from simple static repositories into AI-driven, automated workflow engines that drastically improve operational efficiency. For example, instead of a staff member spending 10-15 minutes per fax retyping information, AI extracts key data like patient name, date of birth, medical record number (MRN), and ZIP code and routes it directly to the correct workflow. Across hundreds of daily documents, this can save hundreds of staff hours each month, freeing teams to focus on higher-value tasks that directly impact both organizational health and patient care.

Kevin Erdal, President, Advisory Services at Nordic
Health IT behind the scenes is becoming a critical operational engine for healthcare organizations as they navigate workforce shortages, margin pressure, and rising patient expectations. Modern ERP, HR, and supply chain platforms are helping organizations standardize workflows, reduce manual processes, and improve visibility.

In finance, healthcare organizations are leveraging modern cloud-based ERP systems to automate core functions like accounts payable, procurement, budgeting, and financial reporting. This reduces administrative overhead while giving leaders more timely access to operational and financial insights that support faster decision-making.

In human resources, organizations are increasingly using integrated workforce management tools to streamline recruiting, onboarding, scheduling, payroll, and employee engagement. With ongoing staffing challenges, health systems are prioritizing technologies that help optimize labor resources, improve retention, and reduce the administrative burden of tasks like scheduling, training, or credentialing on managers and HR teams.

Ultimately, the biggest shift is that back-office systems are no longer viewed as isolated administrative tools. They are increasingly connected to broader transformation strategies focused on operational resilience, financial sustainability, and improved patient and workforce experiences.

Sarah O’Meara, Head of Product at LumApps
Patients take notice when the people helping them can’t give a straight answer about coverage, care plans, or what comes next. Our research found that when service interactions are unclear, only 16% of patients blame individual employees, while 44% blame the internal systems and tools behind them.

People want to trust that healthcare providers and staff have the tools they need to guide patients through questions that are often time-sensitive and stressful.

A connected AI employee hub gives staff one place to find accurate answers and approved resources. By digitizing processes and guidance across every team and shift, information remains consistent, and employees can find what they need fast when patients need it most.

Ajoy Ranga, Chief Digital Officer – Health Care at UST
The honest truth is that the healthcare back-office has trailed every other industry for decades, and the necessary catch-up is currently underway. On the finance side, hospitals and health plans are finally retiring on-premise general ledgers and moving to cloud ERPs such as Oracle Fusion and Workday Financials, which is letting close cycles drop from weeks to days and giving leaders the same near real-time visibility that retail and banking have had for years.

On the HR side, the wins are showing up in workforce scheduling, where the financial investment has been most significant. Mercy, the St. Louis-based health system, reported about 30 million dollars in savings in 2023 after deploying an AI-driven shift marketplace that moved its labor mix to roughly 69 percent core staff, 23 percent flexible and gig, and only 8 percent agency.

For supply chains, the work is invoice automation and contract intelligence layered on top of GPO purchasing. For example, Premier rolled its Remitra invoicing and payables platform into its Supply Chain Services segment in fiscal year 2025, which is one signal of where the industry is heading.

The pattern across all three sectors is thus a consistent push to replace human keystrokes on commodity transactions and reinvest those hours into work that actually requires judgment.

Ram Mohan Natarajan, Global Head of Business Transformation at Sagility
Healthcare organizations are increasingly moving beyond using technology simply to digitize administrative processes and are instead leveraging intelligent platforms to orchestrate work across functions. Modern back-office systems are creating greater visibility into financial performance, workforce utilization, procurement, and operational bottlenecks, enabling organizations to make faster and more informed decisions.

For example, AI-enabled finance platforms can identify payment variances, predict cash flow risks, and automate reconciliation activities. Any work done on the payment integrity space for payers in identifying overpayment will result in potential cash flows, and these need to be factored into the financial planning.

Similarly, human resources systems are helping organizations optimize workforce planning, improve recruitment efficiency, and better manage surges during enrollment season. Supply chain platforms are providing real-time inventory intelligence and predictive demand forecasting, helping reduce waste and improve resource allocation.

The greatest gains, however, come when these systems are connected to operational workflows rather than functioning as standalone applications. Healthcare organizations are increasingly focused on creating a unified operational view that allows leaders to move from reporting on performance to actively improving it.

