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Copyright (c) 2025 Mohammad Saad Saud Alrasheedi, Adel Darwish Almahwari, Alaa Abdulaziz Almuhanna, Rifah Muhammed Saad Aldosseri, Sharoog Abdulrhman Alkuraiea, Marwah Hamoud Albanaqi, Mohammed Obeid Misfer Aldosari, Fares Abdulaziz Sharid Al-Mutairi, Mishari Fuhaid Mohammed Al-Mutairi, Aeshah Bawkaryah Yhazaylaee, Aeshah Ahmed Mohammed Moraya
This work is licensed under a Creative Commons Attribution 4.0 International License.
Health Information Management for Medical Records, Medical Coding, Health Administration, and Medical Secretaries
Corresponding Author(s) : Mohammad Saad Saud Alrasheedi
Saudi Journal of Medicine and Public Health, Vol. 2 No. 2 (2025)
Abstract
Background: Health Information Technology (HIT) has become a foundational component of modern healthcare systems, integrating hardware, software, and standardized data processes to support clinical, administrative, and research functions. It plays a critical role for health information management professionals, including medical records specialists, medical coders, health administrators, and medical secretaries, whose responsibilities depend on accurate, secure, and accessible health data.
Aim: This article aims to examine the role of HIT in supporting healthcare accountability, improving patient and population health outcomes, enhancing healthcare delivery efficiency, and reducing overall healthcare costs, with particular emphasis on its impact on health information management professionals.
Methods: A narrative-based analytical approach was used, synthesizing evidence from established literature, policy discussions, and real-world case examples. The article reviews key HIT components such as electronic health records (EHRs), computerized physician order entry (CPOE), health information exchanges (HIEs), and interoperability standards, and evaluates their influence on clinical decision-making, operational workflows, and population health monitoring.
Results: HIT was shown to improve patient safety through error reduction, support population health surveillance, streamline administrative workflows, and enable data-driven decision-making. However, challenges including high implementation costs, interoperability limitations, data security risks, and user-related inefficiencies persist.
Conclusion: HIT remains essential for effective healthcare delivery, provided its challenges are addressed through strategic investment, training, and system optimization.
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- Liu J, Sakarovitch C, Sigurdson K, Lee HC, Profit J. Disparities in Health Care-Associated Infections in the NICU. American journal of perinatology. 2020 Jan:37(2):166-173. doi: 10.1055/s-0039-1688481.
- Herout J, Baggetta D, Cournoyer A, Dietz AS, Robbins J, Maddox K, Dobre J. Potential impact of data source and interoperability messaging on health information technology (HIT) users: a study series from the United States Department of Veterans Affairs. BMJ health & care informatics. 2019 Apr:26(1):0. doi: 10.1136/bmjhci-2019-000014.
- Norell Pejner M, Ourique de Morais W, Lundström J, Laurell H, Skärsäter I. A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People: Protocol for a Mixed-Methods Study. JMIR research protocols. 2019 Apr 30:8(4):e12447. doi: 10.2196/12447.
- Silverman HD, Steen EB, Carpenito JN, Ondrula CJ, Williamson JJ, Fridsma DB. Domains, tasks, and knowledge for clinical informatics subspecialty practice: results of a practice analysis. Journal of the American Medical Informatics Association : JAMIA. 2019 Jul 1:26(7):586-593. doi: 10.1093/jamia/ocz051.
- Atkinson KM, Wilson K, Murphy MSQ, El-Halabi S, Kahale LA, Laflamme LL, El-Khatib Z. Effectiveness of digital technologies at improving vaccine uptake and series completion - A systematic review and meta-analysis of randomized controlled trials. Vaccine. 2019 May 21:37(23):3050-3060. doi: 10.1016/j.vaccine.2019.03.063.
- Leviton A, Oppenheimer J, Chiujdea M, Antonetty A, Ojo OW, Garcia S, Weas S, Fleegler E, Chan E, Loddenkemper T. Characteristics of Future Models of Integrated Outpatient Care. Healthcare (Basel, Switzerland). 2019 Apr 27:7(2):. doi: 10.3390/healthcare7020065.
