January 18, 2010

The Rush Is On
By Lindsey Getz
For The Record
Vol. 22 No. 1 P. 20

In a time when discouraging employment news is commonplace, the HIM field braces itself for the arrival of an estimated 50,000 new professionals.

The HIM field has been growing steadily, but many predict it’s about to explode. With stimulus funds being pushed by the president and an urgent call for tens of thousands of new workers, big changes are in store in the near future. At the 2009 AHIMA Convention & Exhibit, National Coordinator for Health Information Technology David Blumenthal, MD, MPP, told those gathered that at least 50,000 new jobs were on the horizon. Since his statement, Health and Human Services (HHS) has announced plans to make $80 million available to support HIT workforce grants that will help fund community college training programs, curriculum development, and additional programs.

Community college training programs are slated to receive $70 million in grants while another $10 million is earmarked to develop educational materials to support those programs. As many as five grants will support curriculum development to enhance workforce training.

These monies have been appropriated in a remarkably swift fashion, according to Gail Smith, MA, RHIA, CCS-P, director of the HIM program at the University of Cincinnati. “It’s something that’s unprecedented in my lifetime,” she says. “Not only has the government made clear that we need to move the workforce forward, but they’ve allocated the funds to make it possible.”

The grant announcements confirmed the subject of recent speculation that training of these HIM newcomers would happen at what has to be considered warp speed for a federal initiative. “From President Obama’s speeches, there’s been a definite sense of urgency,” says Smith. “We’re not talking about taking years to beef up education and get new workers trained; we’re talking about the short term. I’m seeing the words ‘six months’ mentioned.”

While these latest developments have sparked a lot of conversation, the need for qualified HIM professionals isn’t new, according to Jeff Lewis, national compliance manager for Kforce Healthcare, who says HIM has consistently needed more members. But the stimulus plan has given it unmatched growth potential. “As long as I’ve been in the field, there’s always been a need for HIM professionals,” he says. “But with the new stimulus plan, when more hospitals and physician offices get online with electronic medical records, attracted by the rebates the government is offering, that’s where a large number of these jobs will come from. They’ll need workers to implement EHRs, trainers to train the users of the EHRs, and others to perform upkeep. There will be a lot of opportunity.”

Training the Workforce
The wheels are in motion to strengthen educational programs and even encourage the recruitment of new students. “The law certainly supports formal education, but it also acknowledges that they should be funding a certificate program that will retrain individuals for this field,” says former AHIMA CEO Linda Kloss, RHIA, FAHIMA. “Specifically, we’re talking about six-month predegree certificate programs and postgraduate programs. What Congress contemplates is a variety of access points for workers to enter the field. They’re looking at training that would speed preparation of a workforce to be rapidly deployed.”

According to Kloss, there are currently around 270 accredited HIM programs, some of which, like other health curricula, have been hampered by a lack of resources. She emphasizes that these existing programs should be expanded and supported by federal help. “We’ve been advocating on the national level for resources for faculty development, student recruitment, scholarships, loan forgiveness, and other needs,” Kloss says. “AHIMA invests in programs to support the HIM educational network but not at a level that will permit ramping up to support accelerated nationwide EHR implementation. We’re expecting the HITECH dollars to support some of these initiatives, many of which will help enable people with the experience and background to transition from their current career to a new career.”

HHS announced that the community college program will establish intensive, nondegree training that can be completed in six months or less by individuals with some background in either healthcare or IT. Participating colleges will coordinate their efforts through five regional consortia that span the nation. In addition, the curriculum development program will support these community colleges by making high-quality educational materials available to make it easier for the training programs to be established quickly. “The unique piece to this grant is that the government is funding the development of a curriculum and its supporting course materials so that participating institutions don’t have to worry about those factors when time is a critical factor,” says Smith. “But it’s important to recognize that we still need to put the effort into educating. We have to prepare quickly, and having those materials available will definitely help.”

With most experts estimating that the number of workers needed will only continue to grow, student recruitment strategies become critical. In the short term, however, it’s important not to forget about the educational needs of the current workforce, according to Kloss. “AHIMA is committed to making sure the educational resources are there for current practitioners who may not have had an opportunity to learn and gain technology skills on the job,” she says. “We’re deeply committed to making sure there are the same opportunities for the incumbent workforce as there are for new graduates.”

Similarly, it should also be recognized that there are currently well-trained HIM professionals seeking employment. “In this economy, we’re always talking about the unemployed. It’s important to remember they’re not all auto workers,” says Smith. “There are people with degrees that are laid off, and we need to look at them as candidates for these future jobs.”

That includes not only HIM professionals who were laid off due to hospital and health system cutbacks but also IT professionals who have the technical training but lack experience in the healthcare industry. Similarly, there are healthcare workers who are trained in the health field but need to learn IT skills. In other words, there is a lot of potential for existing professionals to reinvent themselves. “We have a lot of people who need to evaluate their skills and retool them,” explains Smith. “There is so much work to be done in the health field with the proper technology training—communicating with software vendors, evaluating security systems, analysis of workflow, and so many other needs in a variety of areas.”