Sharat Potharaju, Co-Founder and CEO at Uniqode
GS1 Digital Link-enabled QR codes are dramatically improving the efficiency of healthcare supply chain management. By encoding critical product identifiers, like GTINs, lot numbers, and expiration dates, into a single scannable code, these systems eliminate the fragmented data lookups that can slow down recall responses. When recalls are issued, dynamic QR codes can instantly redirect staff to updated safety information without reprinting packaging, reducing compliance risk and operational disruption across the entire supply chain.

Zack Tisch, Partner, Portfolio Services at Pivot Point Consulting
The biggest shift is that the ‘back office’ is no longer a reactive part of the business. Finance, HR, supply chain, and IT operations now directly affect access, staffing, margin, and ultimately patient care. Modern ERP, workforce, procurement, and analytics platforms are giving health systems a real-time operating picture instead of a month-end post-mortem. Healthcare cannot deliver 21st-century care on 1990s’ operational plumbing.

Greg Miller, Vice President, Marketing and Business Development at Carta Healthcare
Health systems have made real progress connecting back office, clinical, and patient-facing tools, and the next wave of integration work is opening up possibilities that weren’t realistic even a few years ago. Modern APIs and AI are doing more of the heavy lifting, and when you pair that technology with people who understand both the operational and clinical side, you get cleaner data, smoother handoffs, and reports leaders can actually trust. The organizations moving fastest are the ones that see integration as a chance to rethink how work gets done, not just a technical box to check.

Such great insights here! Huge thank you to everyone who took the time out of their day to submit a quote to us! And thank you to all of you for taking the time out of your day to read this article! We could not do this without all of your support.

How do you think back office health IT systems are improving efficiency in areas such as finance, human resources, and supply chain management? Let us know over on social media, we’d love to hear from all of you!

< + > If A Server Fails Today, How Long Until Your Patients Can Be Seen?

The following is a guest article by Michael Ohayon, GM Nexcess Managed Cloud at Nexcess

Go from “backups running” to a clinical recovery mandate

When a server fails at your practice, specialty clinic, or healthcare software company, the questions that follow are immediate and high-stakes. You need to know which systems are affected, where recoverable copies are stored, and most importantly when access will return. These questions require tested answers before the next hardware failure, cyberattack, or accidental deletion interrupts care.

In healthcare, a server outage transcends the IT department. Your front desk may lose appointment schedules, while clinicians find themselves unable to open patient records or review critical medication histories. Staff may be forced to fall back to paper workflows designed for short interruptions, not the uncertain windows associated with modern technical recovery. This is why the most vital question is,  “How long will it take to get the right systems back?”

A successful backup is not a successful recovery

Backups are often treated as evidence of preparedness. A dashboard indicates a job completed, and the organization moves on. However, a successful backup job doesn’t tell you how long a restore takes, nor does it confirm that the copy is usable for clinical applications.

This distinction matters because downtime spreads fast. A scheduling system or patient portal may not be the EHR, but its failure can still paralyze patient-facing work. A practical managed backup and storage strategy starts with recovery requirements, not storage capacity, which means defining two metrics up front:

• Recovery Time Objective (RTO): The target duration for getting a system operational again.
• Recovery Point Objective (RPO): The maximum amount of recent data the organization can afford to lose (e.g., losing four hours of clinical documentation vs. 24 hours).

Recovery priorities should follow the patient workflow

Not every system needs to return simultaneously. During an incident, the priority should be the apps that allow staff to identify patients, understand their clinical needs, and document treatment. Administrative reporting or development environments can wait.

That sequence has to be decided before a crisis, not negotiated in the middle of one. For example, you may decide that identity management and clinical access return first, with the patient portal following. Deciding in advance also exposes the dependencies that break recovery plans in practice: restoring an application server accomplishes nothing if the underlying database is still down.

Protection beyond the primary server

A backup stored only on the affected server is vulnerable to the same event that took the server down. Hardware failures, facility-level incidents, or ransomware can  compromise the original data and the local copy together. This reality was highlighted during the global cPanel security incident in April, forcing emergency patching and temporary service shutdowns across hosting environments to head off unauthorized root access.

Off-server and offsite protection should be the baseline, and the “3-2-1” principle remains the best guide: three copies of your data, on two forms of storage, with one copy offsite. For healthcare, that offsite copy also has to meet security and compliance obligations for encryption and access controls, not only exist. Small restores shouldn’t require big escalations

Not every recovery is a catastrophe. Often, the issue is a deleted document or an overwritten configuration file. If every minor restore requires a high-level support escalation, a small error turns into a four-hour interruption. Self-service recovery options for authorized IT staff lets routine restores  begin immediately and keeps specialized support free for genuine system-wide failures.