- Yousaf K, Mehmood Z, Saba T, Rehman A, Munshi AM, Alharbey R, Rashid M. Mobile-Health Applications for the Efficient Delivery of Health Care Facility to People with Dementia (PwD) and Support to Their Carers: A Survey. BioMed research international. 2019:2019():7151475. doi: 10.1155/2019/7151475.
- Yoshida Y, Boren SA, Soares J, Popescu M, Nielson SD, Koopman RJ, Kennedy DR, Simoes EJ. Effect of Health Information Technologies on Cardiovascular Risk Factors among Patients with Diabetes. Current diabetes reports. 2019 Apr 27:19(6):28. doi: 10.1007/s11892-019-1152-3.
- Russo P, Rosano GMC, Favato G, Staniscia T, Romano F. Cost-effectiveness of direct acting oral anticoagulants in the prevention of thromboembolic complications: limits and concerns of economic evaluations. Journal of cardiovascular medicine (Hagerstown, Md.). 2019 Aug:20(8):500-503. doi: 10.2459/JCM.0000000000000805.
References
Liu J, Sakarovitch C, Sigurdson K, Lee HC, Profit J. Disparities in Health Care-Associated Infections in the NICU. American journal of perinatology. 2020 Jan:37(2):166-173. doi: 10.1055/s-0039-1688481.
Herout J, Baggetta D, Cournoyer A, Dietz AS, Robbins J, Maddox K, Dobre J. Potential impact of data source and interoperability messaging on health information technology (HIT) users: a study series from the United States Department of Veterans Affairs. BMJ health & care informatics. 2019 Apr:26(1):0. doi: 10.1136/bmjhci-2019-000014.
Norell Pejner M, Ourique de Morais W, Lundström J, Laurell H, Skärsäter I. A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People: Protocol for a Mixed-Methods Study. JMIR research protocols. 2019 Apr 30:8(4):e12447. doi: 10.2196/12447.
Silverman HD, Steen EB, Carpenito JN, Ondrula CJ, Williamson JJ, Fridsma DB. Domains, tasks, and knowledge for clinical informatics subspecialty practice: results of a practice analysis. Journal of the American Medical Informatics Association : JAMIA. 2019 Jul 1:26(7):586-593. doi: 10.1093/jamia/ocz051.
Atkinson KM, Wilson K, Murphy MSQ, El-Halabi S, Kahale LA, Laflamme LL, El-Khatib Z. Effectiveness of digital technologies at improving vaccine uptake and series completion - A systematic review and meta-analysis of randomized controlled trials. Vaccine. 2019 May 21:37(23):3050-3060. doi: 10.1016/j.vaccine.2019.03.063.
Leviton A, Oppenheimer J, Chiujdea M, Antonetty A, Ojo OW, Garcia S, Weas S, Fleegler E, Chan E, Loddenkemper T. Characteristics of Future Models of Integrated Outpatient Care. Healthcare (Basel, Switzerland). 2019 Apr 27:7(2):. doi: 10.3390/healthcare7020065.
Yousaf K, Mehmood Z, Saba T, Rehman A, Munshi AM, Alharbey R, Rashid M. Mobile-Health Applications for the Efficient Delivery of Health Care Facility to People with Dementia (PwD) and Support to Their Carers: A Survey. BioMed research international. 2019:2019():7151475. doi: 10.1155/2019/7151475.
Yoshida Y, Boren SA, Soares J, Popescu M, Nielson SD, Koopman RJ, Kennedy DR, Simoes EJ. Effect of Health Information Technologies on Cardiovascular Risk Factors among Patients with Diabetes. Current diabetes reports. 2019 Apr 27:19(6):28. doi: 10.1007/s11892-019-1152-3.
Russo P, Rosano GMC, Favato G, Staniscia T, Romano F. Cost-effectiveness of direct acting oral anticoagulants in the prevention of thromboembolic complications: limits and concerns of economic evaluations. Journal of cardiovascular medicine (Hagerstown, Md.). 2019 Aug:20(8):500-503. doi: 10.2459/JCM.0000000000000805.