The Changing Roles of the HIM Professional
A. 1. Chosen Topic
Several decades ago, paper medical records were the focus of the health information management (HIM) professional. Today, the business of healthcare has become more evidence based and patient centric due to the improvements of electronic health records (EHR) and the health information exchange (HIE). Healthcare is in the process of changing the way it uses, manages, disperses, and creates health information. This and emerging technology have drastically changed the way HIM professionals perform their responsibilities. (Olenik, 2019)
The HIM profession is in the business cycle of “creative destruction,” where current roles, processes, or technologies are replaced by new processes and technologies. HIM professionals must make sure they are ready for the quickly evolving future to be able to survive in the HIM profession. The HIM professionals of today must understand data and how systems work together. (Wulf Plimpton, 2019)
In my Capstone, I will discuss how the HIM professional may be affected by new technology, the changing roles that accompany this new technology, and the importance of being able to work with today’s technology. I will also be discussing new technology that may be coming to the HIM field and the skills that will be needed to be successful in the future.
Why I Chose This Topic
In his article, Health Information Management 2025: “Health IT Revolution” Drastically Changes HIM in the Near Future,” Chris Dimick states that “The health information technology revolution has begun, and as it progresses, the shake-up in health information management departments, processes, and data management will leave the profession profoundly different.” (2012) That was seven years ago. Today, the HIM department has seen the effects of this revolution. Some HIM professionals can now work remotely from their home office. Other HIM professionals have changed the way that they perform their duties. With the adoption of the EHR, there are no longer any paper records to be filed. Coding has become computerized, as have chart analysis and assigning deficiences. HIM professionals are now found in other areas in the healthcare setting. Some of the areas they can be found in is Health Information Technology (HIT), Clinical Data Management (CDM), Data Analysis, and Privacy and Security. (Dimick, 2012)
Students of HIM programs are being taught the skills needed to fill the new roles that the evolving technology has created in the HIM field. But what about the HIM professionals that have been in the HIM field for a while? How will they be able to function in this new HIM setting? They may find that they lack the skills they need to be successful in their career. They need to realize that new technology is coming to the HIM field and new skills that will be needed to use it.
The methodology I chose to use in my research was meta-analysis. Meta-analysis is the statistical process of combining the information from multiple studies. Meta-analysis was the appropriate research method to aid me in writing my Capstone. I will use it to review literature from several different forums including journal articles, web pages, documents, and books. I will use meta-analysis so that I can accurately write about new technology and how it is affecting and will affect the HIM professional and the HIM field. It is important to gather information from different studies to be able to make valid and reliable suppositions.
There are major changes happening in the health information management department, data management, and processes. Behind these changes is a transformation in health information technology (HIT). HIM professionals’ roles are changing as new technology changes the HIM processes and the skills needed to fill these changing roles. Today, HIM professionals will need to know project management, statistics, and the effects of data analytics in order to adapt to the new healthcare environment. (Dimick, 2012)
Now that most of the documentation in healthcare is electronic, roles working with that documentation, such as conducting clinical documentation improvement, managing patient portals, and analyzing data, are already befalling the HIM professional. If HIM professionals do not take the steps necessary to advance their education and to learn the skills needed to fill these future roles, they may find that they are obsolete like Polaroid, Blockbuster, or Borders. These organizations were not willing to make the required changes to adapt to new technology and some of their demise happened in less than ten years. (AHIMA, 2017)
B.1 Explain the problem related to your selected topic.
The procedures for the HIM professionals’ roles have changed and require a higher range of skills for entry-level positions. Historically, the only requirements for the entry-level positions were a “high school diploma” or “some college.” Today, a large number of entry-level positions in the HIM field require at least an Associate’s degree. Some even require a Bachelor’s degree. They may also require that the applicant have education, training, or experience in information technology.
With the ever-evolving technology, it is vital that HIM professionals know how systems work with each other and they must be able to understand data. HIM professionals still have the responsibility of collecting, coding, storing, processing, interpreting, analyzing, sharing, and the privacy of health information. The method in which they carry out these duties has changed radically. They perform these tasks using developing technology. There is a growing demand for HIM expertise in a diversity of roles and has led to the profession implementing a larger set of rules. (AHIMA, 2005) It is essential that those who want to be ready for future HIM roles and emerging technology to find opportunities to advance their expertise, skills, and knowledge to address these developing roles.
B.2 Describe background information about the problem.
Almost 200 years ago the Association of Record Librarians of North America (ARLNA) was founded to help raise the standards of medical records in hospitals and other medical facilities. Registered Record Librarian, the first credential offered by ARNLA, was established a few years later. In 1991, after a couple of name changes, the association’s name was changed to the present name of American Health Information Management Association (AHIMA). AHIMA now offers eight different credentials. They require that an applicant have an Associate’s or Bachelor’s degree, except the coding credentials which require completion of a coding training program or at least two years of experience.
