Back to School: Advanced Degrees High on HIM Professionals' Education Lists

by Ruth Carol

Changing practice and new opportunities are sending HIM professionals back to school in degree-granting programs. The benefits begin immediately.

They do it to meet the demands of a changing workplace, move up the management ladder, or pursue new avenues in the field. Some do it for personal satisfaction. But whatever the reason, it’s clear that many HIM professionals are returning to school in pursuit of a formal degree.

By far, the biggest change sending 20-year HIM veterans back to school is the advent of electronic health records (EHRs), leading them to seek increased systems management knowledge. They need to broaden their personnel management skills to oversee a work force that is working remotely. And they have to stay current with complex compliance regulations and emerging coding and classification issues, such as ICD-10. Once in school, many say the benefits begin quickly, with knowledge that can be put to work at once.

Why Go Back?

Kelly Ferrell, RHIA, LHRM, is risk manager and HIPAA privacy officer for Orange County Corrections in Orlando, FL. When she began pursuing her master’s degree, the facility was planning to implement an EHR system. Ferrell, who was the HIM manager at the time, wanted to boost her HIM knowledge with advanced education, especially in technical subjects. She found the technology and computer courses particularly insightful. “They provoked a lot of questions and considerations that I don’t think we would have addressed otherwise,” she says.

Janet Henderson, MHIS, RHIA, assistant director of HIM at the University of California at Irvine Medical Center, hopes the master’s degree in health information services she received last December will do the same for her as the 380-bed facility rolls out its EHR in 2009. In fact, she pursued this degree over a master’s in healthcare administration, which she felt focused too much on management and human resource issues, removing her from changes occurring in the HIM field, such as the increasing importance of information systems.

Henderson believes that having the advanced degree is advantageous for growth opportunities at the medical center. She also believes it could be helpful in getting involved at some level with the California regional health information organization.

As HIM consultant for the Evangelical Lutheran Good Samaritan Society in Sioux Falls, SD, Jennifer Sundby, RHIA, wants to contribute to the planning and implementation of the EHR system. The society is deciding whether to buy an off-the-shelf EHR or build its own system to serve 240 primarily long-term care facilities located in 24 states.

“With so much happening at the national level with regard to setting standards, there are many things organizations need to be aware of,” says Sundby, who expects to obtain her master’s this December. The process is compounded by the fact that the facilities are in different states with varying regulations; it is difficult to get one product that will meet all of the facilities’ needs.

In addition to following the electronic wave of the future, some HIM professionals have chosen the educational route to advance in the workplace.

When Richmond, Indiana-based Reid Hospital and Health Care Services offered an 18-month coding course, Jennifer Smith, CCS, ambulatory payment classification (APC) coordinator and chargemaster specialist, took advantage of the offer and was hired as a coder. After a year of coding, she became certified. Now she is pursuing an associate’s degree, which she expects to complete this December, and plans to sit for her RHIT certification shortly thereafter.

In the meantime, the role of APC coordinator evolved due to the complexity of the payment systems and the facility’s drive to obtain optimal reimbursement. She was promoted to the position with the understanding that she finish her formal education and receive the additional credentials.

Daniel Behan is southeast district manager for Elsevier Health Sciences in New York. He is pursuing a bachelor’s degree to gain a better understanding of how health information is integrated into health systems. He expects the knowledge will help him make the material more accessible to practitioners, who are the medical publisher’s client base. “Long term, I want to be more involved in product development and project management,” says Behan, who expects to receive his degree in spring 2007. He plans to seek RHIA certification after graduating.

For those teaching HIM, credentials and advanced degrees can make a difference in career options. Stephanie Hackett, MS, RHIA, is a graduate student assistant and clinical education coordinator for the University of Pittsburgh in Pennsylvania. She says that getting a PhD will help advance her teaching career, as well as launch a research career. After obtaining her doctorate this December, Hackett would like to continue teaching part-time and pursue a research career focusing on information systems and technology issues.

Learning Lifelong

Sometimes a combination of job satisfaction and personal satisfaction serves as the impetus for obtaining an advanced degree. Kimberly Rice, RHIA, part-time instructor at Southwestern Community College in Sylva, NC, knew before she graduated with her bachelor’s degree that she would eventually get a master’s. Nearly finished with her master’s degree, Rice is already planning to pursue a PhD. Although she started her career by performing HIM responsibilities as assistant director of medical records, she switched to teaching them five years ago. Still, she wants to gain further mastery in HIM and update skill sets she obtained with her previous degrees.

After 26 years in the HIM field, Ann Rees, RHIA, CCS, assistant director of HIM at Banner Baywood Medical Center in Mesa, AZ, began pursuing a master’s degree in 2005 to ensure that she stays current in all aspects of HIM. “I wanted to make sure I was on top of my game,” she says.

For many HIM professionals, staying on top of their game means investing their time, energy, and money to return to school, because some knowledge can’t be taught on the job or in continuing education classes. They say that there is no time in the day for on-the-job training and that continuing education classes couldn’t incorporate all of the information that needs to be relayed.

