March 2013

Q & A With AHIMA President Frawley
By Sandra Nunn, MA, RHIA, CHP
For The Record
Vol. 25 No. 5 P. 8

As AHIMA enters an era filled with promise and tremendous possibilities, the organization faces several unprecedented challenges. Manning the helm during this turbulent yet exciting time is the organization’s new president, Kathleen Frawley, JD, MS, RHIA, FAHIMA, a professor and the chair of the HIT program at DeVry University in North Brunswick, New Jersey.

Besides running the HIT department, Frawley teaches and mentors adjunct faculty, and works with the school’s Keller Graduate School of Management to create presentations on today’s most pressing healthcare issues. Her project to identify and assist students at risk of failing or dropping out of school should resonate with teachers everywhere.

The following questions focus on her expertise in the education domain, her legal background, and the future of the HIM profession.

For The Record (FTR): You began your studies as an English major. In an information age, what might current HIM students gain from studying English and composition?

Frawley: I do have concerns about our nation’s educational system, particularly the poor English and math skills. Those in our profession need to be able to communicate effectively, to be able to interpret and translate complex information. From an educator’s perspective, students often struggle with online education when faced with engagement in “threaded discussions,” an aspect of learning and collaborating electronically. 

I value my background in English and history, which provided me with critical-thinking skills and the ability to read and analyze questions. Students sometimes experience “test anxiety” when faced with major examinations if they have not had the opportunity to be tested in the classroom—whether face to face or electronically—ahead of time. In my new role, I have noted that the demand from Wall Street and other high-end labor markets is shifting from strictly financial or analytical skills to “soft skills,” such as those skills one would acquire in a liberal arts program.

FTR: You’ve remarked that your special area of interest has been legal issues. How did that come about?

Frawley: I have always been a proponent of lifelong learning. I am the oldest of eight children, daughter of a father who had wanted to go to law school and now has two daughters who are lawyers. I am from humble circumstances, and I put myself through college, starting with working in a bakery and eventually taking on weekend work as a birth certificates clerk in a medical records department.

I knew nothing about healthcare at the beginning, but thanks to my employment in a medical records department, I began to gain exposure and became particularly interested in release of information and coding. When I was getting ready to graduate from college, the coding supervisor at that time suggested I pursue a career in health records administration. She suggested that I consider obtaining a postbaccalaureate certification. I applied to a hospital-based health record administration program at the US Public Health Service Hospital in Baltimore. I completed my practicum at The Johns Hopkins Hospital in Baltimore and was hired by Lottie W. Cole, RRA (a past president of AHIMA) as an assistant director of the department of medical records and statistics. She encouraged me to volunteer for AHIMA right from the start.

The medical/legal aspects of the profession have always appealed to me. When I was 26 years old, I became chief of medical record services at the US Public Health Service Hospital in Staten Island, New York, with 85 employees and myriad responsibilities (admitting, patient accounts, medical records, etc) and was the only non-master’s level department head. The CEO of the hospital was a female MD, which was quite unusual at the time, who agreed to help me get a master’s degree.

While I was completing my graduate degree, my younger sister was applying to law school. I decided to take the LSAT exam with her and apply to law school. Long years of night school studying law and challenging work during the day culminated in a JD four years later.

FTR: What recommendations would you make to current HIM professionals who would like to focus on the legal aspects of HIM as their field of work or for their advanced studies?

Frawley: There are multiple pathways today to acquire more specialized skills in these areas. AHIMA offers specialization in privacy and security, and is working toward additional specialty certifications and pathways for HIM professionals to obtain their master’s degree and even their PhD. If students are interested in this area, they should seek internships that include release of information and get their feet wet. A focus in this area does not require a formal degree. With the current focus on breach violations, there is a ramp up in security audits, which is another area of possible concentration.

FTR: Please discuss the level of progress of Reality 2016, AHIMA’s proposed plan for the future of HIM education and the broader profession. What has been accomplished and what remains to be done? Will there be another “vision” to extend the time frame for accomplishing the goals set forth in Reality 2016?

Frawley: There has been a tremendous amount of work accomplished in this area, transitioning Vision 2016 to Reality 2016. There are four basic tenets that constitute this effort: growth of graduate programs for HIM professionals, the development of specialization tracks, faculty development, and development of alternative pathways for credentials.

There will be no new “vision” but rather a further commitment to complete Reality 2016 with help from the Associate Education Coalition and the Graduate Resources Alliance, which will develop potential specialty tracks and lead the profession to graduate-level education. In addition, the Council for Excellence in Education, which is the leading force in education strategy for the profession, will be tasked with guiding the academic community through improvements to education, coursework, and the curricula of associate, baccalaureate, and graduate programs in HIM.

FTR: Reality 2016 mentions the need for PhD-level professors for master’s and doctoral programs. What measures will AHIMA offer to help HIM professionals?

Frawley: Of the four tenets listed above, the development of faculty is the most difficult. We need to figure out how to help people climb up the ladder. We can help them with more advanced teaching skills, publications opportunities, and skills like grant writing that can lead to the financial ability to pursue more advanced education.

FTR: You mentioned the number of HIM students who are older and making a midlife career transition. Where do these students come from and how are they faring?

Frawley: The majority of the students entering our programs are making career transitions, that is, they are primarily those who have already worked in a previous career. We are seeing many students downsized from the financial sector because we are near Wall Street and also those peripheral to that industry in the IT sector. Another third are students already working in healthcare and the last third, and perhaps the most challenging, are those who speak English as a second language.

It is a challenge to hit the mark with all of these students since they are at many different levels in terms of skills. However, one of the great things about the students is that they are collaborative and help one another to succeed. The less seasoned students get help from the others with job interview skills and assistance with overcoming anxiety about taking exams.

FTR: The program director of my HIT program (at Central New Mexico Community College) faces the challenge of finding “practicum sites” for students. Do you have any tips regarding this problem? How can AHIMA encourage healthcare entities to engage students?

Frawley: This is really tough to do and is one of my primary challenges. We graduate students three times a year, and I am constantly in the process of begging people to take students for practicum experiences. New Jersey is a small state, and you need to have high-quality students to get sites to repeatedly welcome new students. We try to match the students to the environments in which they will most likely succeed. I remind HIM professionals in the field that somebody started them on their path.

FTR: I recently was exposed to AHIMA’s Career Map and was quite impressed. How will you deploy this tool so that it reaches the corners of the HIM profession, particularly those on the front lines in education?

Frawley: The map has been shared already with educators, members, and students. In addition, it will be deployed at annual meetings as well as other significant AHIMA meetings. It also will be featured at the Assembly on Education, the Leadership Symposium, and job fairs.

Another effort is the work we are doing with the Bureau of Labor Statistics to get the Health Occupations Handbook revised. This will help our members explore additional career opportunities.

— Sandra Nunn, MA, RHIA, CHP, is a contributing editor at For The Record and principal of KAMC Consulting in Albuquerque, New Mexico.