Kathleen M. LaTour, MA, RHIA, FAHIMA
Historical Context of the HIM Profession in the US
The first baccalaureate program in health information management (originally called medical record science) in the US was established at The College of St. Scholastica in Duluth, MN in 1934. The College has continuously offered a bachelor's degree program in medical record science/health information management since that time. From 1934 until 1951, health information management education in the US was delivered exclusively at the baccalaureate degree level. Graduates of bachelor's programs were and are eligible to sit for the national registration examination to become credentialed as Registered Health Information Administrators (RHIA). The focus of bachelor level programs is on operations management, clinical data management, clinical quality improvement, and systems development.
Throughout the mid-part of the 20th century, the need for HIM professionals grew, especially in the area of coding, and the need for a technical level in the field became evident. Associate degree programs in health information management were established in community and technical colleges and the American Medical Record Association (now AHIMA) established a correspondence course which later transitioned to an accredited independent study program. Graduates of associate degree programs and the independent study program were and are eligible to sit for the national examination to become credentialed as a Registered Health Information Technician (RHIT). The focus of associate level programs is on supervisory management and technical skills such as coding, release of information, and information processing.
Development of Distance Learning Model for HIM Education at The College of St. Scholastica
In 1981, in response to a documented need in the HIM profession, The College of St. Scholastica developed a degree completion program for associate-degreed RHITs to progress to a bachelor's degree in HIM. Originally the program was a summer-based, intensive program in which RHITs traveled to Minnesota from around the nation and spent three weeks in advanced HIM courses. In the summer-based model, the program took four years to complete. The Progression Program was designed to bridge the gap between associate and baccalaureate level HIM education. The development of educational technology in the late 1990s made it possible to re-design the program to allow completion of coursework via distance learning, and an online model of the program was developed. The new model for the program combines two one-week intensive on-site sessions--one introductory and one capstone--with online courses and professional practice placement, and it allows completion in as little as two years. The RHIT to RHIA Progression Program serves a national audience since it requires only two one-week, intensive on-campus sessions with all other coursework completed via online courses and arranged internship placements. Students who complete the Bachelor of Arts in HIM via the Progression Program are eligible to sit for the national registration examination to become an RHIA.
Development of a Master of Arts in HIM program at The College of St. Scholastica
As the millennium approached, HIM education remained grounded in associate and bachelor's level programs. However, several factors pointed to the need for a master's level HIM education including the growing complexity of the healthcare industry, the development of sophisticated technology that has been increasingly applied to management of health information, the development of new and challenging job settings for HIM professionals, and both federal and industry pressure to develop electronic health records in healthcare facilities in the US. These changes supported the need for graduate education in health information management. HIM professionals historically focused on information in paper-based form and are now engaged within the computer-based world of healthcare to support the entire spectrum of healthcare information users. While a few master's programs in HIM and in the emerging field of healthcare informatics had been established, there were relatively few programs and most were not geographically accessible to the population of HIM professionals or other adult learners. The need for a distance learning graduate program seemed clear and compelling, and The College of St. Scholastica committed resources to developing a distance-based Master of Arts in Health Information Management.
In 1997, St. Scholastica developed the curriculum for a Master of Arts in Health Information Management program that is designed to prepare health information management professionals for leadership positions in the healthcare delivery system. The format and delivery of the Master of Arts program was designed to replicate the successful Progression Program
The Master of Arts in HIM is focused on ensuring the integrity of information resources and the confidentiality of that information. The program prepares professionals to team with technology professionals and collaborate with physicians, nurses, clinicians, and administrators in developing data collection, analysis, and reporting systems. The program prepares HIM professionals for leadership positions and focuses on preparing professionals who work throughout a healthcare enterprise rather than within the confines of a health information management department.
The graduate program at The College of St. Scholastica is structured to facilitate career advancement of practicing HIM professionals, but it also serves many career-changers who see the HIM profession as a growing and thriving area of the healthcare delivery system. The program emphasized quality healthcare data as the foundation for organizational information and knowledge management systems.
The Graduate Curriculum
The curriculum focuses on emerging frameworks for creating integrated healthcare information, data management, and decision support systems. It is specifically designed to prepare professionals to use technology to accomplish organizational objectives and to thrive in a technology-supported and information-driven healthcare environment. The graduate program prepares HIM professionals for responsibilities in areas such as healthcare data resources administration, healthcare data security oversight, strategic and operational information resources planning, clinical data analysis, and information systems development and implementation.
Specifically, the program outcomes state that graduates of the Master of Arts in Health Information Management will be able to:
- Apply advanced knowledge and skills in healthcare data and information management
- Evaluate, select, and implement information technologies to manage healthcare data resources
- Leverage healthcare information technologies to drive integrated clinical and administrative decision making, strategic planning, and outcomes management
- Take a leadership role in establishing an organizational culture that embraces the ethical use of confidential information and information technologies
- Apply effective communication skills and strategies in interactions with multidisciplinary and multifacility professionals
- Assume increasingly challenging leadership and administrative positions in complex provider organizations and related entities in the healthcare arena
- Thrive professionally in a practice environment that is undergoing fundamental change
In December 2001, the Master of Arts in Health Information Management became the first graduate program in the nation to be approved by the American Health Information Management Association (AHIMA), which means that graduates of the program may sit for the national registration examination to become credentialed as an RHIA.