Nobody wants backups; what people want is the ability to restore. Getting there requires understanding the difference between standard backups and disaster recovery, which covers how infrastructure returns after a large-scale disruption.

Test the theoretical

Healthcare data grows relentlessly, and a backup strategy has to keep pace without collapsing under its own weight. Review storage against usage and retention requirements to avoid overprovisioning or hitting silent quotas that halt protection.

A recovery plan is theoretical until it is tested. Testing doesn’t require taking production systems offline; restoring selected files or validating a database copy in an isolated environment will answer the questions a dashboard can’t:

1. Can we access the backup?
2. Is the data complete and usable?
3. How long does the process take?
4. Who makes the call to fail over?

Ask the question in minutes, not hours

“Backups are running” is not an answer you can use. A resilient organization answers  in specifics: the scheduling system has a one-hour recovery target, the most recent copy is 30 minutes old, and the hosting team is executing a documented recovery runbook right now.

Server failures are inevitable, but extended uncertainty about patient care isn’t. Move from a backup mindset to a recovery mandate, and when the next outage begins, the path back to normal care is already mapped.

Michael Ohayon is with Nexcess, a managed hosting platform that provides HIPAA-aligned infrastructure and migration support for specialty practices, regional health centers, and healthcare SaaS platforms.

< + > Flourish Health Raises $46M | Procode Raises $10M

Check out today’s featured companies who have recently raised a round of funding, and be sure to check out the full list of past healthcare IT fundings.

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Flourish Health Raises $46M to Scale Intensive Mental Health Care for Youth in Crisis

Funding Fuels National Expansion of Model that Delivers Proven Outcomes for High-Acuity Kids through Psychiatrist-Led Care Pods and an AI-Enabled Care Delivery Platform

Flourish Health, the mental health provider for young people with serious, complex needs that traditional care models cannot effectively support, announced $26 million in Series A funding led by B Capital, F-Prime, and Cherryrock Capital. Combined with $20 million in previously undisclosed funding, the investment brings Flourish Health’s total raised since inception to $46 million. The new capital will support the company’s national expansion, in partnership with the largest health plans in the country.

Flourish Health helps children and young adults overcome serious mental health challenges through a unique, in-home care model that’s delivered by psychiatrist-led teams. Studies with multiple major health plans have shown that Flourish Health delivers a 70-96% decrease in hospitalizations, a 69-90% decrease in residential treatment, and a sustained 80-95% decrease in higher levels of care post-discharge. These outcomes have led to expansions with nearly every major health plan in the country, including most major Medicaid plans, specialty foster care plans, and commercial insurers.

Flourish Health patients are supported by a dedicated Care Pod of four coordinated professionals: a child and adolescent psychiatrist, licensed therapist, patient guide, and family guide. The company’s AI workflow platform enables these teams and the company to scale effectively by resolving most of the administrative burden so human clinicians can focus on human patients. This model allows Flourish Health to serve families that the current system has been unable to effectively support. It is proven to deliver gold-standard outcomes for the three clinical cases where it specializes. This includes kids with externalizing behaviors (including ODD, IED, DMDD, and conduct disorder); multiple suicide attempts or suicide-related hospitalizations; and complex needs and family situations that force other clinics to turn them away.

“I lost a young patient to suicide working in the pediatric ER. He was getting bullied at school and his mom felt lost trying to advocate for him. The next day, I cared for another teenager in crisis who was in foster care and extremely distressed about having to change homes again. I knew she needed more than another waitlist or referral, and there had to be a better way to help these kids and their families,” said Natalia Birgisson, MD, Co-Founder and CEO at Flourish Health…

Full release here, originally announced July 27th, 2026.

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Procode Raises $10M to Bring Its AI-powered Medical Billing Services to Every Surgical Specialty

Led by Health Velocity Capital, the Round Funds Additional Medical Billing Acquisitions and Follows Procode’s First Peer-Reviewed Study Showing its AI Outperforms Human Coders and General-Purpose LLMs in Complex Surgical Coding

Procode Inc., an AI-powered medical billing, or revenue cycle management (RCM) company, serving private practice surgeons, today announced a $10 million Series A led by Health Velocity Capital. The funding follows Procode’s acquisition of The Auctus Group — the leading RCM company for plastic surgeons and dermatologists — and the publication of its first peer-reviewed research in Plastic & Reconstructive Surgery (PRS) Global Open, the official open-access journal of the American Society of Plastic Surgeons. Procode will use this new capital to expand its AI-powered RCM platform through additional acquisitions and accelerate growth into all surgical specialties and ambulatory surgical center (ASC) billing.