In AHIMA’s whitepaper, HIM Reimagined Transformation starts with you, it states “the passage of time has made it clear that technology is rapidly advancing to the point where current HIM roles will be performed by computers in the future.” AHIMA believes that as workflows adapt to technology, HIM roles will change. They go on to give the example of the how computer assisted coding (CAC) has changed the role of coding professionals to an audit function. (American Health Information Management Association, 2017)
While some HIM roles may become obsolete, other roles will take their place. Two roles that are expected to grow in the future are data quality management and data analytics. The role of integrating data from different systems will be needed as more electronic systems are incorporated into a facility. Another new role that the HIM professional may perform is that of patient advocate. A patient advocate works with patients to help them find and comprehend their EHR. (Dimick, 2012) With the advent of these new roles, HIM professionals may need additional education and develop new skills to be able to perform them.
B.3 Discuss possible causes of the problem.
Automated technology, for example machine learning and robotics, has affected the general workplace. Healthcare is not immune to automated technology. Automation has inundated the manufacturing sector of the workforce, and now has the potential to transform the healthcare sector. Roles that involve advanced skills will be automated at progressively higher rates as automation capabilities advance. (Chui, et al 2016)We have already seen this in the HIM field with computer assisted coding (CAC), electronic health records (EHR), and voice recognition capabilities. Roles that involve management of people or that apply expertise to planning, decision making, or creative work have the least probability of being automated. HIM professionals must have education to stay ahead of automated technology.
Big data and healthcare informatics have become prized skills in healthcare. EHRs and the subsequent wave of big data have already disrupted healthcare. HIM professionals should have data science, IT security, EHR optimization, and analytics abilities. These abilities will be crucial for organizations to succeed with accountable care, value-based reimbursements, and population health. New technology will move forward those that are willing to adapt and will leave behind those that are not. (Bresnick, 2017)
Explain why an examination of this problem is important to the field of HIM.
There are major changes happening in the HIM department, data management, and processes. Behind these changes is a transformation in health information technology (HIT). HIM professionals’ roles are changing as new technology changes the HIM processes and the skills needed to fill these changing roles. Today, HIM professionals will need to know project management, statistics, and the effects of data analytics in order to adapt to the new healthcare environment. (Dimick, 2012) The HIM profession continues to change as technology continues to affect the way providers’ harness, harvest, and acquire healthcare data.
HIM professionals work in almost every operational area of healthcare organizations. These areas include revenue cycle, quality improvement, risk management, financial management, contract management, data management, information management, project management, administration, and information technology. What employers need from HIM professionals are impacted by predictive, preventative, personalized, and participatory approaches to healthcare. (AHIMA, 2017) Evidence-based practices are using EHR data and integration of standardized data sets to improve the quality of healthcare. Clinical professions are utilizing them to improve the quality and efficiency of patient care.
HIM professionals’ roles have also changed due to the EHR and the ONC initiatives to improve qualtiy and access to healthcare. Competency in big data analysis, data mining, system delevolpment, and informatics will be required as HIM professionals transition from providing data to providing information or knowledge. Emerging HIM roles such as data analysts and data stewards will improve decision making in healthcare. (AHIMA, 2017) If HIM professionals seek out the opportunities to develop the skills, knowledge, and compentencies for the emerging technology, then not only will the HIM professionals succeed but the HIM profession itself will succeed.
AHIMA (2017). HIM Reimagined Transformation starts with you. Whitepaper.
HIM Reimagined (HIMR) is a proposal that focuses on the future and recommends changes to HIM education to guarantee the strength of the HIM profession in the quickly transforming healthcare environment. It is a document that provides support for repeated evaluation and improvement of the processes in place to make sure the that HIM education is delivered effectively in these rapidly changing times. It goes on to address the HIM competencies in data analytics, patient advocacy, information governance, and entrepreneurship along with privacy and security in these areas.
HIMR has studied the current and expected future of healthcare and the post-secondary education systems. It discusses the roles of HIM professionals now and what they may be future. They did an analysis focusing on the future and outlined the expected changes in healthcare and how those changes will affect the HIM profession. HIMR informs us that the HIM profession must work industriously now to be ready for the predicted changes. (American Health Information Management Association, 2017)
Chui et al. (2016, July). Where machines could replace humans--and where they can't (yet). McKinsey Quarterly.
The authors of this article have researched which jobs could be replaced by machines. They conducted a detailed analysis of over 2,000 work activities for over 800 occupations. They used data from the US Bureau of Labor Statistics and O*Net. They examined the technical feasibility of three groups of occupational activities being automated. These groups where those that were highly susceptible, less susceptible, and least susceptible to being automated. They went on to discuss which professions where machines were most likely to replace humans. They go on to discuss evolving technology and how they could alter the outlook.
