February 2015

HIM Faces Hurdles to Leadership Roles
By Merida L. Johns, PhD, RHIA
For The Record
Vol. 27 No. 2 P. 6

HIM professionals are needed more than ever in leadership roles. Rapid technological changes, legislative mandates, the rise of consumerism, the restructuring of payment and delivery systems, quality initiatives, process and product innovations, changing patient demographics, and the push for more efficiencies are just a few drivers changing health care delivery. Like the intricate fibers in a spider's web, each is related, pushing and pulling the health care system into transformational and disruptive change.

Amid the controlled chaos, one thing is clear: These forces all depend on a commodity (data) and its precious byproduct (information). But all is not rosy in the world of health care data. Concerns about data quality and the massive challenge of managing it are widespread, a fact to which many HIM professionals can attest. AHIMA's 2014-2017 Strategic Plan calls for HIM professionals to be placed in leadership roles in areas such as data analytics and information governance. It's up to HIM professionals to meet this challenge by exercising influence and stepping forward as leaders to develop strategies and policies.

There is little doubt that HIM professionals have the technical competency, ethical values, and motivation to exceed at operational levels. In a recent survey of HIM professionals conducted by The Monarch Center for Women's Leadership Development, HIM directors were given high marks for their leadership capabilities. However, while HIM directors were regarded as domain experts and tactical managers, they were not viewed as visionary or strategic leaders, especially by those holding senior or executive positions. Furthermore, respondents did not have a high degree of confidence that HIM professionals would advance into senior management or executive roles in the next decade.

Voice, influence, and authority are essential to creating futures and effecting change. In hierarchical structures, these characteristics typically rest with senior and executive management. Unfortunately for the HIM profession, recent statistics from AHIMA show that only 2% of credentialed members hold senior level or executive positions. Consequently, moving more HIM credentialed members into top organizational positions may be a heavy lift.

Rising to the Challenge
How can HIM professionals rise to the challenge of AHIMA's vision, change their image from tacticians to strategists, and gain voice, influence, and top organization positions to make a positive difference in the management of health information?

One way is to examine and then tackle the barriers that are holding them back.

In the Monarch Center survey, respondents identified structural (organizational hierarchies) and intrinsic (individual) roadblocks preventing HIM professionals from reaching leadership positions. In terms of structural barriers, the lack of social capital among females, specifically an inability to garner mentors and sponsors, and limited or no access to informal and formal C-suite networks and powerbrokers, were cited as the top hurdles. On an individual level, respondents felt that focusing on tactical instead of strategic thinking, being a domain expert rather than a leader, a limited desire to advance to the C-suite, a reluctance to take career risks, and the absence of an advanced degree were the main obstacles holding back HIM professionals.

It's not surprising that gender-related issues would be a concern; 92% of HIM professionals are female. Interestingly, those in senior and executive positions viewed the barriers to be related to individual characteristics while those in managerial, supervisory, or operational positions believed structural issues were the culprits. The dissonance between viewpoints suggests a clash of worldviews, the resolution of which means both groups must be prepared to consider and act on the other's perspective. Therefore, it's important to examine all barriers.

Where to Start
Tackling person-related barriers, which are controlled by the individual for the most part, should be the first priority. Resolving these issues will provide the profession with more firepower to overcome the structural hurdles. For example, according to 2013 AHIMA statistics, just 9% of HIM professionals hold a master's degree. Increasing that percentage would open enormous career opportunities.

A limited desire to move into the C-suite and a reluctance to take career risks are associated with other gender-based research findings that show differences in confidence and career ambition between men and women. Findings from the Monarch Center survey indicate that a lack of confidence leads to less risk taking and guarded career choices. How can HIM professionals increase career clarity and raise their confidence and ambition?

Start with this axiom: Leadership is rooted in who you are, not in trying to be someone else. Recognize, acknowledge, appreciate, and embrace your strengths and virtues to craft a personal vision and a career course. To identify key strengths, take the Values In Action survey, developed by the University of Pennsylvania and offered free by The Monarch Center through the VIA Institute.

Research shows that our brains can become more "confident-prone" by taking action. Like toddlers learning to walk, successive action and persistence helps raise self-belief levels. Then, as successes mount, confidence grows. To keep achievements front and center, maintain a journal chronicling three successful moments that occur each day.

Eliminating Structural Barriers
The good news is that the benefits of raising confidence levels may be related to knocking down structural barriers. For example, confident and ambitious HIM professionals may be more inclined to expand their social capital by seeking out mentors and sponsors to help them achieve their career goals. Brimming with more confidence they also may expand and publicize their career ambitions, thus being viewed as shakers and doers rather than tactical managers. And more swagger can propel them outside their comfort zones into other domains, where they may encounter new viewpoints and develop a vision that challenges the status quo.

In the final analysis, stepping into leadership is about confidence and courage. Every great leader has had self-confidence and the courage to not only do things right, but to do the right thing. But the question remains: Are HIM professionals up to the challenge?

— Merida L. Johns, PhD, RHIA, is principal and founder of The Monarch Center for Women's Leadership Development.