Teaching Tune Up

How the New HIM Curricula Will Change Education, Future Employees

By Christi Lower, PhD, RHIA, FAHIMA

The health information management (HIM) professional’s career pathway has changed as technology continues to impact providers’ ability to acquire, harness, and harvest healthcare data. Gone are the days (with rare exceptions) where an HIM professional could begin in an entry-level role and advance to management positions with little or no additional education or expertise. Likewise, the high-demand, high-pay coding positions that were prevalent in the industry a decade ago are decreasing in number as the healthcare landscape evolves. There is an increasing demand for advanced education and expertise in the HIM profession. For example, the industry has already recognized a shift from coding roles to auditing roles that require coders to acquire additional skills. Advances in technology and interoperability will continue to increase the required competency in data and revenue cycle processes required for HIM professionals to fill the roles needed in the future.

As a membership association, AHIMA is positioned to support relevant efforts to guide current and future health information professionals to gain the knowledge and skill set required to meet the future needs of HIM within the global healthcare ecosystem. To this end, AHIMA embarked on a comprehensive analysis of the profession including factors that influence healthcare evolution and impact future job roles—which resulted in the publication of the HIM Reimagined (HIMR) whitepaper. AHIMA’s recent Vision for Transformation introduces an interim strategy that bridges a previously less relevant strategy to a solid framework for a longer-term strategy that better executes HIM transformation. AHIMA recognizes the need to support current HIM professionals while actively and simultaneously preparing for the future state of the healthcare ecosystem.

HIMR Building a Bridge to HIM’s Future

HIMR is an AHIMA initiative aimed at maintaining the current relevance of the HIM profession while preparing HIM professionals to meet the future challenges. Based on research study findings and the recognition that the HIM industry must lay the framework for transformation, the final HIMR whitepaper published in 2017 provides recommendations and suggested actions to strengthen the HIM profession and support HIM professionals throughout this transformation.

The following is an abbreviated summary of the recommendations:

1. Increase the number of AHIMA members who hold relevant graduate degrees.
2. In partnership with other stakeholder organizations, build a mechanism to ensure availability of research that supports the profession.
3. Increase opportunities for specialization across all academic levels while retaining the core skills upon which HIM is built.
4. Align workforce and industry recognition of HIM relevance through credentialing that highlights both HIM foundational skills and knowledge/specialty expertise.

Each HIMR recommendation includes specific actionable steps for attaining the stated recommendation as well as a timeline for completion, resulting in a multi-faceted phased approach to transformation where the outcome is to ensure relevancy of the health information profession throughout the HIMR timeframe and into the future.

One of the actions relating to these recommendations was realized in 2017 when the Commission on Certification for Health Informatics and Information Management (CCHIIM) announced a time-limited certification proviso opportunity. The proviso allows eligibility for the RHIA examination by December 31, 2021 for individuals who previously earned the RHIT credential (by December 31, 2018) and a bachelor’s or higher academic degree. The RHIT to RHIA Proviso allows those individuals with the core HIM skill set and advanced or specialized knowledge to be recognized with the RHIA credential.

Another major action in the implementation of HIMR was the finalization of the new HIM Curricula Competencies in late 2018. The 2018 AHIMA HIM Curricula Competencies were recently introduced to the membership, and academic programs will be required to address curricular changes to meet these competencies by 2021. The thoughtful and purposeful process used to develop the new competencies resulted in a carefully crafted educational roadmap spanning across all academic levels.

The question “What skills and knowledge are required to meet long-term future HIM workforce needs?” guided the effort with an emphasis on building pathways for practitioners to secure current, evolving, and future HIM jobs. Michelle Wieczorek, RN, RHIT, CPHQ, a long-time associate degree-level educator who helped develop the new curricula, says she is already seeing how the curriculum supports opportunities for HIM professionals to utilize their foundational skills and knowledge in HIM coupled with academic or experimental learning to fill roles that support operational efficiency, guide strategic decisions, and impact the delivery of quality care for an organization.

The curricula update is to help HIM practitioners develop an overall skill set geared towards managing data and integrating business, clinical, and information systems—skills essential for the HIM professional of the future. Wieczorek says she appreciates the opportunities for bridging HIM professionals through a laddered curriculum that supports entry into the profession while also providing the workforce with the required knowledge and ability to land more advanced roles.

Updated Curricula Competencies Open Door to Future Roles

The 2018 HIM Curricula Competencies are broader than previous iterations to allow program flexibility and to be easily adaptable as industry needs evolve. The most notable change is at the associate degree level, where programs are required to select either a Revenue Management or Data Management specialty track or both. The associate degree specialty competencies allow academic programs to designate the curriculum content most appropriate to their community of interest. “The associate curricula tracks allow programs freedom, in terms of regional positioning. Revenue management and data management are both critical job roles that continue to evolve, whether it influences quality of care or operational needs,” says Daniel Ellison, RHIA, associate faculty and clinical coordinator at Trident Technical College.

William Limp, MS, RHIA, CHTS-TR, baccalaureate program director at the University of Wisconsin, shares that his programs advisory community supports the curricula emphasis on data governance, health technology, privacy and security, analytics, and healthcare administration at the baccalaureate level and he believes it will contribute to graduates who meet the need of employers to fill more analytical, technology-based, and administrative roles.

