Vol. 12 Issue 12
Emerging Career Opportunities for the Future
(Editor's note: This is the second in a three-part series on career development. Part 1 ran in the April 15, 2002, issue, and Part 3 will be published in the July 22nd edition.)
As health information management (HIM) professionals, keeping current with continuing education opportunities and the latest rules and regulations renders a typical day on the job as hectic and sometimes overwhelming. It is difficult enough to even think beyond your next "To Do" list, let alone consider different career possibilities that are available and those emerging for the future. But here are several questions you may want to ask yourself– Does an average day in your job make you feel "replenished" or "depleted"? Are you enthusiastic about new assignments or are you finding it tedious to get through each day?
We all can feel overwhelmed by the volume of work before us, a hectic schedule of meetings or travel, projects that never seem completed, and certainly the pressures of productivity requirements, supervisory issues and motivating others around us. Changing jobs or career directions may not avoid or eliminate some of these issues, nor will experiencing just a plain "bad day." But, if you've examined the requirements stipulated by your current choice of job and performed a self-assessment as objectively as possible, to outline your abilities, preferences and limitations, and can identify real "disconnects" or what I would term "outlier career objectives" that remain unsatisfiedyou may want to explore some new career alternatives.
In 1996, the American Health Information Management Association (AHIMA) Board of Directors championed the "Vision 2006" initiative to redefine the roles and skills for future practice. By 1999, the seven roles of Vision 2006 were published.1 They reflected the changing American health care system, managed care, increasing technology supporting computer-based patient records (CPR), impending changes in reimbursement, intensified fraud and abuse surveillance, movement of treatment methodologies to the ambulatory sector, and the projection of a decreasing number of acute care hospitals in the United States. These roles included health information manager for integrated systems; clinical data specialist; patient information coordinator; data quality manager; information security manager; data resource administrator; and research and decision support specialist.
Just by their titles you can see those that have increased in visibility and recognition within the health care industry today– 2002–but it is also time to look to the horizon and project new roles for the future. To accomplish this on an official level, AHIMA is embarking on a national Workforce Research Study conducted in several phases with results to be released in 2004, in conjunction with the Center for Health Workforce Studies, SUNY at Albany. 2
Certainly the Health Insurance Portabil-ity and Accountability Act (HIPAA) has the potential to change our work processes, creating greater awareness and procedural changes to protect patient-identifiable information within the electronic data transaction world, as well as heighten awareness of everyone's responsibilities to protect confidentiality and privacy in paper and oral communications throughout our daily health care delivery system. Factors such as reimbursement requirements, an aging population taxing our existing health care services, genetics research, more technologies and pharmaceuticals, as well as the continual search to design an adequate, universal CPR system all impact our work lives as well as our choices.
Hone Your Skills
Health information professionals have a unique composite of knowledge, skills and abilities that can transfer to jobs based on health data or health information in a variety of sectors. Within health care delivery we can choose levels of care and specialtiesacute care, behavioral health, oncology, children's facilities, etc. We can work in various process positions in coding, transcription, registries, reimbursement or in various managerial roles. Surrounding the delivery of care are the various business processes and the vendor environment, as well as clinical research, pharmaceutical firms and governmental entities, including those that deliver health care and those that direct and regulate extending from local, state and national agencies.
Emerging roles for HIM professionals cross all of these boundaries, but determining where and how your particular skills fit presents the real challenge. Here are a few job titles to consider, and this is by no means a complete list.
Privacy and Compliance Officers
The release of HIPAA privacy requirements has expanded the role of information security manager to that of privacy officer with a focus on communication, policies, procedures and training of a health care organization's entire workforce. This is no small job and as we are seeing this role in its full dimensions, with the potential for governmental sanctions and liabilities, as well as a patient's civil rights, a core body of knowledge is also emerging. AHIMA and the Healthcare Information and Management Systems Society (HIMSS) are cooperatively presenting certification programs to reinforce the knowledge and training necessary to meet the position requirements.
Although the compliance officer is a fairly new role, it's recognized in the industry and several training programs and seminars are available to build one's knowledge and skills in this role. From the position descriptions currently available, both roles generally require a baccalaureate degree or master's level education, and in some organizations a law degree may be a prerequisite. What these new roles have provided is a wonderful opportunity to capitalize on a love of jurisprudence and to work with clinical information and its supporting processes and technologies that we know so well.
Clinical Documentation Coordinator
Building on this need, many health care organizations have evaluated the coding and reimbursement process, realizing that the underlying clinical documentation must be there and must be adequate to support appropriate reimbursement. An emerging role is the clinical documentation coordinator/specialist/educator, which suites the HIM professional very well. With a strong working knowledge of coding requirements, education grounded in medical science, coupled with excellent communication skills and a desire to educate and improve the documentation behavior of our clinical staffs, hospitals are beginning to recognize this as a fundamental position to bridge the communication gap and drive improved results. These positions work with inpatient and outpatient coding issues and have a routine presence where patient care is being delivered–on the patient floors, in the clinics, wherever educational opportunities can be incorporated in a reliable, resourceful manner.
To seek this role requires little more than the standard HIM education, but with ongoing knowledge of coding and reimbursement requirements, good organizational skills and creativity, coupled with a high skill level in presentation abilities and communication techniques to relate to physicians and other clinical staff in a positive, convincing manner. This role also interacts routinely with coders and creates the conduit to improving coding accuracy and documentation improvement.
