Business Etiquette’s Role in HIM Consulting and the Impact on Quality

By Daniel Land, RHIA, CCS

The subject of business etiquette, which has been described as a toolbox of skills necessary for professional success, has achieved prominence in today’s climate of value-based medicine and consumer-driven healthcare. Business etiquette in the healthcare industry goes well beyond the tropes of power suits and proper handshakes; it also encompasses how consultants, health information management (HIM) professionals, and clinicians interact with and impress their customers—who are often patients.

Healthcare leaders are aware of the impact satisfied patients have on the bottom line. “The focus on improving the [patient] experience is clearly everywhere,” says Jim Merlino, MD, president and chief medical officer at Press Ganey, who previously served as the Cleveland Clinic’s chief experience officer, in a recent Modern Healthcare article.1 “At the end of the day, it is about having better health outcomes and well-being for people,” says Joan Kelly, chief patient experience officer for NYU Langone Health System, based in New York City, NY.2

The foundational tenet of the HIM profession—ensuring complete and accurate clinical information for effective patient care and management of healthcare organizations—is central to quality initiatives. To that end, healthcare leadership has partnered with HIM professionals in the quest for enhanced patient satisfaction through quality outcomes. At times, organizations reach out to HIM consultants to help devise a strategy for improving quality outcomes through improved management of health information.

The current state of HIM consulting mirrors that of the healthcare industry in general: ever-broadening roles with dependence on strategic, sophisticated, out-of-the-box thinking for success. The effective HIM consultant relies upon business etiquette in their daily lives to build the relationships necessary to effectuate change for their clients. This article explores the role of business etiquette in the world of HIM consulting and its importance in the ever-changing healthcare landscape, as well as its direct impact on quality care outcomes.

Technical Expertise Not Enough

HIM consultants spend years acquiring and refining their knowledge with the goal of achieving the status of “expert” in their profession. Although technical expertise is essential, it is not the sole requirement for success. The consultant who utilizes business etiquette and finely-honed soft skills to solve problems has a distinct advantage and is the one who will most likely effectuate the greatest change for their clients. The success of a well-crafted message is greatly dependent upon its delivery; the whole effect of a message is lost if no one listens. This is also true with HIM consulting, and proper business etiquette helps ensure people do want to listen.

“X-factor” has been described as “a variable in a given situation that could have the most significant impact on the outcome” and “an indescribable quality that makes someone very special.” Consider your X-factor. Which unique qualities do you possess that allow you to make sustained contributions to healthcare? What aspects of your professional persona are most valued by your clients? Your X-factor is one of your most powerful professional tools, and your approach to business etiquette should highlight this quality.

Humans are creatures of habit and, therefore, introspection is a valuable tool for continued professional success. As we periodically evaluate our effectiveness, we may learn that a long-entrenched way of thinking or a particular communication style will no longer achieve the desired results. It takes courage to analyze one’s self but doing so empowers you to grow into the best version of yourself and make the greatest contribution. The following offers ways to self-audit your business etiquette and communication style to find opportunities for improvement.

Seek to Understand Before Seeking to be Understood

A consultant is the guest of a client and remains on an assignment at the client’s will. It is the job of the consultant to set the tone for an engagement and create an atmosphere of goodwill wherein great things can be achieved. The successful consultant first develops a true understanding of their client’s challenges, motivations, and goals. Only then can the consultant use their technical expertise to address the client’s needs.

Good communication is the foundation of a long and productive relationship with a client. HIM consultants must remember that verbal and written communication is a two-way street, one that involves listening and expressing—both components are equally important for a successful outcome. It is important to understand one’s audience and consider their professional background, level of expertise, and education in order to craft an effective message.

The art of listening—one of a consultant’s most important X-factors—includes the following concepts:

  • Listen: Not just to words but to tone as well.
  • Concentrate: Be fully present in the moment and concentrate on what the other person is saying; resist the temptation to allow your mind to wander to what you want to say next.
  • Reconfirm: Occasionally paraphrase the client’s words to demonstrate that you understand.
  • Wait: In conversation, patience is a virtue and interrupting is a sin. Be patient—some people take longer to get their point across than others.
  • Gratitude: Always show your appreciation by thanking the speaker for their time.

