October 2019

Full Tilt Into the Future
By Dava Stewart
For The Record
Vol. 31 No. 9 P. 10

As HIM career options become diversified, the opportunities for new paths become boundless.

In health care, changes happen fast. Perhaps the only industry that changes more quickly is technology. For HIM professionals, who work at the crossroads of those two fields, the pace can be blinding. How can someone map out a career when it’s impossible to know where the field is headed over the next five years?

HIM professionals can view the massive wave of change as a terrifying tsunami or, with just a little preparation, find a way to ride the crest into an exciting, satisfying career. The ability to adapt, an understanding of how skills can be deployed, a commitment to lifelong learning, and a strong, diverse professional network are some of the keys to mapping a successful career path amid all the turmoil.

A Changing Health Care Landscape
“For a long time, right out of school, being a registered health information technician allowed you to gain a position easily,” says Scott Sittig, PhD, MHI, RHIA, an assistant professor in the health informatics department at the University of South Alabama, who adds that the strong connections of faculty benefited students. “We still have those coding jobs. They aren’t as plentiful, but they are still there. We are now starting to see a diversification of jobs and we are starting to see HIM educators advocating for more nontraditional jobs.”

There are two sides to the issue: There are fewer traditional HIM positions, but there are also more new roles than ever before. Kathy Giannangelo, RHIA, CCS, CPHIMS, FAHIMA, an HIM consultant, offers a different view of the changes within HIM, saying, “I wouldn’t call [the new roles] nontraditional roles. I think they are really environmental changes that are impacting the health care industry overall, and that are also changing the way health care is delivered.”

Professionals working in the field face a slightly different set of challenges than new HIM graduates, but there are tools available to help navigate the changes. By understanding their strengths, critically assessing what they have to offer, determining what areas of HIM they’re interested in, and taking advantage of the available resources, professionals at any stage of their careers can remain relevant in an evolving workplace.

A Strong Professional Network Is Key
It’s a fact some HIM professionals may not realize: An HIM degree provides a broad base of education that can be valuable across many departments within any health care organization. Registration, informatics and analytics, legal services, and revenue cycle are just a few areas where the skills and competencies that are part of an HIM education can be utilized.

“HIM professionals must be comfortable with breaking down the walls and become more engaged with industry standardization, data informatics, and the electronic health record with regard to access and uses,” says Christine Metheny, MSL, RHIA, CHPS, CHTS-IM, director of HIM and director of senior enterprise operations of HIM at WVU Medicine.

She recommends becoming involved in teams and committees. “A United Way campaign or other company committee activity are often good ways to get involved and inject oneself through networking in a nonconfrontational way, and sets the tone for learning about what people do in a social atmosphere,” Metheny says, noting that attending meetings in other departments and making friends is both networking and developmental.

Involvement in multidepartmental programs is one of the best ways to build a strong, diverse professional network. Because an education in HIM is broad, learning more about how other departments in an organization work can provide insights into just how much HIM professionals bring to the table, Metheny says.

Many HIM professionals aren’t fully aware of the importance of their skills across the health care spectrum. “I think [HIM professionals] underestimate their knowledge base, quite honestly,” says Denise Johnson, RHIA, MS, CPHQ, vice president of process excellence at nThrive. “I think if they don’t seize those opportunities they’ll be in a similar position to roles we’ve seen pass from HIM into other professions because individuals there will gravitate and explore and take those roles if the HIM professionals don’t stand up and be proactive in pursuing those opportunities.”

The importance of a strong professional network cannot be underestimated. Sittig says that it’s an HIM professional’s biggest and best resource. “Those individuals are going to continue to provide new ideas, new concepts, journals, and things [HIM professionals] haven’t been exposed to yet,” he says.

In addition to joining committees and teams, Sittig recommends taking advantage of social media to build a strong network. “Your peer network will always be your most important resource. Even follow someone on Twitter. Sometimes those connections are more important than traditional resources,” he says.

Determining a Direction
“I really think there’s no lack of opportunities for HIM professionals with the right skill set,” Giannangelo says. “Things are impacting us, but it’s an opportune time for people with HIM backgrounds because there are different ways to put yourself into the world.”

The number of possible paths available to HIM professionals is something of a double-edged sword. While there’s no dearth of opportunities, professionals must decide on the direction they want to head.

All HIM programs include the same domains and competencies, but depending on interests and inclinations, graduates with identical qualifications can follow very different career paths. For example, someone with an interest in clinical documentation may go on to develop a much different skill set than someone inclined to learn more about revenue integrity.

HIM professionals concerned with a changing landscape must “understand and learn about what’s going on in the industry. These industry changes provide new roles for HIM professionals,” says Johnson, who suggests networking with people who have similar areas of interest. “Learn and be curious about [different] roles. People will really gravitate to being a mentor, so if there’s something you have an interest in, seek out opportunities to understand.”

Johnson cites artificial intelligence and natural language processing as two noteworthy developments, along with robotic process automation. “I think [HIM professionals] might be surprised to see that there may be some easy transitions into some roles just based on their knowledge of data itself within the EHR and bridging their knowledge of clinical and financial data,” she says.

Johnson recommends using AHIMA’s career mapping tool to explore job descriptions and requirements. The tool also can provide advice on how to move from one field to another and how to conduct a self-assessment to determine whether a position is a good fit. The map is divided into four sectors: coding and revenue cycle, informatics, data analytics, and information governance. Within those sectors, positions are shown as entry, mid, advanced, or master level and categorized as current or emerging roles. Each role, which includes a job description, provides a map for transitions and promotions into other roles.

