September 2019

HIM Challenges: The Future of HIM
By Keith Olenik, MA, RHIA, CHP
For The Record
Vol. 31 No. 8 P. 8

The transition of the health care industry to become more patient centric and evidence based has given rapid momentum to improvements in adoption of EHRs and health information exchanges. The industry is in the process of dramatically changing the way it creates, uses, manages, and disperses health information.

To discuss the future of the HIM profession, let’s turn back the clock to revisit some timely and accurate information, published by AHIMA, that outlined where the profession should or would be going.

Vision of the Future
In the early 1990s, a call to action for HIM titled “Vision 2000” was created to address technological advances. It was during this time period that the association changed its name from the American Medical Record Association to AHIMA to publicly acknowledge its expanded focus from medical records to HIM.

Jump to 1996, when “Vision 2006” was released, to build upon the previous document with the purpose to communicate AHIMA’s strategic commitment to position the profession for an effective transition into the envisioned, but admittedly uncertain, roles and responsibilities of the 21st century.

All along, AHIMA’s efforts and actions have been driven by the belief that the impact of these trends will not bring about incremental change but rather a fundamental change to the profession. “Vision 2006” gave each HIM professional a model for emerging roles and a transition chart. Another fundamental principle of the initiative included the need for lifelong learning with a clear expectation that ongoing education and professional development was required.

Released in 2007, “Vision 2016: A Blueprint for Quality Education in HIM” further defined the future and created an increased sense of urgency for the profession and individuals. The report highlighted key areas and suggestions for the future of education in the HIM field.

These recommendations were revisited in 2010 due to an apparent lack of action by the profession and a failure to see the connection between the education changes and the impact to the profession. As a result, in 2017 AHIMA released the whitepaper “HIM Reimagined,” which makes note of technology’s expanding role in the profession and the need for members to develop new skills and become better educated.

Technology’s Impact
According to findings in “Jobs Lost, Job Gained: Workforce Transitions in a Time of Automation,” a 2017 report from the McKinsey Global Institute, over the next few decades, approximately 25% of US employees (36 million jobs in 2016) will have experienced high exposure to automation.

In addition, according to an Accenture analysis, artificial intelligence (AI) applications may create $150 billion in annual savings for the US health care economy by 2026. The analysis lists administrative workflow assistance as the third-highest category of applications, with an estimated $18 billion in annual savings.

Collecting and processing data are specific tasks that can be accomplished more efficiently through machines. The McKinsey report states that information and record clerks could experience a 15% to 24% decrease in the number of jobs. As it happens, these are the same types of tasks that are most susceptible to automation (as well as offshoring). According to HIM Reimagined, the job class in which coders are grouped has a 91% risk of automation.

The whitepaper indicates that more than one-half of the AHIMA membership holds an associate’s degree or less. Meanwhile, the average automation potential of occupations requiring less than a bachelor’s degree is 55%, more than double the 24% susceptibility among occupations requiring at least a bachelor’s degree. Workplace disruption has the potential for substantial costs to those directly affected, as these individuals will need to upgrade their skills or possibly move into new roles.

Future Job Roles
The top five skills found in the LinkedIn profiles of individuals working at tech companies are the following: health care, hospitals, HIT, HIPAA, and health care management. Companies such as Facebook, Apple, Amazon, Salesforce, Lyft, and Uber employ people with these skills to tackle health-related projects and build teams to address the health care industry’s myriad problems.

Based on these findings, HIM professionals have the ability to create their own roles and the opportunity to consider some very nontraditional locations for their next job.

Vision 2006 offers ideas on emerging HIM roles, including clinical data specialist, data quality manager, research analyst, patient information coordinator, document and repository manager, and security manager, along with positions in consulting, education, and applications design.

AHIMA’s 2011 whitepaper “A New View of HIM: Introducing the Core Model” organizes future job roles by function to support increased automation, changing regulations, and data dissemination. It provides enough detail for individuals to create their own new job description and justify the need to their place of employment.

The fact that HIM professionals work in almost every setting of the health care industry significantly expands their employment opportunities beyond traditional settings.

AHIMA’s HIM Career Map, which can be found on the organization’s website, can be utilized to create a career plan as well as to chart a path to a higher-paying position.

Education Moving Forward
There is no question that education must play a vital role in a future that involves the rapid deployment of technology. The HIM profession has embraced formal standards and guidelines for education dating back to 1943. Since that time, the educational standards have been regularly revised to incrementally advance the quality of the process and enhance the content to address the changing roles and responsibilities of HIM professionals within the health care job market.

There is widespread agreement among labor economists that workers need access to continuous education to stay ahead of rising automation. For more than 20 years, AHIMA has included clear recommendations and strategies for education as part of its vision. Programs are working to make adjustments in how education is provided to meet the demands and needs of today’s students and adults in the workforce looking to further their knowledge.

Many HIM professionals in leadership roles attained their skills by learning on the job. While these individuals are accomplished, many are not formally trained at the graduate level. As technology evolves, such informal career advancement methods may not be viable. There will be room for those with lower levels of education, but they will be working in a different capacity than they are today.

Forming an Action Plan
For the HIM profession to survive and have a viable future, the following actions should be considered:

• Redesign business processes to obtain productivity gains. Determine the best way to capture value from new technologies by reimagining how the business operates rather than mechanically applying automation to the current processes. A thorough review of business processes and workflows will be required to assess where automation could improve performance.

• Rethink organizational design and keep in mind that automation adoption will not occur overnight; doing so has profound implications for how the workforce is structured and organized. Successfully evaluating organizational design ensures that work processes are more efficient and takes advantage of the new technical possibilities available. It will also result in making work more meaningful and rewarding for HIM professionals as the rote aspects of their jobs are taken over by machines.

• Construct core digital and analytics capabilities. Ensure the availability of digital assets, big data, and analytics to successfully implement automation and AI. This includes building knowledge of advanced analytic techniques and tools.

• Adapt talent strategy and manage workforce transitions. HIM leaders will need to ensure that the talent required to transition to more automated operations is in place. This will involve a combination of recruiting knowledgeable professionals as well as retraining workers to play new roles. Determining the right mix of current talent, redeployed talent, and new talent from outside the organization will require careful consideration.

• Develop partnerships for talent development. Investigate establishing partnerships with universities and other educational institutions to provide workforce training and skill development. These partnerships can also be utilized to shape and create curriculum for specific degree or certificate programs. This enables large-scale retraining without creating the staff and overhead to manage it internally.

AHIMA has not announced a mandate for action as part of efforts to create a future HIM roadmap. The “HIM Reimagined” whitepaper attempted to create bold recommendations to justify the rational for why change is necessary.

For the HIM profession to survive, it’s up to each individual to ensure he or she is prepared for a rapidly evolving future. There is no time to wait for another version of AHIMA’s vision. As a result, HIM professionals must take decisive action today and define their own future and ultimately that of the HIM profession itself.

— Keith Olenik, MA, RHIA, CHP, is the owner of The Olenik Consulting Group and an HIM consultant at Pivot Point Consulting.