Health Information Management (HIM) and Health - IT (HIT) Workforce Issues|
By: Brian P. Foley, M.Ed., MHA, CPHQ, FACHE
On Oct 6, 2009 at the 81st annual American Health Information Management Association (AHIMA) convention in Grapevine, Texas, David Blumenthal, MD the National Coordinator for Health Information Technology stated: “At least 50,000 new health information management jobs will be needed as the nation moves from a paper to a digital healthcare system”
- HIM professionals are expected to be in high demand as the health sector expands into the next century.
- The Bureau of Labor Statistics cites health information technology as one of the fastest growing occupations in the US.
The Purpose of this briefing is to inform you about:
- HIM Career Field
- The Difference Between HIM and Health-IT
- The HIM Professionals
- The American Recovery and Reinvestment Act
- NoVaHealthFORCE initiatives to address the HIM and Health- IT Workforce Shortages in Northern Virginia
- HIM Center of Excellence
- HIM Opportunity for Military Spouses and the Department of Defense (DoD)
The Health Information Management (HIM) Career Field: http://himcareers.ahima.org/
David Blumenthal, MD stated at the AHIMA Convention on Oct 6, 2009: “health information is the life blood of healthcare and that HIM is the arteries”.
Health information management is the study of the principles and practices of acquiring, analyzing, and protecting digital and traditional medical information vital to providing quality patient care. HIM is the link to clinicians, technology designers, and information technology; it is the value-adding bridge between patients’ health information and payers, government, and regulating agencies. HIM practitioners demonstrate leadership and management of health information in all formats (paper, scanned, or computerized forms), and are a critical component of the electronic health record (EHR) workforce.
HIM Professional Domains:
- Data content, structure, and standards
- Privacy, confidentiality, and security management
- Electronic health record life cycle
- Data administration and analytics
- Personal health information management
- Reimbursement, regulatory compliance and fraud surveillance
- Organization and management
HIM is a profession that:
- Is a value-added “bridge” between clinicians, payers, regulators, patients/consumers and technology (EHRs, PHRs)
- An “Adventure in the Middle” between the clinicians and Health-IT
- A “synthesis” profession
- The “glue” that holds the healthcare delivery system together
- Has critical skills and competencies essential to build the nationwide health information network (NHIN, HIEs)
- Established educational, accreditation and credentialing processes
The difference between HIM and Health-IT (HIT):
Health Information Management (HIM) is an allied health profession that is responsible for ensuring the availability, accuracy, and protection of the clinical information that is needed to deliver healthcare services and to make appropriate healthcare-related decisions
Health-IT (HIT) are the professionals responsible for the computer technology (hardware and software) combined with telecommunications technology (data, image, and voice networks); often used interchangeably with the term information system (IS). IS refers to the automated systems that use computer hardware and software to record, manipulate, store, recover, and disseminate data (that is, a system that receives and processes input and provides output)
As healthcare organizations implement EHR systems, Pharmacy systems etc., new skills and training will be required for the traditional IT workers (i.e. HIPAA)
The HIM Professionals:
Registered Health Information Technician (RHIT): Pass the AHIMA RHIT certification exam. Professionals holding the RHIT credential are health information technicians who ensure the quality of medical records by verifying their completeness, accuracy, and proper entry into computer systems. They may also use computer applications to assemble and analyze patient data to improve patient care or control costs. RHITs often specialize in coding diagnoses and procedures in patient records for reimbursement and research. With experience, the RHIT credential holds solid potential for advancement to management positions, especially when combined with a bachelor's degree. Education: Associate Degree
Registered Health Information Administrator (RHIA): Pass the RHIA certification exam. Function as the critical link between care providers, payers, and patients; the RHIA is an expert in managing patient health information and medical records, administering computer information systems, collecting and analyzing patient data, and using classification systems and medical terminologies. RHIAs possess comprehensive knowledge of medical, administrative, ethical and legal requirements and standards related to healthcare delivery and the privacy of protected patient information. They often manage people and operational units, participate in administrative committees, and prepare budgets. Education: Bachelor’s or Master’s Degree
Clinical Coding (CCA, CCS, and CC-P): Are professionals skilled in classifying medical data from patient records. These coding practitioners review patients' records and assign numeric codes for each diagnosis and procedure. To perform this task, they must possess expertise in the ICD-9-CM (February 2013: ICD- 10-CM will be required) coding system. The Clinical Coder is knowledgeable of medical terminology, disease processes, and pharmacology. Education: RHIA, RHIT or Certified Coder
The American Recovery and Reinvestment Act:
The American Recovery and Reinvestment Act (ARRA Public Law 111-5) was signed on February 17, 2009 by President Obama. The ARRA incorporated the Health Information Technology for Economic and Clinical Health (HITECH) Act that provides $19.2 billion in support of furthering the Nation’s adoption of health IT.
- Incentives for adoption of EHRs
- Support for Health Information Exchanges (HIE)
- New privacy regulations (Subpart D of XIII) for both HIPAA and non-HIPAA entities
- HIM workforce training opportunities
Specifically the HITECH ACT addresses the following HIM workforce initiatives:
- Developing and revising curricula
- Student recruitment and retention
- Acquiring necessary equipment for student instruction including installation of test bed networks
- Establishing or enhancing bridge programs in health informatics programs between community colleges and universities.
- Priority should be given to existing education and training programs and programs designed to be completed in less than six months.
HHS’s National Coordinator for Health Information Technology, David Blumenthal, MD, recently announced plans to make available $80 million in grants to help develop and strengthen the health information technology workforce.
