"It's great to be cross-training and cross-learning to absorb and understand as much as you can for your customers and the patients." -Kristin Hagen, CPHIT, CPEHR, CPHIE, AHDI-F

She's certified in health information technology (HIT), electronic health records (EHRs) and health information exchange (HIE)--plus billing and coding. It seems unusual for the CEO of a medical transcription service organization (MTSO), but Kristin Hagen finds it a perfect mix.

"It gives me a great base for what I do--of being able to understand the minutiae of HIT on up to a larger picture of HIE, and everything in between," she said. "As my role evolves, I want to be able to overcome some of the dynamics of HIT, yet still work with the customer."

Hagen's career has been a constant mark of evolution. She began as an emergency medical technician, then sought IT experience in the marketing department of a microchip company. In 2002, she began taking transcription classes in hopes of landing a career that would be portable while still providing for her family. After spending a year at an MTSO, Hagen learned of an opportunity to launch her own transcription business, with accounts at a local surgery center. A Line Above LLC was up and running in 2 weeks. "I grew up with my family owning a business, so I knew what that would look like and what time commitments it would take," Hagen said.

Starting as a one-woman enterprise, the business took off, doubling in clients each year for the past 5 years. To meet the demand, Hagen outsourced the transcription and performed quality assurance (QA) reviews on the completed work. Now, with a full transcription and QA staff--to which she attributes much of the business' success--Hagen has taken on a supervisory role and has turned her attention to making the process more technology-friendly. "Overall, I'd say [I do] everything from project development to implementation coordination to marketing," she said. "It really seems to be a blended, hybrid role of being able to work in operations...but really being out there in the industry as well."

Hagen's always looking to improve service, and that's where her transcription and technology backgrounds combine. When she notices a need at a facility, she'll contact her software provider to suggest a new feature; some of those ideas prompted system-wide changes. "It's been great to know your feedback is being listened to--for the customer and the transcriptionist using it, the QAs, the admins logging into the system and the support system on the back end," she said.

Hagen has her own ideas about client needs, but she also takes cues from national associations, like the Association for Healthcare Documentation Integrity (AHDI), Medical Transcription Industry Association, American Health Information Management Association and Healthcare Information and Management Systems Society. "I worked the grassroots, but then I would evaluate the national vision and initiatives, and then go back to the local level," she said.

A member of AHDI since 2002, Hagen said she was "floating along" as a casual member until 2007, when the conference theme "Change is Everything" struck a chord. "I thought, 'I better find out what's going on and make sure I'm fitting those roles,'" she recalled.

After that conference, Hagen teamed up with the Utah state chapter to launch a joint Utah-Idaho regional association of AHDI and earned her fellowship designation. She also joined several committees; co-chaired the AHDI HIT/patient safety group that sent recommendations to the Certification Commission for HIT; and contributed to the Health Story Project, where she flexed her technical muscles. In 2009, she joined the AHDI board of directors. "It was a busy year, but I'm glad I've learned what I've learned," Hagen said.

Even with those accomplishments, Hagen continues to evolve. She's studying HIT/project management through Kaplan University, and she advised others to explore similar opportunities. "It's great to be cross-training and cross-learning to absorb and understand as much as you can for your customers and the patients," she said.

Hagen looks forward to another year on the AHDI board and hopes to contribute more to professional associations at the local and national levels, especially as meaningful use and EHR incentives take hold. "This whole thing is meant to be," she said, "and I think I'm on a new journey now the way health care has changed."

Cheryl McEvoy is an assistant editor with ADVANCE.

"Bridging the Gap"
A proponent of speech recognition and EHRs, Hagen explained what MTs should do now to keep their skills in demand, and why it helps to bring personal experiences to the table. Listen to the audiocast below.