Three Companies, One Platform

The $10 million will fund two additional acquisitions, to be announced in the coming months. Procode intends to follow the same playbook it used with The Auctus Group: acquire the best surgical billing companies and layer in Procode’s AI to drive better outcomes for surgeons:

• Procode: AI coding for surgery that automates the coding workflow from charge capture to submission, reduces coding-related denials, and fully captures reimbursements
• Procollect: An operating system for billing teams with native reporting, AI support, and automation that reduces days in AR and accelerates reimbursements
• Auctus Provider App: An app that puts real-time financial data at Procode’s clients’ fingertips

“We’re on track to double The Auctus Group’s revenue and quintuple its EBITDA margin,” said Jeff Cripe, CEO at Procode…

Full release here, originally announced July 28th, 2026.

< + > Human in the Loop Does Not Mean Safe: The Hidden Risks of Agentic AI in Healthcare

The healthcare industry treats artificial intelligence like just another software rollout. We write policies, form committees, and assume standard guardrails will keep operations safe. But agentic AI behaves entirely differently than previous digital health tools.

At the recent eHealth26 conference in Halifax, Nova Scotia, I sat down with Julia Zarb. She is the force behind Blue x Blue, a company building AI infrastructure with governance incorporated. She warned that applying the old IT playbook to this new medium creates massive unseen risks.

Core Insight: Human Oversight is a Liability Trap Slapping a “human-in-the-loop” label onto an AI tool does not guarantee patient safety, it simply shifts the legal and operational liability onto overwhelmed clinicians.

The Human-in-the-Loop Fallacy

Executives love hearing that a human will review AI outputs before finalizing a clinical decision. In reality, these reviewers lack the time and system explainability to catch microscopic errors under high stress.

“What we’re doing is transferring the liability that comes with that review,” Zarb noted. “We don’t have what’s called explainability to go back in and see how that got to it, who knew what, when, and where, and why?”

The Threat of Invisible Errors

AI models fail in tiny, logical steps that easily bypass human reviewers.

“What makes agentic AI good is also its internal flaw,” Zarb explained. “The way that it processes, it carries forward little micro fissures and flaws.”

Standard IT guardrails fail because AI naturally jumps boundaries. When multiple AI agents interact, a single logical error propagates until it results in a much larger failure.

“If 100 agents speak to 100 other agents and those mistakes are brought forward, these aren’t mistakes that are just errors, these are mistakes that make sense [to Ai at the time] because of the way the AI is built.”

Questions Healthcare IT Leaders are Asking

Why is the “human-in-the-loop” approach risky for healthcare AI? Relying solely on human oversight transfers immense liability to clinical staff. Fast-paced environments and high stress prevent humans from properly auditing AI outputs. Furthermore, clinicians lack the technical explainability tools required to understand exactly how the AI arrived at its conclusions.

How do AI errors differ from standard digital health software bugs? Traditional software bugs are often clear and trackable. AI generates “micro fissures” or small gap-fillers that look perfectly logical to the system. These tiny errors bypass standard guardrails and multiply rapidly when different AI agents share data across an organization.

Learn more about Blue x Blue at https://www.bluexblue.com/

Listen and subscribe to the Healthcare IT Today Interviews Podcast to hear all the latest insights from experts in healthcare IT.

And for an exclusive look at our top stories, subscribe to our newsletter and YouTube.

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< + > Applying AI to Healthcare Integration and Interoperability

One of the coolest AI tools I’ve seen recently was the healthcare integration agent, Rhapsody Axon.  It’s an AI integration agent embedded directly in the Rhapsody and Corepoint platforms, built to speed up the work integration teams do every day. It also lines up with my theme that AI is going to be able to be applied to almost every aspect of healthcare.  In fact, that’s what makes Axon so cool.  Rhapsody applied AI to a topic that they understand deeply, and they know is a challenge for the interoperability and integration experts out there.

Here’s what I keep coming back to: as more AI agents show up across healthcare, they’ll all eventually need to move data across systems. Axon is an early example of an agent that doesn’t just answer questions about integration, it can actually help build the connections (not just wait for a human to do it).

