Take Action to Educate and Expand the Health Information Management (HIM) Professional Workforce

Approved October 2009

AHIMA’s Position

AHIMA regards the adoption and maintenance of electronic health records (EHRs), personal health records (PHRs), and the formation and utilization of health information exchange (HIE) networks as imperative to lasting improvements in the quality of healthcare delivered in the United States. But achieving an effective electronic information infrastructure for healthcare delivery is more than a matter of technology deployment supported by a technology workforce. A distinct need exists for a qualified health information management workforce focused on the effective application of technology to improve the information used to make healthcare decisions. Health information management (HIM) professionals possess unique knowledge in:

• Data content, structure, and standards;
• Confidentiality, privacy, and security management;
• Electronic health record life cycle;
• Data administration and analytics;
• E-Discovery;
• Personal health information management;
• Reimbursement, regulatory compliance, and fraud surveillance and the
• Organization and management of information.

HIM professionals also possess the skill to facilitate effective integration of technology to meet the needs of care delivery compliance, legal, public health, research, administrative, and policy development.

The need for qualified HIM professionals to facilitate the transition, implementation, and ongoing management of health information systems that support the goals of an effective and efficient healthcare system and health data integrity is growing substantially. The provisions of the American Recovery and Reinvestment Act (ARRA) to invest in rapid implementation and meaningful use of electronic health records accelerate this demand. Meanwhile, the US Bureau of Labor Statistics’ (BLS’s) data projects the number of active HIM professionals will fall well below the necessary level to accomplish this transformation. This shortfall is due to an aging workforce, coupled with an insufficient number of graduates from too few HIM academic programs.

While the potential for funding for HIM education expansion and strengthening is outlined in ARRA, the funding is short term and comes at a time when HIM academic programs are faced with reductions or closure due to limits in community and state education funding and allied health education funding limitations in general. Allied health education was at one time funded under Title VII of the Public Health Act, but in the last decade this funding has been focused on medical, nursing, and pharmacy education and not those professions that traditionally make up allied health.

AHIMA calls upon leaders of the healthcare industry and federal and state governments to support and fund the education necessary to ensure adequate numbers of HIM professionals are in place to provide access to accurate, complete health information in this transitional electronic environment, and to manage, sustain, and improve our nation’s use of health information in the years to come.

Why AHIMA Supports the Position

• The US Department of Labor Bureau of Labor Statistics projects HIM jobs as one of the higher growth health occupations in America.¹ Each year the industry needs several thousand new HIM professionals to occupy new and existing positions left vacant by retirees and professionals leaving the field. Each year about 3,000 new graduates enter the HIM profession. The gap widens with each passing year. At the same time our needs for HIM expertise are dramatically increasing.
• The ARRA legislation acknowledges and identifies the need for HIM education and calls for funding for some (unidentified) level of advanced graduate and six month education programming. ARRA funding is limited, and based on BLS data it will not meet the long-term need for HIM professionals at various education levels, and especially for the ongoing work with EHRs and EHR data in future years after implementation.
• In 2005, AHIMA, the AHIMA Foundation, and the American Medical Informatics Association (AMIA) organized a summit to review, clarify, and develop initial strategies addressing workforce challenges related to EHRs and HIEs. Summit participants included a broad representation of industry stakeholders from academia, professional associations, provider organizations, business professionals, and the federal government. The group identified crucial factors for the success of the healthcare industry in a time of transition, and made nine recommendations to the industry, academia, and government. These factors and recommendations are highlighted in the 2006 report “Building the Work Force for Health Information Transformation.”² AMIA and AHIMA are adhering to these recommendations, which include advocating for funding of HIM and informatics education.
• HIM education, like that of other allied health professions, is funded through Title VII of the Public Health Service Act. However, recent budget and appropriations for Title VII outside of medical and nursing professions have been either limited or zero.
• In 2003, AHIMA and the AHIMA Foundation developed the HIM Virtual Lab with in-kind contributions from HIM systems vendors. The Virtual Lab allows students to experience technology through simulations and hands-on exercises, preparing them for an electronic record environment. While almost 200 schools have had the resources to permit HIM student participation in EHR education using the lab, many schools’ students have not had EHR training and EHR use as part of their curriculum. In 2007, an AHIMA/AMIA task force identified the need for such experience by other healthcare professions, especially allied health programs

Recommendations

AHIMA calls on decision makers in industry, government, and higher education to acknowledge the unique contribution of HIM professionals to EHR and HIE implementation and the need for an expanded HIM workforce by:

• Expanding educational funding at the federal and state levels to meet the educational and academic needs of the HIM profession and to facilitate:
• Recruitment, preparation, and retention of educators in the HIM field
• Ongoing evolution of curricula, including continued changes in HIM and health informatics
• Expansion of HIM programs for master’s and doctorate-level education
• Provision of loans and scholarships to students who enter the HIM field and current practitioners who want to further their education to advance the transformation of the profession
• Access to current technologies that prepare students for the future workplace.
• Providing support for the continued education of HIM practitioners engaged in managing the healthcare industry’s transition from a paper to an electronic environment.
• Creating a specific occupational category for HIM professionals at the managerial level by the BLS, to permit ongoing tracking of national progress in solving this workforce shortage.
• Funding research related to:
• Best practices for HIM related to EHR implementation, management, and health information exchange.
• The impact of a trained workforce on the meaningful use of health records.

The promise of EHRs, HIEs, quality, safety, and improved healthcare delivery, efficiency, and effectiveness will not be realized solely through purchasing hardware and software. Such an assumption fails to recognize the complexity involved in planning, implementing, and integrating HIT into existing healthcare systems and regulations. It also fails to recognize the importance of managing information in a new environment of dispersed records and the increased need for management of data integrity, completeness, uniformity, security, confidentiality, and analysis within an array of technologies, terminologies, and classifications. This is the role of today’s HIM professional. Without an adequate HIM workforce, HIT adoption, implementation, and use will not achieve the return on investment and goals envisioned for the 21st century.

Notes

¹ Hecker, D. E. “Occupational Employment Projections to 2016.” Monthly Labor Review, November 2007.
² AHIMA and AMIA. “Building the Work Force for Health Information Transformation.” Available at www.ahima.org.

AHIMA is the premier association of health information management (HIM) professionals. AHIMA's more than 53,000 members are dedicated to the effective management of personal health information needed to deliver quality healthcare to the public. Founded in 1928 to improve the quality of medical records, AHIMA is committed to advancing the HIM profession in an increasingly electronic and global environment through leadership in advocacy, education, certification, and lifelong learning.

www.ahima.org