Today, many new professionals enter the market in entry-level coding jobs. Because it is expected that the number of entry-level coding positions will decline with the continued emergence of advancing technology, it is important that HIM students who choose to focus on coding-based jobs—such as auditing and clinical documentation improvement (CDI)—have deeper knowledge of how the coding process informs other higher-level positions. Michelle Green, RHIA, CPC, FAHIMA, an associate degree-level educator, says, “The implementation of computer-assisted coding is impacting our profession from an automation perspective, and although I personally believe that medical coders will be needed for many years in the future, it is also logical to plan for a future that embraces such technology.”

Wieczorek says that advances in workforce automation will eliminate some entry-level roles but create many new roles with greater influence and earning power. “The need for the human integrator role that helps make sense of data, who can interpret information that is created for a specific intention, such as claims data, but can be utilized in other ways such as clinical research, risk adjustment, operational and administrative functions, is huge,” Wieczorek says.

She further stresses that individuals in these current entry-level workforce roles have opportunities to increase their value to employers by seeking higher-level skills. It is these types of positions that will continue to emerge, and they will require greater knowledge at the entry level than today’s coding position requires and are generally grouped in the revenue management category. This change in curriculum is supported by AHIMA’s renewed strategy to focus on coding and CDI.

Similarly, greater knowledge and skills in data management will pave the way for students that have elected the associate-level data management specialty content to be prepared for roles that have not yet emerged. The proliferation of electronic systems—and their data progeny—are expected to grow in the future. “Our industry partners indicated they are looking for employees who possess key analytic skills along with relevant technology and leadership skills that allow them to adapt to change,” Limp says.

Underlying all health information needs is the need for data management in electronic form—the “roots” of health information management haven’t changed. HIM still must ensure that healthcare data content is accurate, complete, accessible for clinical care, and accessible and transferable for continuity of care while also being protected, confidential, and secure. All HIM students will learn these skills, but those that choose the data management specialty will enter the workforce better prepared to manage healthcare data in all forms. With continued growth in the amount of electronic data and data sources, the Data Management focus also aligns with AHIMA’s strategy. AHIMA is dedicated to identifying new and innovative ways for HIM professionals to meet employer needs around data analytics.

Following the release of the 2018 HIM Curricula Competencies, the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) adopted the curricula into their revised standards and initiated communication to academic programs regarding timelines for meeting the curricula standard. HIM Reimagined’s recommendations focused on transitioning the RHIT credential to a RHIT+ (specialty designation). At this time, CCHIIM has elected not to move forward with this HIMR recommendation for the RHIT+ certification. CCHIIM understands that there is more than one way to designate specialty knowledge, such as through micro-credentialing or certificates instead of certifications. For this reason, and as a result of the concerns voiced by AHIMA members about a potential change to the existing RHIT certification, CCHIIM reached the conclusion to not move in the direction of the RHIT+ specialty credential. There will be no changes to the current AHIMA RHIT credential and there will be no exam content changes to address the +specialty. The RHIT credential will be recognized in the workplace as it always has been: the entry-level credential for an HIM professional.

Transformation Begins With You

When considering current and future employer needs within healthcare, HIM professionals must recognize the opportunities that exist to continue advancing individual skill sets in anticipation of future needs. One need only visit a job board to recognize the diverse number of HIM roles that require specific skills, competencies, and expertise as well as the expectation of the advanced degree level. Current HIM professionals and current students alike have opportunities to build upon their skills and expertise. One way that current professionals can demonstrate their competencies and skill set is through credentialing. A credential signifies that an individual has demonstrated a set of skills and competencies expected by employers in the current workforce.

Both students and current HIM professionals can benefit from the use of AHIMA’s career development tools which include the HIM Career Map, Salary Snapshot, and Career Assist Job Bank. The Career Map is an interactive tool that identifies transitional, progressive, and emerging career pathways within HIM and provides descriptions of job roles including the expected skills and educational requirements to attain each job role. This tool allows individuals to map their knowledge and skill development according to their chosen career path.

HIM professionals should regularly review their regional environment, identify the current state, and recognize future trends. Professional networking is a strong tool to support efforts and understand the transitions within a geographic region. Attending conferences, annual meetings, and local events is a great way to widen your network, increase your influence, and learn about changes others see occurring in their respective organizations. The AHIMA Engage communities also offer opportunities to network and follow industry trends and challenges among peers who may not be geographically accessible.

Transformation begins with you. “HIM professionals are at risk if they don’t continue to develop soft skills and technical expertise,” Ellison says. “As HIM professionals we need to know, sow, and grow. It is important that we realize as a profession it is our job to remain relevant, to be a part by networking, volunteering, and supporting each other.”

Accepting that the current behaviors, competencies, skills, and knowledge you presently possess will not be enough for the future is daunting. Yet it is critical that those who wish to be prepared to support future needs within the profession must pursue individual opportunities to advance their knowledge, skills, and expertise to address emerging roles. Ellison says that as a profession HIM will be stronger together, and HIM professionals should continue to stay involved, volunteer, and network in order to be informed about and remain relevant through workforce changes.

While AHIMA helps with healthcare information advocacy, provides a voice to the profession, and offers products and services to support current and emerging professional development needs, individuals are solely responsible for their own professional growth.

Christi L. Lower (christi.lower@ahima.org) is a subject matter expert in Academic Affairs at AHIMA.