Additionally, formal education offers networking opportunities the other options don’t. Networking allows Sundby to follow the trends in other healthcare settings as the long-term care arena begins to move forward with health IT. It also helps her learn about regional health information organizations being formed across the country.

Returning to school is made much easier by the increase in online education. Many HIM professionals who work full time and go to school part time take the majority of their classes over the Internet. Behan has had a great experience getting his degree this way. He notes that online courses can require extra motivation and discipline, and it’s essential to learn to incorporate school workload into daily workflow.

Studies Pay off on the Job

Many returning students find that their education enhances knowledge and skills that can immediately be put to use in their workplaces. Some credit the gains of increased generalized knowledge, such as a better understanding of the technological issues that affect HIM.

Understanding more about other disciplines and getting the bigger picture can help in day-to-day situations at work. As Rees put it, “I talk HIM language; IT people talk IT language. We’re saying what we need. They’re saying what they have. You have to be able to understand and interpret that.” Others, like Smith, point to diverse classes that helped enhance different skill sets. For example, statistics classes helped Smith improve her ability to produce reports, perform revenue cycle management tasks, and conduct chart audits. Classes focusing on communication and technical writing skills enhanced her ability to give presentations and conduct meetings.

When Hackett was working full time in a hospital IS department and attending school part time for her master’s, she learned about the technology that she was implementing in the hospital. When she was pursuing her master’s degree full time and teaching part time, she was able to pass along the knowledge she learned in class to her students. “My teaching and learning very much complemented each other,” she says.

Similarly, when Rice was going to school and working at the state agency, she learned about EHR implementation at the same time she was implementing a system at the facility. Now she’s learning about various EHR systems and the different settings in which they’re used and relaying this cutting-edge information to her students. Rice says her students are energized by the knowledge because it doesn’t represent pie-in-the-sky concepts that won’t happen for years. “They’re learning about a technology, and six months later we have a facility in the area that is implementing it,” she says.

In lieu of developing a personal Web site as a class project, Henderson developed a site for her department to post on the medical center’s intranet. The site, which is still in use today, offers basic information about the department, such as its policies, hours, contacts, and location.

For her master’s applied project, Sundby received a grant from the Department of Labor to conduct a pilot study within her organization offering Web-based training for HIM staff who lacked a formal education. The course, which addresses ICD codes and medical terminology, was offered free of charge to several staff members throughout the country. Sundby, who in her role as consultant is largely responsible for employee training, is hopeful that her organization will support its ongoing use and make the course part of the society’s HIM learning path. “We hope that the course will give them a foundation, decrease turnover, and increase professionalism within the organization,” she says.

For one of his project management courses, Behan had to evaluate employee efficiency. That assignment helped him better evaluate how the eight publisher sales representatives he manages spend their time. “It has helped me to manage projects for work…to evaluate goals and outcomes, and set a timeline,” he says.

For the Future: “Preferred” or “Required”?

Degrees that provide benefits in work situations today increasingly may be mandatory in the future as more and more employers continue to seek bachelor’s and master’s degree “preferred” or “required” candidates.

In the past, a facility would hire an individual with an associate degree or RHIT credential, says Rice. But in the future, she believes these same individuals will need a bachelor’s degree. The growing academic expectation doesn’t stop there, she predicts. As healthcare organizations continue to merge, “facilities are looking for individuals with a higher-level skill set to be able to manage multiple service lines, departments, or facilities. You have to be able to look at the big picture instead of the day-to-day operational issues,” Rice says.

Rees concurs. “At our facility you must have at least a bachelor’s degree to become a director or administrator, and we prefer a master’s. The more requirements and regulations the facility has, the more responsibilities placed on the HIM professionals and the greater the need for a higher education,” she says.

In fact, Rees hires only credentialed coders. “The financial well-being of the facility is basically in the hands of the coders. You want to make sure they have the education and credentials to back them, so they know the coding conventions and guidelines,” she says. The same goes for keeping compliant with various regulations. “People can be taught some aspects [of compliance issues] on the job, but when you have the educational background, you understand the implications of why your facility must be compliant,” says Rees, who also teaches HIM and advanced coding at a local community college.

Whether just getting started in their career or entering the next decade of it, for many HIM professionals advanced degrees will play a pivotal role in their future. Rice, for one, is thrilled to see a growing number of individuals returning to school in their 40s and 50s. “It’s not uncommon to hear a student say that he or she has been in the field for 20 years,” she says. Having those veterans return to school has a positive impact on their younger counterparts, who are motivated to ask what skills they need for the future in this rapidly evolving field, observes Rice. “HIM professionals are seeing the value of a formal education,” she says. “They understand that to move forward they have to move up, and one way to do that is furthering their education.”

Ruth Carol (ruthcarol1@aol.com) is a Chicago-based freelance writer specializing in healthcare.