The grants that will be made available include $70 million for community college training programs and $10 million to develop educational materials to support these programs. Both programs will support the immediate need for skilled HIM and health information technology (Health IT) professionals who will enable the broad adoption and use of health IT throughout the United States.
Community College Consortia to Educate Health Information Technology Professionals:
Health Care program seeks to rapidly create HIM/HIT academic programs at Community Colleges (as defined by the 1965 Higher Education Act) or expand existing ones. Each student with appropriate prerequisite training and experience will be able to complete intensive training in one of six roles within six months or less. Roles include: Practice workflow and information management redesign specialists; Clinician/practitioner consultants; Implementation support specialists; Implementation managers; Technical/software support staff; and, Trainers. Academic programs may be offered through traditional on-campus instruction or distance learning modalities, or combinations thereof. This program is critical to achieving the goal of HITECH and supporting the work of the regional centers.
It is expected that by the end of the two-year project period, collectively all of the Community Colleges participating in the program will have established training programs with the capacity to train at least 10,500 students annually to be part of the HIM/HIT workforce.
Healthcare IT Regional Centers:
- The government has allocated $70 million to start 70 regional centers (at least one per state), patterned after the cooperative extension centers developed to provide farmers with agricultural research and advice.
- The healthcare IT regional centers would provide physicians and other healthcare providers with help on the EHR front – not only with selection and implementation, but also with help using the systems.
NoVaHealthFORCE initiatives’ to address the HIM and Health - IT Workforce Shortages in Northern Virginia:
NoVaHealthFORCE (www.NoVaHealthFORCE.org ) is a coalition of private sector, business, government, community, healthcare, and educational leaders whose mission is to establish a long-term, business-driven, sustainable strategy to address the Northern Virginia healthcare worker shortage
NoVAHealthFORCE developed three primary goals and supporting strategies in 2005 http://www.novahealthforce.com/solutions/index.html to address the healthcare workforce shortage in Northern Virginia:
Goal 1: Increase capacity within the healthcare education and training system
Goal 2: Develop and sustain an ongoing supply of persons interested in entering healthcare career fields
Goal 3: Nurture Innovation
The Nurture Innovation Goal addresses:
The following actions to address the HIM and Health-IT workforce shortage were approved at the November 16th 2009 NoVaHealthFORCE CEO Roundtable consisting of the Presidents and CEO’s of George Mason University, Marymount University, Northern Virginia Community College, Old Dominion University, Shenandoah University, Inova Health System, Virginia Hospital Center, Reston Hospital Corporation of America, Prince William Health System, Potomac Hospital and the Kaiser Foundation Health Plan of the Mid-Atlantic States:
- Convene a meeting of the CIO’s, HIM Directors and HIM/IT educators in the region to
– Develop an Action Plan
– Create a HIM/Health-IT Steering Committee
– Determine the increased demand for HIM and HIT workers in the region
- Determine the specific healthcare industry training requirements for the regions’ IT programs
Align the HIM and IT education programs in the region to enhance:
– Career ladders/lattices
– Articulation Agreements
Educate students, guidance counselors and parents about the career opportunities in HIM/Health-ITIT
HIM Center of Excellence:
Northern Virginia Community College (NOVA) www.nvcc.edu is establishing a HIM Center of Excellence to function as the focal point for coordinating and developing the HIM and Health-IT workforce in Metropolitan Washington DC Region. The vision of the HIM Center of Excellence is to become a national model for HIM and Health-IT. The HIM Center of Excellence will be lead by the Edward H. and Marilynn Bersoff Endowed Chair in Health Information Management and Health-IT.
The HIM Center of Excellence will be supported by the HIM Program http://www.nvcc.edu/campuses-and-centers/medical/academic-divisions/allied-health/health-info-tech-management.html and the Workforce Development and Continuing Education Office
www.nvcc.edu/wdce/mec of the Medical Education Campus www.nvcc.edu/medical
HIM Opportunity for Military Spouses and the Department of Defense (DoD):
The Department of Defense (DoD) Military Spouse Career Advancement Accounts (MyCAA) program provides up to $6,000 of Financial Assistance for military spouses who are pursuing degree programs, licenses or credentials leading to employment in Portable Career Fields:
The MyCAA program coupled with the civil service hiring preference for military spouses is an excellent opportunity for the DoD and other Federal Agencies to meet their HIM and Health-IT workforce needs worldwide. This also provides military spouses the opportunity for the continuity of a civil service career, in spite of numerous moves, as they are transferred with their active duty spouse from one post/base to another in the continental United States and overseas.
In order to meet this great demand for HIM and Health- IT workers the region must:
- Improve career ladders that meet the needs of students and industry
- Increase continuing education for incumbent workers
- Blend, create and encourage academic pathways from Certificate to Associate to Bachelors to Masters level
The key to success will be the synergy created by the alignment of all stakeholders:
- High Schools
- Community Institutions
- Local Government
- Healthcare Institutions
- Economic Development Authorities/ WIBs
• ARRA: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f%3Ah1enr.txt.pdf
• NoVaHealthFORCE: www.NoVaHealthFORCE.org
• American Health Information Association (AHIMA): www.ahima.org
• Health Information Careers: http://himcareers.ahima.org/
• Building the Work Force for Health Information Transformation:
• Health Information Management and Informatics Core Competencies for Individuals Working with Electronic Health Records
• e-him: http://www.ahima.org/e-him/
• NOVA HIM Program http://www.nvcc.edu/campuses-and-centers/medical/academic-divisions/allied-health/health-info-tech-management.html
• MyCAA: http://www.militaryonesource.com/MOS/FindInformation/Category/MilitarySpouseCareerAdvancementAccounts.aspx
• Community College Consortia to Educate Health Information Technology Professionals in Health Care Program: