Embracing the Future: New Times, New Opportunities for Health Information Managers

Summary Findings from the HIM Workforce Study

Health information management (HIM) is the profession dedicated to the effective management of patient information and healthcare data needed to deliver quality treatment and care to the public. The fundamentals of the HIM profession continue to evolve over time, becoming less paper-based and increasingly electronic. HIM plays a critical role in the successful implementation of electronic health records (EHR) and ensures that providers, healthcare organizations, and patients have access to the right health information when and where it is needed while maintaining the highest standards of data integrity, confidentiality, and security.

A number of factors influencing the healthcare environment have a direct impact on the HIM profession. HIM professionals are responding rapidly to these changes and are highly adept at meeting the evolving need for realtime health information at the point of care. HIM professionals are increasingly becoming standard-setters for electronic health records; advocates for quality patient records and for patient access and utilization of personal health information; and data experts for collecting, interpreting, and analyzing health information.

As the HIM field has evolved from medical records management to this wide range of roles and responsibilities, HIM professionals are playing an increasingly critical role in a variety of organizations throughout the healthcare industry. Within any given healthcare organization, HIM professionals are no longer centralized in one single department; but rather are decentralized, applying their expertise across entire organizations. As a result of these expanding roles, there is a growing demand for skilled, trained HIM professionals throughout the healthcare industry. HIM academic and continuing education programs are expanding and adapting to meet the industry’s demand for a robust and dynamic HIM work force.

The American Health Information Management Association (AHIMA) plays a critical role in the growth and success of the HIM profession. In response to the growing demand for HIM professionals, AHIMA has undertaken three key strategic directions to advance the profession and enhance the role it plays in the healthcare industry: (1) professional development, including an emphasis on specialized areas of technical expertise and an increase in the number of advanced certificates; (2) promotion and enhancement of educational programs to grow the number of qualified HIM professionals; and (3) leadership of HIM as a well-known and highly regarded profession that provides value to healthcare organizations, patients, the government, researchers, and a variety of other stakeholders.

Table of Contents

The Evolution of Health Information Management

Changing HIM Environment
Rapid Growth in HIM and Expanding Roles of HIM Professionals
Education of HIM Professionals
Expansion of HIM Throughout the Healthcare Industry

Strategic Directions

Professional Development
Education and Preparation
HIM Leadership

In 2002 the American Health Information Management Association (AHIMA) contracted with the Center for Health Workforce Studies at the University at Albany, State University of New York (SUNY) to conduct research about the health information management (HIM) workforce. Using FORE funding, the research project goal was to understand the current status of AHIMA members, education programs accredited by AHIMA and employers of HIM professionals, and to help assess future directions of the HIM work force. The survey results confirmed previous findings by the US Department of Labor, Bureau of Labor Statistics, predicting significant future growth in the size and scope of the HIM profession.

Based on the survey findings, AHIMA developed a series of action initiatives to enhance the development of HIM professionals. AHIMA is expanding the number of HIM educational and advancement opportunities, and providing leadership for the profession through promotion of the growing diversity of roles and responsibilities of HIM professionals; raising awareness about the profession and AHIMA; and educating the healthcare industry about the critical role HIM professionals play in their success.

The Evolution of Health Information Management

Health information management is the body of knowledge and practice that ensures the availability of health information to facilitate real-time healthcare delivery and critical decision making for multiple purposes across diverse organizations, settings, and disciplines.
HIM has evolved from an emphasis on paper medical records to playing a key role in ensuring the availability of health information to facilitate real-time healthcare delivery and critical health-related decision making for multiple purposes across diverse organizations, settings, and disciplines. The field continues to be centered on patient information; however, its precise role is influenced by the adoption of new technology and other changes impacting the US healthcare system. The profession has the unique ability and opportunity to influence the implementation of EHRs and shape the ways in which health information is used to deliver quality patient care.