This is why I was really excited to check out their webinar called “What’s Next in AI for Healthcare Interoperability? See Rhapsody Axon in Action.”  Click the link to watch the full webinar or check out the highlights below that we shared on social media during the event.

What do you think about applying AI to healthcare integration and interoperability?  What other novel approaches to AI in healthcare have you seen?  Let us know on social media.

How does Rhapsody Axon reduce the grind of integration work?

I’ve heard this from a number of integration experts in the past.  Many of them spend more time looking at the documentation than they do actually coding.  Not to mention time spent troubleshooting an integration that has broken because some interface has changed.  The time spent on these actions are real and required.  Axon’s AI helps remove some of this friction.

Is Rhapsody Axon embedded or a standalone tool?

I think every CIO I talk to is afraid of AI sprawl.  In other words, they’re afraid of having hundreds of different AI applications that they have to support.  Thus, it’s a welcome sight that Axon is embedded in Corepoint and Rhapsody.

How does Axon understand your integration environment?

I’m also impressed that Axon not only understands the standards and integration documentation, but it also understands your Corepoint and Rhapsody set up.  This type of personalization to your environment is so powerful and helpful when building new integrations or troubleshooting existing ones.

How does Axon help onboard new integration staff?

Of course, I also love the idea of Axon quickly upskilling a new person at your organization rather than having the new person continually bothering your other integration staff.  A new employee can ask Axon all the questions they want without annoying them.

How does Rhapsody Axon handle data security and privacy?

These are the types of questions I see a lot of CIOs asking of their AI vendors when it comes to AI security and privacy.  I love that Rhapsody just shared these details up front.

I think we’re probably going to have this conversation about technology replacing humans forever.  Clearly humans have shown themselves to be pretty resilient.  It’s great to see Axon helping those humans be more efficient.  As I often say, AI is going to replace all those time consuming things that humans don’t want to do.  That seems to be what Axon is doing for integration experts.

Can Rhapsody Axon build integrations automatically?

I was a little surprised that searching through standards documentation wasn’t on the list of things that most integration experts spend time on.  Although, maybe that’s part of the two that they listed.

No doubt these two tasks are important and accelerated by AI.  As their customer said on the webinar, if you don’t like Axon after you see how it can automatically create the integration routes for you, then he doesn’t know what to tell you. These agents can consume interface specs and create integrations for review. I’d add that if you don’t see the value in agentically created integration routes, you’re probably not an integration engineer.

AI programming engines have become all the rage.  Programmers have really come around to using them.  The problem is they don’t work for this kind of custom coding that’s needed for healthcare integrations.  That really is what makes Axon unique, but still in line with what’s happening with coding in other languages.

I imagine that an integration engineer’s least favorite task is upgrading their integration from one HL7 standard to the new one, or migrating an old HL7v2 interface over to FHIR. That’s a bunch of work to essentially make sure it keeps doing the same thing.  That’s not fun work.  In other words, it’s perfect work for an AI agent.

How are teams using Axon to review integration documents?

This example from Jennifer of how they’re using Axon was really brilliant.  No one likes reviewing documents for a new integration.  Axon can do that quickly and highlight the areas that really matter so you can quickly have the right conversation with the vendors you’re looking to integrate with.  That’s powerful.

I’ve felt Jennifer’s pain a lot with the Healthcare IT Today website.  I know just enough to be dangerous and things that would be easy and quick for an expert take me far too long.  AI has really helped me solve these more technical issues quickly.  Sounds like she’s doing the same in her job with Axon.

Having Axon run reports for her is fascinating too.  I love the concept that she ran the reports manually for so long that she can really know if the AI is doing well or not.  The fact that she trusts the AI now is saying a lot.

Those are a few of the highlights from the webinar.  You can watch the full webinar including a demo of Axon or check out the Rhapsody Axon page to see it in action for yourself. What do you think of this use case for AI in healthcare?

< + > This Week’s Health IT Jobs – July 29, 2026

It can be very overwhelming scrolling through job board after job board in search of a position that fits your wants and needs. Let us take that stress away by finding a mix of great health IT jobs for you! We hope you enjoy this look at some of the health IT jobs we saw healthcare organizations trying to fill this week.

