Work Force Study Reveals New Picture of HIM

Information on HIM work force needs and trends to support a full range of uses by AHIMA and the industry is now being analyzed by researchers from the State University of New York at Albany. Three major reports of surveys done this year of a sample of nearly 6,000 members, all students who completed their health information education last spring, and the directors of educational programs in health information administration and technology programs are being readied. Information is still being collected for the employer phase of the research and these reports will be available in 2003.

Raising Awareness for HIM Work Force Shortages

This research, funded by AHIMA's Foundation for Research and Education (FORE) through the generous financial support of member and corporate donors, was commissioned to answer pressing and far-reaching questions for the field. What is happening to salaries in the field? Where do we work and what positions do we hold? These and many other crucial answers inform AHIMA planning for HIM education and for services to help practitioners across their many roles and career phases. The information also helps HIM managers with recruitment and retention of qualified staff and give us insight into how HIM roles are evolving and what new opportunities are emerging.

As we reflect on 2002, growing public recognition of the shortage of nurses (and pharmacy, radiology, and laboratory scientists too) will surely be at the top of the trend list. The shortages have been linked to patient safety and to low and eroding profits and morale in healthcare organizations.1, 2  HIM is also experiencing a work force shortage, and it is not only in coding roles. Key managerial positions go unfilled for so long that the productivity of HIM services is compromised.

To raise awareness about the needs and trends in our field, we need hard numbers and facts. A sampling of some of the more interesting data uncovered so far is shown below.

  • The median age of students in HIA programs is 27.6 years, and 35.3 years for HIT programs. Many students are entering our programs with several years of work experience or previous degrees, although not necessarily in an HIM-related field. Approximately 20 percent of all recent graduates are single parents, and students overall are more likely to be working than they were even five years ago, and are more frequently part-time students.
  • HIM students are more ethnically and racially diverse than current practitioners, and than those entering other allied health professions--60 percent are white, 22 percent African American, 8 percent Asian, and 7 percent Hispanic. Gender diversity is also increasing slightly with new students, 12 percent of whom are male vs. 5 percent in the current AHIMA membership.
  • Geographic variations are apparent in a number of significant areas, including distribution of HIM formal education programs, job availability, advancement opportunities, and salary levels. The causes and implications of these variations will be the focus of additional data analysis and in-depth interviews.
  • Members reported more than 219 different job titles in 120 practice settings--gone are the days when nearly all HIM graduates became assistant directors at acute care facilities. Although the hospital inpatient setting is still by far the most common practice setting for current and new professionals, the variety of options in other settings, and beyond what might be considered "traditional" HIM roles, is both exciting and challenging.
  • Members express concern that positions that should be filled by HIM professionals are going to others, either because no HIM professional is available or because employers are not aware of the unique knowledge and ability we bring to expanded roles in changing healthcare models. This will be explored in more depth during interviews with employers.
  • Two-thirds of HIA students and nearly 50 percent of HIT students say they plan to pursue further education, most often expecting to pursue a master's degree and BA respectively. Preliminary member survey data show that members already in the profession see a bachelor's degree becoming increasingly important. In addition, more than one-third of members indicate that the application of new technologies to HIM demands continuing education.
  • Schools are facing reduced availability of practical education and internship sites. The consolidation of hospitals is one factor in this shortage, as well as growing demands on departments that may not feel they have the appropriate time available to devote to supervision of interns. Students report that their internships are a significant factor in determining later employment, and the vast majority feel that their internship was a very valuable experience.
  • Formal education programs are facing a multitude of pressures, from difficulty recruiting new faculty to lack of clinical sites. Educators report that the top three issues for both HIT and HIA programs are low enrollment, crowded curriculum, and the time and effort required for student recruitment.
  • Members report the continuing perception that HIM professionals at all levels are undervalued considering the knowledge and education required to perform in these roles. At the same time, they identify areas where HIM professionals should focus continuing education efforts--areas like management, leadership, and technology that can help position us for new opportunities.

Project Phases and Plans for 2003

Now that data is beginning to come in, the real work of the Work Force Assessment study can begin--analysis of the data and development of reports and recommendations based on the implications of the data. To recap the work that has already been completed:

Phase I: Issue Identification and Planning

Through meetings and discussions with AHIMA leaders and stakeholders, the project team clarified critical strategic issues and options facing the profession and its stakeholders relating to work force issues.

Phase II: Research Phase

Work completed in 2002 included surveys of educators, graduating students, members, and employees of HIM professionals.

Phase III--2003 Work Plan

The work in Phase III will include:

  • Additional employer case studies targeting "non-traditional" employers in geographic areas not covered by earlier cases
  • Targeted employer surveys, to gather insights about the future of HIM and the implications for the HIM work force
  • Final HIM employer report focusing on future directions of HIM and future expectations of HIM employers
  • Design and testing of a prototype for an ongoing HIM Work Force Tracking System. An online survey system will be developed, which will periodically ask a standing panel of HIM professionals and employers questions to track important trends over time and to address hot topics of current interest to HIM
  • In a similar fashion, an ongoing educator and student exit survey system will be designed
  • Specific research and analysis may include such topics as HIM salaries; relationships between job titles, functions, and educational background; HIM education patterns; HIM career paths and job choices; and projections of HIM employment and job demand

Watch the Journal of AHIMA and AHIMA Advantage throughout 2003 for full coverage of research findings, analysis of its implications, and actions to be taken as a result.

1. Aiken, Linda et al. "Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction." Journal of the American Medical Association 288, no. 16 (2002): 1987-1993.

2. Barney, Steven M. "Retaining Our Workforce, Regaining Our Potential." Journal of Healthcare Management 47, no. 5 (2002): 291.

The Work Force Assessment Study is funded by the Foundation of Research and Education (FORE) and supported by generous grants from 3M Health Information Systems and MedQuist Inc.

Source: AHIMA Advantage 6:8 (December 2002)