by Carol Ann D. Wilhelm, MPH, RHIA, and Claire Dixon-Lee, PhD, RHIA, FAHIMA
This summer AHIMA proposed three bold challenges to transform and realign formal education in health information management by 2016.
Health information is being redefined. Patient information once written on a paper file now resides as electronic data in systems throughout organizations, and it is beginning to move regionally through health data exchange networks. These data reside not on storage shelves or microfiche but in databases beyond the normal realm of HIM supervision and management. Data are coming from consumers themselves, who are encouraged to create and maintain their own personal health records, introducing yet another dimension to the challenge of health data availability and quality. Add to these changes the rise of diversified new disciplines within health informatics, which challenges HIM as in no prior decade.
The shift to electronic practice has enlivened the profession and opened doors to new work settings. There remains a critical need for HIM professionals to guide and manage EHR implementations in acute care settings, but the marketplace for HIM graduates is expanding to additional markets such as biotechnology, public health, pharmaceuticals, and government.
Major change in practice requires major change in education. HIM graduates will require academic preparation to gain the professional skills necessary to promote the value of HIM. Faculty will need academic preparation to demonstrate leadership and visibility on college campuses. An advanced body of research in electronic practice is needed, and doctorally prepared HIM educators and researchers are essential to make this a reality.
At no other time have these issues had greater significance than now. HIM needs a new blueprint for education to ensure quality health information within healthcare organizations and within new markets. HIM education must build on a solid body of research to gain recognition, credibility, and sustained longevity of the HIM profession.
The time is now to reach consensus and execute on a new educational strategy, one with action steps and milestones. If we do not, the industry will pass us by.
A Decade of Studies
AHIMA has been evaluating, writing, researching, and discussing these issues in various industry circles and member volunteer groups for more than a decade. In 1996 AHIMA announced a strategy called Vision 2006, a set of goals for the changes that lay ahead for the healthcare industry and the HIM profession. New roles were emerging, education curricula required changes, and the very medium that anchored the professionthe paper medical record-was transforming into electronic health data.
AHIMA subsequently coined the term e-HIM® to describe this transformation, and the 2003 report “A Vision for the e-HIM Future” encouraged us to accelerate our efforts in meeting this future by preparing HIM professionals to take roles in planning, implementing, and managing electronic health records (EHRs). What appears to be missing still is the acknowledgment of HIM as a unique and highly qualified profession with an essential role in EHR decision making.
Among the many issues that emerged from this earlier work is the recurring theme that HIM is a profession with unique domains and defined skill sets that bridge the divide between health information technologies and the people who use them.
The expertise within the HIM knowledge domainsregulatory standards and compliance; clinical vocabularies and terminologies; legal, privacy, and confidentiality regulations; electronic data standards; the biomedical sciences; data analytics; quality data management practices; and the rules of healthcare reimbursementis fundamental to the management of accurate, complete, high-quality health information within electronic systems.
As EHR implementations increase, so will the need for HIM professionals to manage them. To provide highly specialized HIM professionals at all levels, it is imperative that new strategies provide accessible and high-quality formal education, enough educators to support program growth, and continuing professional development.
HIM graduates will need to be academically prepared for the professional skills necessary to promote the value of HIM. Education program faculty will need to be academically prepared to demonstrate leadership and visibility on college campuses. An advanced body of research in electronic practice is needed, and doctorally prepared HIM educators and researchers are essential to make this a reality.
In 2004 the AHIMA HIM Education Strategy Committee delivered a new education framework based on 2004 AHIMA work force research. It described current and emerging roles for HIM professionals, presented as a continuum of academic levels from predegree certificates to master’s degrees.
A link to the growing field of health informatics, as technologies are applied to the generation and management of health information, further redefined the professional competencies and knowledge to effectively work in the increasingly electronic environment. HIM academic programs were urged to revise curricula, and the seeds for master’s degree programs among existing baccalaureate degree programs took root.
Three Milestones by 2016
In 2006 the AHIMA HIM Education Strategy Committee began work on a new 10-year strategy, emphasizing that AHIMA make an objective assessment of the need for future HIM education such that the profession will further sustain and lead amid a rapidly changing healthcare environment.
That assessment, based on the premise that health information itself is being redefined, centers on three key priorities for HIM education in the coming 10 years:
- Transform HIM to a graduate-level profession
- Realign the HIM associate degree with work force needs
- Prepare an effective, qualified pool of HIM faculty
The strategy is presented in the white paper “Vision 2016: A Blueprint for Quality Education in Health Information Management.” It discusses the need for HIM to be viewed as a graduate-level profession, with strong technical skills exemplifying graduates of associate degree programs and coding specialty programs, in order to remain competitive in the e-HIM environment.
More than 5,000 HIM professionals now hold master’s or doctoral degrees, but this will not be sufficient to sustain the profession in the future. Baby boomers will be retiring in large numbers, and more graduate-level HIM practitioners may choose to become educators to support the growing number of HIM academic programs.