Here’s a quick look at some of the health IT jobs we found:

• Business Development Representative – The Garage
• Senior Data & AI Engineer – The Garage
• Coding Client Success Specialist – WellSky
• Program Consultant, Health Care – American Heart Association
• Appeals and Grievances Specialist – Medica
• Business Systems Analyst – Dept of Medicine – Hartford HealthCare
• Patient Service Specialist – Texas Children’s Hospital
• Medical Billing Office Representatives – Concentra
• Patient Access Representative – Patient Access Center – CHRISTUS Health
• Medical Records Reviewer – VITAS Healthcare
• Chief Medical Coding and Compliance Officer – XpertDox
• Director IT Portfolio & Program Delivery – Regulatory & Strategic Programs – CVS Health
• Associate Chief Digital Information Officer – AMN Healthcare Leadership Solutions | B.E. Smith
• Sr. Director – Enterprise Connectivity & Network Services – Eli Lilly and Company
• Market IT Principal Consultant and Team Lead – Kaiser Permanente
• Head of Data & Infrastructure – Crimson Health
• Manager II Technology – Elevance Health
• HIM QA Lead, Remote, Health Information Management – Baptist Health
• Medical Device Cybersecurity Risk Specialist – Tata Consultancy Services
• Deputy CIO, Care Technologies & Informatics – Information Solutions – MUSC Health

If none of these jobs fit your needs, be sure to check out our previous health IT job listings.

Do you have an open health IT position that you are looking to fill? Contact us here with a link to the open position and we’ll be happy to feature it in next week’s article at no charge!

*Note: These jobs are listed by Healthcare IT Today as a free service to the community. Healthcare IT Today does not endorse or vouch for the company or the job posting. We encourage anyone applying to these jobs to do their own due diligence.

< + > Lessons from CHIMA: Coding for Clinical Care Instead of Reimbursement

The Health Information Day at eHealth26 in Halifax was an unexpected treat. The event hosted by CHIMA felt entirely different than previous revenue cycle and health information management (HIM) conferences. The biggest surprise was the lack of discussion on payer friction and claim denials.

Core Insight from CHIMA26

The conversations in Halifax proved that health information management is moving out of the back office. Without the constant battle of fighting insurance companies for reimbursement, Canadian professionals are focusing increasingly on data quality and governance. They are actively evolving into the essential data stewards needed to make future AI projects successful.

Coding for Care Instead of Cash

US hospitals code every minor patient condition to justify costs and ensure payment. In Canada, the single-payer model changes the rules entirely. Jodi McMullin, founder of ScoJo Consulting, holds certifications in both countries and explained the stark contrast.

“Because it’s a funding portfolio, we don’t look at those smaller issues,” McMullin explained. Because primary care in Canada is a capitated system, physicians are not as concerned about reimbursement accuracy. As long as the patient is treated and the information recorded into the EHR, everyone just moves on.

Expanding the Profession

The health information role is expanding rapidly across Canada. Mahmoud Suliman, CEO of CHIMA, pointed out that the profession often struggles to explain its true value to the public. He wants to change that narrative.

“There are a good number [of our members] that are coders, but we’re finding there are people part of clinical documentation improvement, release of information,” Suleiman explained.

These professionals ensure patient data remains secure, accurate, and accessible for clinicians and policymakers making critical decisions for the health system.

The Bottom Line from CHIMA’s Health Information Day

Health information management is no longer just a back-office administrative task. These professionals are strategic assets for data governance. Organizations looking to establish a strong and accurate data foundation, need look no further than their HIM department for a pool of capable professionals ready for the challenge.

Questions Healthcare IT Leaders are Asking

Why is clinical coding volume lower in Canada than the US? The United States operates on a multi-payer system that forces providers to document every condition to secure reimbursement. Canada uses a single-payer system that focuses strictly on the primary reason for the patient visit. This results in fewer codes and far less administrative friction.

How do health information professionals impact AI strategy? Artificial intelligence models require accurate, clean data to produce safe clinical outputs. Health information professionals act as data stewards who enforce governance and maintain privacy compliance. Their oversight guarantees that the data feeding these models is trustworthy.

Learn more about CHIMA at https://www.echima.ca/

Learn more about ScoJo Consulting at https://scojocoding.com/

Listen and subscribe to the Healthcare IT Today Interviews Podcast to hear all the latest insights from experts in healthcare IT.

And for an exclusive look at our top stories, subscribe to our newsletter and YouTube.

Tell us what you think. Contact us here or on Twitter at @hcitoday. And if you’re interested in advertising with us, check out our various advertising packages and request our Media Kit.