Changing the HIM Environment

Changes in the Environment. HIM is highly sensitive to changes in the healthcare industry, requiring HIM professionals to be able to readily understand and assimilate healthcare changes as they occur. Trained HIM professionals are responding rapidly to these changes and are highly adept at meeting the evolving need for real-time health information at the point of care.

HIM professionals are already addressing many factors influencing the healthcare industry, including changes in technology and its impact on delivery of patient care; consumer-driven healthcare and the movement for patient-centered care; and the value placed on health information for functions in healthcare organizations outside of medical records, such as quality improvement and other administrative functions, revenue cycle management and financial and strategic planning.

Impact of Evolving Technology on HIM and the Healthcare Field. The HIM field is in the midst of a business cycle often referred to as “creative destruction,” in which existing technologies, processes or roles are destroyed when new technologies and processes are created. The role that HIM professionals play is evolving, and many of the paper forms of data are being eliminated as healthcare organizations convert to electronic health records (EHRs). The influence of this growing shift toward technology is already being felt across the industry, as many of the past roles of HIM centered on paper medical records are eliminated and replaced by new roles focused on patients’ electronic health records.

Electronic Health Records. HIM’s unique perspective and role in the healthcare field has resulted in HIM professionals serving as key players in the implementation of EHRs and in the transition of patient information. In fact, eight in ten HIM professionals responding to the AHIMA 2002 workforce study reported being in some phase of the EHR implementation process.

Rapid Growth in HIM and Expanding Roles of HIM Professionals

Changing Responsibilities. Thirty years ago the HIM profession was focused on paper medical records that were used primarily by clinicians in hospitals. Although HIM professionals are still responsible for the collection, storage, coding, processing, analysis, interpretation, application, privacy and sharing of information for a wide range of purposes in healthcare settings, the method by which these duties are carried out today has changed dramatically. HIM professionals are increasingly performing these tasks using emerging technology, and helping people access information to support clinical decision-making, research, financial management, and personal health management. The HIM profession has earned a prominent leadership role in ensuring the quality, privacy, and efficiency of clinical information as the healthcare industry moves toward an increasingly electronic and global environment.

Rapid HIM Growth. As the information needs of the healthcare field advance, HIM professionals are playing an increasingly pivotal role. Employers responding to AHIMA’s workforce study reinforced that HIM professionals are highly valued, and believe that they will be even more highly valued in the future. This value is due to a number of factors, including the escalating speed of transition from paper and manual entry to electronic entry and storage of data, resulting in an increasingly complex field that requires a significantly larger number of qualified HIM professionals. Technological advancements used by HIM professionals to manage patient information and healthcare data are assisting healthcare organizations in becoming more efficient and improving quality through access to data for evidence-based care, access to clinical expertise, increased information to patients and supportive information systems.

A Shortage of Qualified HIM Professionals. The rapid growth and increased demand for HIM professionals resulted in the US Department of Labor, Bureau of Labor Statistics projecting a 49 percent growth in the number of HIM workers by 2010, making HIM one of the nation’s fastest-growing health occupations. It is projected that 6,000 HIM professionals will be needed each year to fill new positions and replace vacant positions; however, currently only 2,000 new graduates enter the HIM field each year. Nearly 75 percent of the AHIMA workforce survey respondents that manage or employ HIM professionals indicated there are not enough qualified applicants to fill open HIM positions in their organizations.

Education of HIM Professionals

HIM Educational Programs. New HIM graduates are entering a changing workplace, and their training and credentialing must reflect all the emerging needs and demands of healthcare organizations. Geographically dispersed degree programs and qualified educators with advanced degrees are needed at all levels of HIM education to ensure that academic programs proactively reflect the changing demands of the healthcare industry and address the continuing needs of HIM professionals. AHIMA’s recent workforce study indicates that a significant majority of HIM students are interested in further education after graduation; AHIMA is assisting currently accredited academic programs and educators with the resources necessary to prepare future industry leaders.

Professional Identity. While HIM has traditionally been viewed as a single profession, the roles performed by HIM professionals now impact a variety of areas throughout healthcare organizations and across the entire health system. This increasing diversity within the HIM profession is resulting in a growing number of educational programs with specialized areas of emphasis. Education programs are also using an increasing number of problem-based modules, technologies, and practical experience to train HIM professionals, preparing them for the critical role they play across the healthcare spectrum.

Expansion of HIM Throughout the Healthcare Industry

The Expanding Role of the HIM Profession. There is a growing diversification of needs as HIM professionals work in settings other than the traditional hospital setting. The field currently offers nearly 40 different work settings, including:
  • Hospitals, physician offices and clinics, and skilled nursing facilities;
  • Educational institutions;
  • Government agencies;
  • Technology companies;
  • Insurance companies and HMOs; and
  • Consulting firms.
Within this variety of settings HIM professionals fulfill a wide range of job positions, and increasingly work in critical and influential positions. Job specializations include:
  • Enterprise-wide data and information policy development;
  • Clinical data quality oversight;
  • Organizational privacy/security officer;
  • Document specialist responsible for monitoring accuracy and completeness of electronic and personal health records and other clinical databases;
  • Chief information officer;
  • Organization-wide clinical coding and revenue cycle management;
  • Data mining and analytics; and
  • Information access and disclosure specialist, including release of information under HIPAA.
Changing Roles of HIM Professionals. Healthcare providers and HIM employers are increasingly utilizing health information for a variety of decisions and benchmarking measurements, increasing their reliance on HIM professionals to provide data management and analysis and ensure quality and security of information. This growing demand for HIM services in a variety of functions has resulted in the profession embracing a broader set of roles. As a result, HIM professionals often specialize in a particular area of expertise, in addition to being trained in a core set of HIM skills. HIM professionals are becoming:
  • Standard-setters for electronic health records and other emerging technologies;
  • Educators to patients, providers and administrators about privacy, content, access, and interpretation of records;
  • Consumer advocates who work with patients to help them access and understand the information in their records and control their usage;
  • Experts who understand the structure and content of patient records and their multiple uses;
  • Data experts involved in abstracting patient records to understand and improve clinical outcomes and enhance economies in administrative process;
  • Brokers of information who understand where information resides, how it can be retrieved, and the limits or boundaries on usage including privacy and security issues;
  • Advocates for quality records and the monitors of compliance with information standards and regulatory requirements;
  • Informaticians who support clinical researchers and business analysts; and
  • Data analysts who investigate and compile data for different purposes, including clinical research, data auditing, quality assessment, cost estimation, risk assessment, physician practice monitoring, management of resources, and reimbursement mechanisms.

Strategic Directions

HIM will increasingly be perceived as a long-term career option as the number of opportunities for master’s education increases
AHIMA research about the current HIM profession and its future opportunities has resulted in the development of three key strategic directions for the HIM field: professional development, education and preparation, and HIM leadership.

Professional Development

Specialized Advanced Certificates. To accommodate changing industry demands, HIM bachelor’s and master’s level training has evolved to educate future HIM professionals using a broad curriculum, with project management, change management, strategic thinking and leadership skills as a high priority. To ensure the value of credentials, AHIMA is updating certification exams to ensure they reflect current and future practice. In addition to master’s education, an increasing number of advanced certificates are available for specialized HIM topics. As the field becomes more advanced, certifications for specific areas such as the EHR, HIM system design and classification systems will be increasingly available.

AHIMA Efforts. AHIMA is working toward a future in which health information is electronic, patientcentered, comprehensive, longitudinal, accessible, and credible. As part of an initiative to promote electronic health information management (e- HIM™), AHIMA offers a number of professional development opportunities to help members develop stronger technology skills, enhanced research and analytical skills, and project management skills. In addition, AHIMA publishes practice guidelines and other materials that reflect how HIM practice evolves and enables members to continue to move it forward. Credentialing and continued educational and advancement opportunities are critical to the future success and growth of HIM.