Data Quality Manager
Opportunities continue to expand for the data quality manager as described in Vision 2006. Initially focused on the quality of coding and reimbursement, this exciting role embraces technology and the tools of data capture, statistical analyses, trending, surveillance and graphics to present data mining results, with the latest work in mapping various code sets such as ICD-9-CM to SNOMED and other systems. A data quality manager may be primarily exploring the requirements of standardized data elements and working with varied databases and data dictionaries within a health care organization, across an integrated delivery network or the challenge of data synthesis at a corporate level among several hospitals within a system. Today's modern hospital has more data than ever before, but most health care providers do not routinely have the time or inclination to sort through massive data sets. An HIM professional in such a role provides the communication link to know the operational issues in various service delivery areas, can work at an executive or corporate level to provide value-added surveillance and mine trending data to support operational and organizational efficiency, and can interface with information systems' staff to assure that connectivity measures are in place.
In addition to an HIM educational background, experience or training in standard statistical analysis, knowledge of computer applications and database management, plus in some cases an advanced degree at the master's level may be required.
If mentoring and teaching others is a natural talent, and breaking down a process or concept into incremental chunks to help a colleague or subordinate learn something new is a characteristic quality, then consider the great need within the HIM profession for educators at all levels. Traditional roles in colleges and universities are now moving into the realm of distance learning, and you may be surprised to find a teaching opportunity even though you don't live near the actual academic campus. Most of us don't enter the HIM profession to be an educator, and this is certainly not a new HIM role, but the need is great and the personal satisfaction is rewarding. Most educators try an adjunct role first to guest lecture or teach a single course to determine if that role is right for them.
Teaching is also characteristic of consulting roles and depending on the subject matter and audience, current expertise in coding, HIPAA, Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or other regulatory areas may provide just the right opportunity to satisfy this natural talent. Some positions require solid expertise, requisite certifications and excellent communication skills, while other opportunities within the academic realm require advanced degrees at the master's or doctoral level. It is not unusual to align with a college or university at an entry-level faculty position, and progress to advanced degrees within that organization while productively teaching new health care professionals or participate in research activities as you move along the academic route yourself.
Working for a Vendor
Working on the business side of health care delivery for a product or service vendor continues to be a growing option for many HIM professionals. The health care industry has realized the value of HIM professionals in a multitude of varied roles, including product design, product implementation, project and product management, marketing, sales, business development, product training, and various team leader or corporate management positions. Certainly the expanded roles of consultant and coder have all provided options for various "subject matter experts" who seek the challenge.
Being current in your knowledge and skills related to specific HIM areas, reliable, self-motivated and skilled in team management, leadership and communication abilities all support the continually growing opportunities in working for vendors. Some roles may require additional training and education, which may come from targeted seminars and certification programs, while other roles require an advanced degree.
An emerging role that is growing in momentum is the field of informatics. The realm of medical informatics has typically embraced physicians, engineers and others seeking improvements in the health information technology applications supporting clinical practice, natural language text processing and other aspects in the development of computer-based patient records. The field has grown since the early 1970s and today is expanding into health informatics, public health informatics and other dimensions. The expansion of focus takes into consideration the context of the systems and the operational areas in which they reside or support. Health informatics is a broader term that embraces HIM at the graduate level and often couples knowledge with research and systems integration across various levels of health care delivery, and to various categories of health care professionalsvisiting nurses, physical therapy services, etc. It explores technology and data standards for advanced systems design as well as the data management requirements.
The term "informatics" denotes a science and body of knowledge that is still expanding. Public health informatics focuses on the standards, technology and information needs of our public health system, both within the United States and internationally. The core of "informatics" in health care is organized, standardized health information. Positions in informatics typically require an advanced degree, but offer an opportunity to be on the cutting edge of new technological developments, the analytical side of health information or the challenge of involvement in research endeavors that may lead to breakthrough technologies or ideas for the future.
These are only a sampling of the emerging new roles for HIM professionals. The most important factor is that opportunities exist. Some may require a return to academia, but many new skills and certifications can be gained by a small investment in time and money to expand your knowledge base to embrace a new opportunity, a new work environment or an expanded career path. Some may merely require that you look around your community or within your current organization. Sometimes an emerging new role is right before you if you critically look at an old problem and give it a new viewpoint or approach. The spectrum of HIM professional roles continues to amaze us as we certainly have come a long way from our roots in 1928, with exciting prospects for the future.
To expedite our choices and opportunities for the future, one step everyone can take will be to participate in the AHIMA Workforce Study by completing the "Member Questionnaire," which will be circulated both by e-mail and post during this summer.
Fully understanding the challenges and responsibilities today will help your professional association develop tracks and training opportunities, as well as provide the much needed guidance our academic programs require to strengthen and grow curricula. The results, coupled with other surveys and the supporting data, can provide you with new workforce ideas to improve your career options and your future, as well as the next generation of HIM professionals in the decade ahead.
1. AHIMA, Evolving HIM Careers: Seven Roles for the Future Vision 2006, 1999, AHIMA Publications.
2. Wing, P. and Salsberg, E., "How Trends Shape The Work Force Today and Tomorrow", Journal of AHIMA, April 2002, 73/4, 38-45.
Claire Dixon-Lee is president of MC Strategies Inc., an adjunct assistant professor at the University of Illinois-Chicago, a past president of AHIMA and currently chairs AHIMA's Workforce Research Project Advisory Committee. She is also a member of ADVANCE's Editorial Advisory Board.