They concluded that the activities that were most likely to be automated where those that involved repetitive motions. These areas would include manufacturing and retailing. Healthcare falls in the middle range category that could be automated. Collecting and processing data exceeded 60 percent of having the potential of being automated. This article lets us know what type of jobs are more susceptible to automation or being replaced by computers. (Chui, 2016)
Dimick, Chris. "Health Information Management 2025: Current “Health IT Revolution” Drastically Changes HIM in The Near Future." Journal of AHIMA 83, no.8 (August 2012): 24-31.
In this article, Chris Dimick discusses the future health information technology (HIT). This article is seven years old, but it demonstrates to me that the HIM field is changing rapidly. In it the author informs us that the traditional HIM department with a director managing the medical record systems and staff, which include HIM professionals, coding staff, release of information, and privacy officers could change drastically in the next decade. He also writes that the HIM department will become decentralized and that HIM professional’s role will change from managing a formal department to managing HIM workers throughout the organization. It hasn’t been a decade since Chris wrote this article and these changes and more have happened. I will use this article to write about what they thought the HIM profession would look like in the future and compare it to today’s HIM profession. (Dimick, 2012)
Wiggs Harris, Wylecia. “Taking the Next Step Toward the Future.” Journal of AHIMA 90, no. 5 (May 2019): 11.
In this article, Wylecia Wiggs Harris writes about how the HIM professional has been dealing with the continuous cycle of change. She goes on to write that the crucial part of building the future workforce all begins with education. She also gives the names of other AHIMA articles that I may be use. (Wiggs Harris, 2019)
Lepore, Jill. “Are Robots Competing for Your Job?” The New Yorker. (February 25, 2019) Retrieved from https://www.newyorker.com/magazine/2019/03/04/are-robots-competing-for-your-job
In her article, Jill Lepore informs us that a study done by the University of Oxford predicted that 47 percent of jobs in the U.S. are at risk of being replaced by artificial intelligence (AI) and robots over the next fifteen to twenty years. She goes on to write about how remote intelligence (R.I.) is also replacing workers. R.I. are people from other countries who, via the internet, can take your job.
How do you know if you can be replaced by robots, AIs, or R.I.s? Ms. Lepore answers this question by informing us that your job can be automated if it is easily explained. Several of HIM professions, such as coding and release of information, can be easily explained. Coders roles have changed with computer-assisted coding and release of information personal roles have changed because most medical records are electronic. In closing Ms. Lepore gives us the advice, “Mint a new coin.” (Lepore, 2019)
Lower, Christi. “Teaching Tune-up.” Journal of AHIMA 90, no. 5 (May 2019): 12-15
Christi Lower starts her article writing about how the HIM professional’s career pathway has changed as technology continues to impact providers’ ability to acquire, harness, and harvest healthcare data. HIM professionals can no longer begin an entry-level role and advance to a managerial role with little or no education. She goes on to write that the high-paying coding positions that were in high demand are decreasing in number due to evolving healthcare. Today there is already an increase in the demand for advanced expertise and education in the HIM profession. She gives the example of how healthcare industry has seen a change from coding roles to auditing roles that require coder to learn additional skills.
Ms. Lower writes about HIM Reimagined (HIMR) whitepaper, which is an initiative by AHIMA that aims to maintain the current importance of the HIM profession while also preparing them to meet the challenges of the future. One of the major actions in the implementation of HIMR was the completion of the new HIM Curricula Competencies in 2018. Some of the entry-level roles may be eliminate by the advances in automation but other may create new roles with more influence and earning power. She concludes her article by saying that “transformation begins with you.” (Lower, 2019)
Wulf Plimpton, Julie. “The Evolution of Technology in HIM: Where Are You in Your Journey?” Journal of AHIMA 90, no. 3 (March 2019): 26–27; 28.
In this article, Julie Wulf Plimpton writes about some of the changes that have happened to the HIM industry over the last several years. One example is the change from filing paper medical records to indexing and analyzing the medical record through the EHR system. She goes on to explain that it is still the legal health record and that HIM is still responsible for it. She includes in her article a table that compares the HIM functions pre-EHR and post-EHR. I will use this article to show how HIM functions have changed with the implementation of the EHR. (Wulf Plimpton, 2019)
Sandefer, Ryan. "Data Analytics: The Straight-Lined Labyrinth that Entrapped the HIM Profession" Journal of AHIMA 90, no.8 (August 2019): 16-19.