The education blueprint committee identifies fundamental considerations and suggested actions for a new education blueprint, and it outlines interim steps that will achieve it. Some of the primary actions include:
- Examine those professions that have engaged in a similar professional and academic transition and glean lessons learned and the outcomes they experienced
- Survey the healthcare industry to validate emerging HIM jobs and opportunities and the comparable degree requirements employers seek for coding professionals, and associate, baccalaureate, master’s, and doctoral degree-level HIM professionals
- Assess the ability to add more content to the curricula for associate and baccalaureate degree programs, which are now at capacity, as increased content is added to the e-HIM domain
- Examine the entry-level credentials for registered health information technician and registered health information administrator as they exist today against the level of competencies supporting the EHR
- Explore whether advanced education at the master’s degree should be considered as the terminal degree in HIM and whether a master’s degree should be required at career entry for registered health information administrators
- Survey current baccalaureate degree HIM programs for receptiveness to develop master’s degree offerings and draw from academic models in other disciplines to provide a practical approach to HIM graduate education
- Examine HIM associate degree generalist education against the many emerging e-HIM specialties as well as the value of an associate degree to prepare job-ready coding professionals
- Improve recognition of the HIM career across all levels and types of practice as an academically based profession
- Raise the visibility of HIM faculty by encouraging advanced degrees and provide assistance in transitioning from practitioner to educator, an essential step to grow the HIM profession and achieve the other priorities
All HIM professionals today are challenged to focus on the transformation of HIM practice by developing personal professional development plans and collectively to guide the direction of HIM formal education for the future. These recommended steps are intended as that blueprint
“Vision 2016: A Blueprint for Quality Education in Health Information Management” can be found on the AHIMA Web site under “HIM Resources.” It contains background information, statistics, references, and suggested actions, presenting opportunities and benefits of each priority with an outline of the challenges. It identifies factors that may accelerate the need for each priority as well as factors that could impede or decelerate progress toward them. The white paper serves to generate public discussions about the future of HIM and establish annual milestones for working toward achievement of this vision by 2016 or sooner.
From Practitioner to Educator
Mona Calhoun couldn’t wait for her first fresh-faced student to walk through the classroom door. Since 2005 Calhoun had worked tirelessly to create the new HIM program at Coppin State University. With the first HIM class of the program held in August, Calhoun finally realized a long-standing dream of transitioning from practicing HIM full-time to teaching it full-time.
Calhoun, MS, RHIA, is chair of Health Information Management at Coppin State University, located in Baltimore, MD. Her move to education was a gradual one, following years of work as a director of HIM in various healthcare facilities. Calhoun taught HIM classes part-time at a local community college, but from 1985 to 2006 her full-time work was spent in the HIM field.
“I have always had the desire to teach, but the timing just wasn’t quite right for it,” she says. When the opportunity arose to leave the field to help craft and lead a new university HIM program, Calhoun found the chance she was searching for.
She says her years of HIM experience are useful when teaching students what to expect in the real world. Transitioning from practitioner to educator offers various rewards, she says, including the great sense of purpose she gets preparing the next generation of HIM professionals.
“Education is where it begins, it is where we all started,” Calhoun says. “We need knowledgeable people who have been in the field and see what it takes to make a great HIM professional. There is nothing like training new people on what this profession has to offer.”
Progressive Studies for a Long and Productive Career
When she started working in HIM, Emily Graham wasn’t focused on higher education. But, she says, she quickly realized there is only so far you can go professionally without a degree.
Aiming for a long and productive HIM career, Graham studied up and earned her RHIT. Then she kept going. Associate degree earned, Graham has started down the road to her bachelor’s degree, with RHIA certification as a goal. Obtaining a degree is rewarding both personally and professionally, she says. There is accomplishment in earning the degree, and professionally, it makes an HIM professional “more marketable and more valuable.”
Graham, RHIT, CCS-P, CPC, is an associate director of regulatory affairs with ASCRS/ASOA, a healthcare advocacy association based in Fairfax, VA. While in high school, Graham was first introduced to HIM working as an assistant at a local physician’s office. Four years ago, Graham was hired at ASCRS/ASOA, where she works as a lobbyist advocating for physician and healthcare administrator interests. When hired, Graham did not possess an associate degree, placing her in the minority in both her organization and her field. In order to learn more about HIM and enhance her professional worth, Graham obtained her associate degree in May 2006 from Northern Virginia Community College.
By studying HIM, Graham felt she was bringing unique skills to the healthcare advocacy profession. “Most people who are on the Hill lobbying members of Congress, they don’t have any practical idea about what it is like for someone who works in a doctor’s office… But I have been there before.”
Calling Dr. Wisdom
The name Dr. Wisdom just has a nice ring to it, admits Theresa Wisdom.
But aesthetics alone are not driving the 20-year HIM veteran to earn her doctorate in health informatics. Wisdom, MBA, RHIA, embraces the HIM profession, and the ongoing changes in electronic health information management. Earning a doctorate will allow Wisdom and others like her to be at the forefront of change and help shape the profession, she says.
Wisdom is standards harmonization manager at the Healthcare Information and Management Systems Society. She has spent most of her career heading HIM departments in medical facilities. After earning her bachelor’s degree in 1986, Wisdom focused on outpatient and inpatient HIM departments.
She soon wanted to expand her education and advance her career. In 2000 Wisdom graduated from Lewis University, based in Romeoville, IL, with an MBA in information systems. “The master’s degree, in my mind, prepared me for the challenges that I was looking for within my profession,” Wisdom says. “It gave me the respect to move along that path.”
Earning her master’s prepared her for advanced work with health IT and health information exchange. Wisdom says that getting the degree also helps HIM professionals sharpen their skills for the transformation to electronic practice.
Wisdom is now preparing to get her doctorate in informatics. Having the advanced degree will again raise her opportunities to join projects that aim to build a nationwide health information network. “I don’t want to miss an opportunity to be part of this,” she says.
Carol Ann D. Wilhelm (firstname.lastname@example.org) is a consultant based in Irvine, CA, and chair of AHIMA’s HIM Education Strategy Committee. Claire Dixon-Lee (email@example.com) is vice president for education and accreditation at AHIMA and executive director of the Commission on Accreditation for Health Informatics and Information Management Education.
Wilhelm, Carol Ann; Dixon-Lee, Claire.
"New Blueprint for HIM Education"
Journal of AHIMA