The program is a 36-semester credit program that is offered in a distance learning format that allows professionals to maintain their current employment status while enhancing their knowledge and skills. The program can be completed in two years with two to three courses per semester and two one-week on-site intensive sessions that are offered either on the main campus in Duluth, MN, or in selected other cities. All courses in the program are two semester credits and include those in the outline below.
On-site Intensive Courses
Development of Computerized Health Information Systems (initial session)
Database Methods for Clinical Information Management (initial session)
Strategic Management (capstone session)
Healthcare Data Mining (capstone session)
Graduate Seminar (capstone session)
Required Online Courses
Technology Applications in Healthcare
Health Information Networks and Standards
Organizational Behavior
Process Redesign and Project Management
Medical Vocabularies and Classification Systems
Assessing Clinical Outcomes/Outcomes Research
Expert/Decision Support Systems
Health Information Security Systems
Final Applied Project (research) Component Courses
Applied Project Research and Writing
Applied Project Proposal and Literature Review
Final Applied Project
Elective Online Courses
Students must take two of three courses, or transfer electives will be accepted in lieu of one or more of these courses.
Statistical Analysis in Health Systems
Financial Management
Program Evaluation
Because the program is offered in a distance learning format and faculty do not have to be located on the main campus, the College has used Distinguished Visiting Professors to teach several courses in the graduate curriculum. Nationally recognized experts in the content areas teach specialized courses and bring state-of-the-art knowledge, skills, and experiences as resources in the courses. Most have been with the program since its inception in 1997 and are very loyal to the program. The integration of Visiting Professors and full-time faculty has been an asset and a hallmark of the program.
The platform used for the online courses is WebCT, a vendor-based educational technology product that is provided to the College through a lease agreement. Students log onto The College of St. Scholastica Web site and click into WebCT. The connection to WebCT is made through an interface with the College's Web page so the student does not have to log into WebCT.
Development of Healthcare Informatics Certificates
As the application of information technologies grew dramatically in the US healthcare industry, the need grew for health information professionals with skills in application of that technology to clinical and administrative systems. At the same time, the concept of informatics was developed and took hold in the healthcare industry. Informatics is the application of computers to generate, validate, secure, and integrate data. The growth of healthcare-related informatics as an academic discipline is a reflection of the integration of sophisticated computer-based applications within the healthcare industry. These applications have grown within specific health disciplines giving rise to medical informatics, nursing informatics, clinical informatics, etc.
To meet industry demands for healthcare informatics professionals and to provide a pathway for existing professionals to enhance their skills, The College of St. Scholastica developed several informatics certificate programs. The healthcare informatics certificates are comprised of subsets (4 to 16 credits) of existing HIM graduate courses that lead to a certificate but not to a master's degree. For healthcare professionals who already have a degree, the certificates offer a means of focusing educational efforts on specific coursework. For those considering a master's degree, the certificate programs provide a stepping stone to a full degree, since most of the coursework in the certificates apply to the master's program. Certificates are currently offered in:
- Healthcare Informatics
- Healthcare Data Privacy and Security Management
- Nursing Informatics
- Project Management
- Electronic Health Record (EHR) Implementation
Enrollment Trends
The Master of Arts in HIM program began in the summer of 1997 with enrollment of 18 students all of whom held bachelor's degrees in health information management. As of 2004, 103 students have been admitted to the master's program and an additional 20 students have enrolled in one of the graduate-level healthcare informatics certificate programs. The enrollment numbers have increased steadily over the past four years, and the educational backgrounds of the students have become increasingly diverse including HIM professionals, nurses, IT professionals, physicians, and others. In the summer of 2004, a cohort group was started at the College's campus in St. Paul, MN; in fall 2004 a cohort will begin the graduate program in Dallas, TX, and in spring 2005 another cohort will begin in southern California.
Since the Master of Arts in HIM is approved by AHIMA for graduates to sit for the national registration examination to become an RHIA, the program has appeal for career-changers with bachelor's or even master's degrees who want to become credentialed as Registered Health Information Administrators.
Summary
The administration of The College of St. Scholastica has identified the Department of Healthcare Informatics and Information Management as a target area for institutional support for growth and development, and strategic initiatives are in place to support further growth of this department especially in the distance learning programs. Graduates of the program report increased professional opportunities, advancement within their organizations or in new ventures, improved salaries, and increased professional recognition as a result of earning a master's degree. Finally, the program has provided a viable route to the national exam for healthcare professionals who want to become credentialed HIM professionals.
| Source: 2004 IFHRO Congress & AHIMA Convention Proceedings, October 2004 |