Self-Assessment With a Critical Eye
Whether just out of college, working in the field, or in midcareer, determining a suitable career path based on interest is just the first step. The next is more difficult: a critical self-assessment that identifies strengths and weaknesses.

All AHIMA-approved HIM programs must cover the same six domains. However, depending on how a program is structured or what competencies are used regularly in a given job, HIM professionals may become much stronger in certain areas than in others. Sittig notes that while all programs hit the same domains, “you can bend your curriculum in certain ways,” adding that even if students graduate with a solid education in all six domains, skills that are rarely used will become rusty.

Valerie Watzlaf, PhD, MPH, RHIA, FAHIMA, vice chair of education and an associate professor of HIM at the University of Pittsburgh and president and board chair of AHIMA, believes HIM professionals can benefit from periodic soft assessments to determine newfound interests and areas where they may need to refresh. “Think about seeking out professional development and where your focus might be,” she says.

Staying up to date with industry changes and honing the necessary skills to remain current are must-haves when developing a career path in an evolving profession. “Five to 10 years is forever in the health care space,” Sittig says, noting artificial intelligence wasn’t a common subject in HIM 10 years ago. “But now we are talking about things such as helping to refine sepsis algorithms to better detect sepsis six to 12 hours in advance, where 10 years ago we weren’t talking about any of that. We were just kind of brushing the surface.”

Along with knowing in what direction they’d like to venture, HIM professionals must consider their level of expertise. “If you’re in a master’s program, for example, the competency at the end is to be able to analyze classification systems of clinical vocabulary and nomenclature, and what the impact of those systems would be on the health care continuum, so at that level you’re actually applying the knowledge, whereas at an associate’s level, that area of competencies is only to explain the use of clinical vocabulary and nomenclature,” Giannangelo says.

Tools for the Journey
Building a wide professional network, exploring possibilities, identifying interests, and honestly assessing strengths and weaknesses are excellent steps in developing a realistic career path. What comes next? Figuring out which of the many available tools are appropriate for reaching the next goal.

In addition to joining teams and committees within their own organizations, HIM professionals may want to consider joining other groups in their areas of interest. For example, Metheny made valuable connections while attending Healthcare Financial Management Association meetings.

Sittig says taking such initiative is wise. “In many circumstances we need to beef up the resources we have with specific domain knowledge, especially if you’re employed in a nontraditional HIM job,” he says.

Options abound for those who wish to refresh skills or gain new ones. Journals, conferences, webinars, social media, volunteer work, and traditional university programs can boost knowledge in the quest to land a desired position. Harnessing the power of knowledge gives HIM professionals far more opportunities than may first appear on the surface. Just by pursuing opportunities, they can add depth to various positions that may not immediately seem to fit the HIM profile.

“As a coder, looking beyond, could you be part of the charge description master team? Could you be a charge integrity auditor, a position that has historically been held by a nurse? HIM professionals go through anatomy and physiology, and while they might not be at the bedside clinically, they certainly understand the disease processes,” Johnson says.

Depending on career status and goals, higher education may be a good option. Watzlaf, who holds multiple advanced degrees, says, “I think about going to get certain certificates in areas I don’t know well.”

Formal education, whether in the form of degrees, postdoctoral training, or obtaining certificates, can provide a bridge to transition from one area to another, as well as satisfy the curiosity of lifelong learners enthusiastic about their work.

“Another way for HIM professionals to expand their knowledge is by joining a professional organization, such as AHIMA, and participating in opportunities they provide to network and expand skillsets,” Watzlaf says.

“AHIMA publishes practice briefs, which are great because they are authored by experts in the field and provide best practices for people to institute,” Giannangelo says.

Watzlaf also recommends writing and editing professional material. “You learn so much when you take on additional challenges,” she says. “A lot of professionals even take on adjunct teaching, another great way to immerse yourself in new experiences.”

A Field of Near-Boundless Opportunity
Any recent HIM graduate concerned with employment opportunities need only to consider how their skills may be applied differently. To find interesting and appropriate job listings, Giannangelo advises looking deeper than job titles and being creative in search techniques.

“When people start to search for jobs, they need to consider the fact that job titles vary,” she says. “They think, ‘Maybe I want to be in clinical terminology.’ Well, they probably won’t find that many jobs for clinical terminology. But I did a search today out of curiosity on Indeed, a job search engine, for SNOMED. And it returned not a ton, but some. There are positions out there for new graduates if they think about ways they can look for opportunities.”

Sittig, who is optimistic about the employment prospects for HIM professionals, believes data analytics and statistical analysis are “where the jobs are and they are going to be hot jobs for many years. The beautiful thing that HIM has that others don’t is an understanding of terminology, what the data mean, and where they come from. It’s the perfect blend.”

Metheny recommends embracing and adopting areas such as analytics, informatics, and mobile technologies, so they become part of the HIM span of influence. “Be open to any opportunity—even if it is not in the HIM department,” she says. “As an HIM professional, you have knowledge that is greatly useful in ensuring the patient record is complete and accurate.”

Johnson offers similar advice, saying, “It’s your responsibility to stay relevant. I encourage people to seek opportunities to network outside the HIM department.”

In spite of any uncertainty that may permeate the profession, the future appears bright for those entering the HIM arena. “Our graduates now are getting jobs that I don’t think that we could have ever imagined back when I started,” Watzlaf says. “In the past—and even currently—we do see graduates focusing on the traditional roles within the HIM department, but many of them are getting jobs all over the health care industry.”

— Dava Stewart is a freelance writer based in Tennessee.