Graduate Level Education. Graduate level education programs are developing to help HIM claim some “turf” for future involvement and development of electronic health records. Graduatelevel options may be independent, such as HIM and applied health informatics, or may be modules combined with other master’s programs such as Master of Business Administration or Master’s in Information Systems. HIM will increasingly be perceived as a long-term career option as the number of opportunities for master’s credentials increases.

Education and Preparation

Meeting Workforce Needs. AHIMA and HIM professionals must undertake several initiatives to enhance the strategic positioning of the profession. AHIMA’s overriding objective is to build a dynamic work force, skilled at collecting, organizing, and analyzing critical data, in order to improve healthcare outcomes, implement standards, ensure privacy and security, and control costs.

Increase the Number of HIM Professionals. To ensure the longevity of the profession and the quality of information management, it’s critical to increase the number of HIM professionals. AHIMA is working to increase the number of HIM professionals in states or regions where their numbers are low. Education is a key part of this process, as the best and the brightest will pursue the HIM profession if the field is viewed as recruiting top performers and offers advancement opportunities.

Ensure Students Are Prepared for the Future. A recently developed framework for HIM education at the master’s, baccalaureate, associate, and pre-degree level is becoming the foundation for education. Educational programs must ensure that their curricula reflect what students need to know for careers in electronic environments. Their progress will be reflected in accreditation by the Commission on Accreditation for Health Informatics and Information Management Education, created in 2004 as an accrediting body for degree-granting programs in HIM and health informatics. And the Association is making sure that HIM educators are up to date on the latest developments in HIM practice and providing new learning tools, such as a virtual learning lab to provide students experience in the electronic environment. All these ensure that HIM graduates have practical, hands-on experience and a curriculum reflecting the evolution of the profession.

HIM Leadership

AHIMA seeks to lead in the following areas:

Build on the Strengths of Increasing Diversity. HIM professionals are increasingly employed in nontraditional settings. For instance, HIM professionals don’t work only in hospitals any more—they hold 125 different job titles in 40 different work settings according to recent data. AHIMA seeks to help members meet the needs of a growing variety of employers and to broaden the influence of the profession throughout healthcare.

Raise the Profile of the Profession. Patients need to become more aware of the services and advocacy provided by HIM professionals, and HIM professionals want the public and the places they work to know more about them, too. In addition, HIM tasks are becoming increasingly decentralized—so an HIM professional might conceivably work in many different areas of an organization. These two forces provide new opportunities for AHIMA and HIM professionals to gain increasing visibility among their colleagues and among the public. AHIMA is committed to supporting its members as they work to raise their professional profiles.

Use Influence Wisely. AHIMA is committed to advancing the profession by supporting its members and using its influence to make strong HIM practices pervasive throughout the industry.

With the national focus on health information and the need for information technology that is comprehensive and interoperable across the country, AHIMA is in a unique position to help shape the national agenda. Change is happening on four fronts:

  • Privacy and security;
  • Standards for data interchange and system interoperability;
  • The EHR; and
  • The overall national health information infrastructure.
With the overriding goal of HIM always in mind—ensuring the availability of health information to facilitate real-time healthcare delivery—AHIMA is involved in initiatives designed to advance the role of HIM in informing clinical practice, developing standards to improve data quality and facilitate information exchange, and helping healthcare organizations migrate to the electronic health record (EHR).

Helpful Links:

The Foundation of Research and Education (FORE) www.ahima.org/fore

AHIMA Workforce Study Project www.ahima.org/fore/practice/workforce.cfm

The Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) www.cahiim.org

The workforce research study and publication of this report is supported by a grant to FORE from MedQuist, Inc. Additional support was provided in part by a generous leadership grant from 3M Health Information Systems and by contributions from AHIMA’s Component State Associations and member gifts.