“Skills in data analytics are critical to the future of health information management (HIM), yet there has been considerable confusion regarding how to articulate what data analytics means for the profession,” writes Ryan Sandefer. He goes on to explain that in one survey, data analytic skills were among the top five most vital skills for the future HIM industry. Another survey ranked skills in analyzing big data in the 10 most important skills for HIM professionals in the future. He goes on to explain how data analytics are being used in the HIM profession to evaluate operational, clinical, and financial performance. This article indicates the importance of the HIM professional learning new skills for the future. (Sandefer, 2019)
Olenik, Keith. “HIM Challenges: The Future of HIM” For The Record, Vol. 3, No. 8: P. 8
In this article, Mr. Olenik writes about the healthcare industry’s transition to being more patient centric due to the EHR and health information exchanges (HIEs). In the early1990s there was a call to action by AHIMA to address advances in technology that was titled “Vision 2000.” Since then there have been several other initiatives by AHIMA, with the most recent one being “HIM Reimagined.” He also writes about technology’s impact on HIM roles and the future skills that HIM professionals need.
Education must play an important role for the future that involves the quickly developing technology. Mr. Olenik informs us that we must form an action plan for the HIM profession to survive. These actions should include a redesign of business processes, rethinking organizational design, and constructing core digital and analytic skills, among others. It is up to each individual to be prepared for the future technology for the HIM profession to endure. (Olenik, 2019)
Bresnik, Jennifer. “HIM Pros Must Shift from Coding to Health Informatics, Analytics”. Health IT Analytics. (May 18, 2017) Retrieved from: https://healthitanalytics.com/news/him-pros-must-shift-from-coding-to-health-informatics-analytics
In this article, Ms. Bresnik writes about the HIM profession being in the midst of a huge transformation as healthcare informatics and big data skills become more and more valued in the healthcare industry. Data science skills are expected to become more important than the traditional coding skills. This is due to computer assisted coding (CAC) becoming more advanced and more healthcare organizations adopting it. HIM professionals should start learning skills in analytics, IT security, data science, and EHR optimization to prepare for these changes. These skills will be crucial for organizations to succeed with accountable care, value-based reimbursements, and population health management. She goes on to write about HIM Reimagined that include AHIMA’s recommendations for realizing its goals during the transformation.
HIM professionals should look for specialization opportunities to set themselves up as greatly sought-after experts in the industry. The emerging areas that HIM professionals could specialize in are data analytics, information governance, informatics, and project management among other areas. It will not be speedy or easy for coding and compliance experts to become data analysts and informaticists. HIM professionals must keep up as the healthcare industry continues it transformation to data-driven care. They can do this by pursuing further education and learning new skills that will keep data accessible, clean, accurate, and complete for care providers. (Bresnick, 2017)
C.3. Explain how all 10 sources collectively support the chosen topic.
The articles, reports, journals, and web pages that I reviewed helped me better understand the past, present and future roles of the HIM professional. In reviewing them, I learned that the HIM professional’s role is ever changing and that the HIM professional must seek out education and new skills to keep up with these changes. I learned that skills in data analytics and big data are becoming more sought after since EHRs have become more widely used. This has caused a significant increase in the amount of data to handle.
I read that the biggest change in healthcare today is automation. Automation includes machine learning and robotics. We can already see machine learning in the HIM department in computer-assisted coding, EHRs, and voice recognition technology. My literature review reiterated that the HIM professionals are still responsible to keep data accessible, secure, accurate, no matter how technology changes the way they do this.
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Submitted as a separate document.
American Health Information Management Association. (2005). Embracing the future: new times, new opportunities for health information managers. Chicago: American Health Information Management Association.
American Health Information Management Association. (2017). HIM reimagined transformation starts with you. whitepaper. Chicago: American Health Information Management Association.
Bresnick, J. (2017, May 18). HIM pros must shift from coding to health informatics, analytics. Retrieved from healthanalytics: https://healthitanalytics.com/news/him-pros-must-shift-from-coding-to-health-informatics-analytics
Chui, M. M. (2016, July). Where machings could replace humans--and where they can't (yet). McKinsey Quarterly.
Dimick, C. (2012). Health information management 2025: current “health IT revolution” drastically changes HIM in the near future. Journal of AHIMA, 1.
Lepore, J. (2019, Feburary 25). Are robots competing for your job? Retrieved from newyorker.com: https://www.newyorker.com/magazine/2019/03/04/are-robots-competing-for-your-job
Lower, C. (2019). Teaching tune-up. Journal of AHIMA, 12-15.
Mauro, P. (2019). AHIMA19 concludes with a focus on building toward the future. Retrieved from jounal.ahima.org: https://journal.ahima.org/2019/09/24/ahima19-concludes-with-a-focus-on-building-toward-the-future/
Olenik, K. M. (2019). HIM challenges: the future of HIM. For the record, 8.
Sandefer, R. (2019). Data analytics: the straight-lined labyrinth that entrapped the HIM profession. Journal of AHIMA, 16-19.
Wiggs Harris, W. (2019, May). Taking the next step toward the future. Journal of AHIMA, 11.
Wulf Plimpton, J. (2019). The evolution of technology in HIM: where are you in your journey? Journal of AHIMA, 26-27.