Lynn’s HIM Back-to-School Update

US medical groups' adoption of EHR (2005)

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Given the changes facing us in this field, graduates from modern HIM programs will be valuable additions to our HIM and HIT teams. I hope so – because (since I never finished the program I started many years ago for various reasons) I’m officially taking classes again now. And how FUN it is to take classes that are immediately relevant to what I do on the job every day. How often do we get to say that about classes we might take towards a particular degree program? I can tell you that I don’t use 85% of what I learned in my project management classes. And much of what I learned during the time when I thought I’d grow up to be an English teacher? Well, as much as I love him, let’s just say I’ve never been called upon to quote Yeats in my life.

I can tell you this for sure – I thought some of my coursework was going to be easy because I took the same or similar classes a long time ago. Well guess what – this is not your father’s HIM program. 🙂 I was originally annoyed that so many of my old classes had to be repeated. Now I am glad!

I honestly feel as though the majority of coursework I’ll be doing in my HIM program will be absolutely useful to me. My only concern is whether or not I can keep up with the – ahem – somewhat younger students. But I plan to give my two children – also college students – some competition for the best grades on the refrigerator in the Kosegi kitchen.

I’ll be interested to see how HIM education keeps pace with the changes coming to healthcare and particularly to health information. Everyone now is concerned about teaching ICD-10 instead of ICD-9. That’s a given. What will HIM personnel need to know about Meaningful Use? About measuring quality outcomes?

And of course we all know that for a number of years HIM will be living in a hybrid world consisting of both paper and electronic records and facilities that have reached varying stages of Meaningful Use compliance. We will also need to handle information that has been coded using ICD-9 along with information that has been coded using ICD-10. After all, even if we do effectively flip the switch and convert from ICD-9 to ICD-10 in one day, there is no magic “easy button” that will retroactively re-code the information that was coded yesterday.

I mentioned previously that something that concerns me a bit is that the HIM students I’ve talked to over the past few months don’t want to go to work for hospitals or other healthcare providers. They want to work for technology companies. The reason for this seems to be that the technology world is forward thinking and exciting whereas the HIM departments that they’re exposed to during their clinicals are backwards, resistant to change. The students I speak with see a lot of paper on these clinicals and a lot of backwards appearing processes. What I say however is that the reason these departments are engaging in seemingly backwards ways of doing things may not be that the users are resistant to new ways of thinking. It may be that the technology available to them doesn’t serve their needs. If they are printing information from the EMR and matching it with other paper documentation to make a complete record – isn’t it possible that this is because the EMR isn’t providing the workflow that meets the needs of both clinicians and the HIM personnel?

So what can we do to counter the impression that HIM in the provider realm is boring and backward thinking while technology is exciting and progressive? Here are a couple of things that might help:

  • Don’t be an obstacle to change! Yes, speak up about change that doesn’t make sense – but don’t object to change just for the sake of objecting. Show those who are new to the field that we bring something special to the table – an understanding of the real needs of users of health information – in addition to our ability to learn and implement new ways.
  • Think about health information from a holistic perspective. We talked before about how all of the various stakeholders in the HIM process focus on their own unique challenges. Transcription providers, coders, billers, HIM correspondence personnel (for whom ROI means release of information), hospital finance personnel (for whom ROI means return on investment), auditors, CDI specialists, technology vendors, and of course clinicians – we all separate the larger topic of health information into the pieces that directly affect us. Let’s look at the discussions taking place in groups outside our own to get a better idea of what “quality” health information really means.
  • Educate ourselves. There is a wealth of information out there that will help those who live in the reality of the HIM today to prepare for tomorrow.

Here are a few excellent sources of information to get you started:

AHIMA Body of Knowledge: If you aren’t a member of AHIMA, join. They have a wealth of information available covering a wide variety of topics including a Meaningful Use Vocabulary Toolkit made available in late October.

• CMS –in particular, their Quality of Care Center

CCHIT’s EHR blog

Disruptive Women in Health – they often have links to great information.

Kaiser Health News

Maybe we “old schoolers” can show the folks who are new to the field that we too can be forward thinkers…

Til next time,

4 Responses

  1. I think your point about having the holistic view is very important. Till now we have all concentrated on our “piece of the pie” and by doing that we have lost view of the bigger picture. It is important to look at the whole picture and then concentrate on improving our contribution to it. Ultimately the aim is to help make quality healthcare economical and easily accessible to everyone. Thanks for the enlightening post.


    • Appreciate the comment Renee. Especially those of us in transcription – I think everyone tends to forget that we are an integral part of HIM.


  2. As a fellow professional exploring the academics of HIM, I understand and share your concerns with education keeping pace with practical changes. That message has been alluded to by AHIMA in the past (concerning attracting HIM Educators and involving them in the milieu).

    Although programs are faced with all sorts of obstacles, it is very much up to those committed to the cause to take it up.

    Regardless, let’s hope the current educators look for support out of their peers within health care.

    • Agree 100% Kevin – thanks for the comment!

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