There are times when a consultant’s message will be met with resistance no matter how well-crafted it is. A message that is contrary to a client’s entrenched way of thinking can be hard to accept. In cases like this, it may be beneficial to pause and allow the client to think about your message. Offering the opportunity for the client to gather their thoughts and contemplate is a smart thing to do. Returning to a difficult conversation at a later time may promote better discussion and a deeper understanding of how to reach a common goal. Some people require more time than others to process new information.

HIM Business Etiquette “Do and Don’t” List

  • Set the client’s expectations appropriately—never overpromise and under-deliver.
  • Know when to pause. Offer the client the opportunity to contemplate your message, especially when dealing with a complex issue.
  • Pay careful attention to the fact that tone can be easily misconstrued in emails—carefully craft your messages.
  • Do not email when you are angry, irritated, or annoyed. No good will come of this.
  • Have the courage to admit that you don’t know everything. Clients respect the consultant who is willing to research the solution to a complex question.
  • Treat everyone with whom you interact as you would expect to be treated.

Interdependence of Communication and Quality

The paradigm shift to consumer-driven healthcare has created strong competition among providers for market share. Savvy consumers utilize an arsenal of publicly available data related to quality outcomes to make informed healthcare purchasing decisions. The trend of top-down commitment to quality has become the norm in healthcare institutions across the country, wherein all stakeholders are engaged in the quality conversation. Accurate and reliable data that support quality reporting is central to a healthy revenue cycle.

A dynamic relationship is created when clients and HIM consultants partner with the common goal of superb data quality, which directly influences patient outcomes, quality scores, and reimbursement. The wise HIM consultant understands that business etiquette is necessary for a healthy and effective long-term client partnership. The ability to build and maintain relationships is based on sophisticated listening skills, meaningful dialogue, creative problem-solving, and the ability to think globally.

Quality outcomes, which are co-produced by professionals who work interdependently across the healthcare continuum to achieve a common goal, are dependent on strong relationships. Although silos are less prevalent today, they are still very much a part of the healthcare landscape and communication among them can be uneven. HIM’s unique contribution to healthcare, which involves the integration and translation of information into a meaningful whole, affords HIM professionals the opportunity to communicate with a broad spectrum of healthcare professionals, often crossing silos in the process. The HIM consultant is afforded the unique opportunity to serve as an ambassador of the quality message to a diverse range of stakeholders.

For example, a current client of the author’s company—a large Level 1 trauma center—partnered with HIM consultants to work strategically with their C-suite to advance an initiative of clean patient data. The HIM consultant’s role began with a record review that identified patterns of provider documentation gaps and coding errors. The consultant worked closely with the clinical documentation improvement department to craft provider education on better documentation practices and worked with the HIM department to train the coding staff on better coding practices. The consultant’s message to all stakeholders included the fact that clean data directly influences patient care as well as the public’s perception of healthcare institutions. Business etiquette helped the consultants successfully navigate silos and convey the idea of interdependence to all stakeholders.

Proper Etiquette Helps a Message Get Heard

Refined business etiquette is a method of presenting one’s self in such a way that one’s message will be taken seriously, helping to secure a seat for HIM professionals at the table with key decision-makers in the healthcare industry. The HIM profession is rapidly changing, as evidenced by AHIMA’s 2017 white paper titled “HIM Reimagined: Transformation Starts with You.” As healthcare continues its rapid evolution, HIM professionals must push beyond their comfort zone and carefully examine ways of strategically blending their unique industry knowledge with new skills in order to remain relevant. HIM professionals must do everything possible to ensure that its message is heard at all levels of healthcare, thereby clearly defining the profession’s irreplaceable position in the quality healthcare equation.


  1. Whitman, Elizabeth. “When a Hospital Patient is also a Guest.” Modern Healthcare. May 13, 2017.
  2. Ibid.


AHIMA. “HIM Reimagined: Transformation Starts with You.” White paper. 2017.

Edmondson, Amy C. “The Kinds of Teams Health Care Needs.” Harvard Business Review. December 16, 2015.

Milne, Pamela E. The People Skills Revolution. United Kingdom: Global Professional Publishing, Ltd, 2011.

Post, Peter. The Etiquette Advantage in Business Third Edition. New York: HarperCollins, 2013.

Daniel Land ( is director of revenue integrity and compliance review services at MedPartners.