Lewis agrees that it would be foolhardy to focus solely on new workers without providing continuing education for those already in the field. “There was a time a couple decades ago when the health information field was thought of as being one where you didn’t need a college degree,” he says. “According to many, it was even viewed as a field that would be a good fit for individuals that didn’t want to obtain a college degree. But it’s come a long way since then and couldn’t be more different. Today, healthcare systems and physician offices really need to hang their hat on credentialed people. Hospitals should be encouraging employees that don’t have credentials to go get them. There’s no question it makes the hospital or physician office more professional, but it’s also important to know your employees have all the necessary training with the advancements in this field. HIM is constantly changing and that means keeping up with education. It’s not like accounting where two plus two will always equal four. With changing requirements plus EHRs and technological advancements, there’s a lot to keep up on within this industry.”

For existing employees who need to refine their skills or receive updated training, the primary setback may have been financial—something many hope the stimulus dollars will remedy. “To date, the challenge to fill the open roles and positions that are in demand for healthcare facilities is primarily a budgetary one,” says Darice Grzybowski, MA, RHIA, FAHIMA, president of HIMentors. “With more healthcare facilities having to cut costs, paying the competitive salaries and benefits to either employ full-time HIM professionals or utilize experienced consultative advisors becomes more difficult. Existing employees who may have been competent in previous managerial or technical roles find themselves in need of extensive and, at times, costly continuing education about emerging technologies, workflow processes, or changing regulations. The change to ICD-10 alone will require millions of dollars of system reengineering, software updates, and staff retraining in order to make the necessary transition successful.”

While the new grants should support existing professionals, Smith says the funds will also provide great opportunity for some of her graduates, as well as those from Cincinnati’s two-year HIT program. “The grant talks about workers with ‘appropriate background,’ so we’re not talking about people off the street,” she says. “It’s a comprehensive plan that’s looking to move the whole profession forward, and that incorporates more than one level of trained professionals.”

Future Faces 
The arrival of 50,000 new workers may be only the beginning, and that means a renewed emphasis on future leaders: today’s students or even potential students. In light of the Bureau of Labor Statistics’ estimate for an additional 100,000 HIT professionals, Kloss says there is more that can be done to recruit new students. “While we’re very proud of all of the marketing we’ve already done, I think there’s still a long way to go, and there’s a lot more opportunity to market the field,” she says. “It’s really a matter of ratcheting up what we’re already doing. We’re currently using new media like Twitter and Facebook to reach out because that’s where the students are.”

Lewis adds that all this talk about growth in the HIM field will likely be enticing to today’s students. “In the current economy, where jobs are hard to come by, the promise of new jobs in the HIM field should be attractive to many deciding on a profession or current students,” he says. “Salaries have jumped in recent years and are even higher for consultants contracted by consulting firms. HIM professionals working as consultants also have the opportunity to travel and learn at some of the nation’s best healthcare facilities. And as the conversion to EHR continues, most will be able to work remotely from home.”

It’s not just a matter of adding bodies; new workers must be well trained. If the industry fails in that regard, serious problems are sure to materialize. One industry insider fears not enough is being done. “We’re not teaching the necessary skills in the classroom,” says Deresa Claybrook, MS, RHIT, president of Positive Resource Health Care Industry Consultants. “Most nurses today will walk out the door with no exposure to EHRs. Even some physicians aren’t getting the necessary exposure. While there is exposure through clinical sites, there is no classroom experience. We’re finding that there just aren’t a lot of computer skills taught at all. There may be an intro to computers class, but there’s often no full-blown course on EHRs and the necessary skills to work with them.”

Smith believes there needs to be more educational pathways to capitalize on the renewed interest in HIM. “For instance, say you have a master’s degree and you enjoy technology, but your degree is in fine arts,” she says. “You’re educated, work in healthcare, have the drive to learn technology, but I have limited options for you to obtain an HIM credential. Online learning does support the educational needs of the nontraditional students by providing flexibility and access to HIM experts throughout the country. Distance education is one of the solutions to the growing demand to educate the workforce.”

Despite concerns about how to properly educate the influx of newcomers, there’s never been a better time to promote the HIM profession, whether through adding eager students or encouraging current employees to boost their skill sets.

“Now is certainly an important time to promote the profession to prospects who may be interested in the field,” Lewis notes. “As we transition to EHRs and ICD-10, many tenured HIM professionals may choose to retire rather than learn the new systems, so there is a great need for new professionals who are knowledgeable of the new system. But it’s also a great time for those already involved. With the president putting these promises and future plans in writing, HIM is going to come to the forefront and be more visible than ever before. It’s a great time to be involved in this industry.”

— Lindsey Getz is a freelance writer based in Royersford, Pa.