What is the initial step for a HIM director facing issues with on-call physicians completing their health records?

The initial step for a Health Information Management (HIM) director facing issues with on-call physicians completing their health records is to consult with the medical director for suggestions. This approach is strategic because it fosters collaboration and communication among healthcare leaders. The medical director typically has insight into the challenges on-call physicians face and can provide valuable perspective on how to address these issues effectively.

Engaging with the medical director can lead to identifying root causes of the delays in record completion, exploring potential barriers—such as workload, understanding of documentation standards, or any systems-related constraints. This collaborative effort lays the groundwork for developing appropriate strategies or interventions that may promote better compliance among on-call physicians.

Considering other options, sending additional deficiency notices may address the problem in the short term, but it does not tackle the underlying issues or foster a collaborative environment. Implementing penalties might create resentment or tension without addressing the reasons for non-completion, and changing to a different EHR system could be a more costly and disruptive measure that may not solve the core problem. Therefore, consulting with the medical director is a constructive first step toward improving health record completion.