December 20, 2010

Students Wanted
By Lisa A. Eramo
For The Record
Vol. 22 No. 23 P. 14

Designed to boost workforce numbers, federally funded HIT training programs offer new career paths for HIM professionals.

When 38-year-old Shelly Jude, RHIT, received an e-mail from her alma mater, Columbus State Community College, about a new HIT program focused on EHRs, her curiosity was piqued.

Jude, who currently works as a coding and compliance specialist performing coding audits for a primary and specialty care group that includes more than 40 physician offices in Columbus, Ohio, says learning more about EHR workflow redesign would enable her to be a resource for physicians as they implement EHRs in each affiliated office. It’s important for HIM professionals to tout their EHR knowledge, particularly when working in an office setting, she says. Physicians tend to overlook the valuable input that HIM professionals can contribute to an EHR rollout, choosing instead to focus too heavily on clinical information.

“We’ve had a couple of doctors who are real leaders on getting the EHR up and running, but they may be missing some of the key players,” says Jude, who earned an associate’s degree in HIT from Columbus State Community College and a bachelor’s degree in health administration from Warren National University. “My hope is that by taking this course and being certified, I can validate to them that HIM professionals like me and with my background need to be a part of the team to help with the transition.”

Like many providers scrambling to implement EHRs and qualify for incentive funds, the physician group for which Jude works is under a tight timeline. It plans to roll out EHRs in each of its affiliated primary care offices this April.

Without the help of HIM professionals—particularly those who have gone through HIT training programs—physicians will struggle to meet meaningful use requirements, says Jude. “I think that all the healthcare reforms are going to make physicians realize they need certified, educated HIM professionals and coders to be a part of their team,” she says.

In addition to lending a hand to physicians, Jude hopes to take some of what she learns to train office staff members on how to more effectively use an EHR. “If they’re going to be using the electronic record on a daily basis, they’ll need some underlying training so they grasp it and will ask questions,” she says.

Patti Carmody, RHIA, also understands the need to expand her EHR knowledge, which is why she signed up for the HIT training program at her alma mater, Dakota State University. Carmody, who currently works as a health information consultant for a long-term care corporation in Sioux Falls, S.D., enrolled primarily so she could learn more about project management. She hopes knowledge gleaned from the program will help her provide valuable input regarding important decisions during the EHR rollout process for each of the corporation’s 180 nursing homes.

Carmody says the corporation for which she works is debating whether to work with an EHR vendor or build its own EHR. If the corporation decides to choose a vendor, Carmody says she wants to help search for one that would best integrate with its MDS 3.0 billing software and be able to tap into a health information exchange network.

HIM Professionals and the EHR
Like Jude and Carmody, many HIM professionals want their seat at the EHR decision-making table. That’s why some have already begun to sign up for the intensive six-month nondegree HIT training programs now offered through the federally funded program known as the Community College Consortia to Educate Health Information Technology Professionals in Health Care. The Office of the National Coordinator for Health Information Technology (ONC) hopes the program will yield more than 10,500 new HIT professionals annually to replenish a deficit of qualified workers who can help implement EHRs.

The program kicked off September 30 thanks to a $70 million federal grant awarded to five community colleges in five different geographic regions. The colleges then dispersed grant monies to schools within their regions, resulting in disbursements to more than 80 other community colleges nationwide.

The training program focuses on the following six workforce roles:

• practice workflow and information management specialists;

• clinician/practitioner consultants;

• implementation support specialists;

• implementation managers;

• technical/software support staff; and

• trainers.

HIM professionals are well suited for most—if not all—of these roles because of their ability to see the big picture in terms of how information flows throughout an organization, says Kay Gooding, MPH, MAEd, RHIA, project director for the Region D HIT Consortium and former program chair of the HIT program at Pitt Community College in Greenville, N.C. Region D, which includes 20 community colleges, was granted approximately $10.9 million for the first year of the two-year grant—the largest sum granted to any of the five consortia.

“It’s an enhancement of what [HIM professionals] already have with a further focus on the IT aspects,” says Gooding when describing the program that capitalizes on HIM professionals’ knowledge of the EHR, their ability to serve as liaisons to clinicians, and their understanding of the delivery, capturing, and charging of healthcare.

HIM Recruitment Efforts
Although the HIT programs are appealing to students with an IT background, many of the schools are specifically targeting professionals with an HIM background or a formal RHIT or RHIA credential.

For example, Dakota State University is focusing on alumni from its HIM academic programs, says Jamie E. Husher, MS, RHIA, CHPS, an HIT educational specialist at Dakota State. “We do feel they are a prime group to target. If they graduated five to 10 years ago, a lot has changed,” she says. “This is a good opportunity for them to update their skills and gain knowledge in a short amount of time.”

The college is stressing to graduates the importance of making themselves more marketable in the event of a career transition or enhancing their ability to interact with other departments involved in an EHR rollout. “Knowledge is power, and these training programs will help HIM professionals feel more confident discussing and partnering with IT professionals and departments,” says Husher.

Pitt Community College is taking advantage of affiliations with its state HIM association as well as ancillary associations such as the state HIMSS chapter and the North Carolina Healthcare Information and Communications Alliance. “We’re leaning very heavily on them to get the word out,” says Gooding.

Dakota State University is tapping into its HIM affiliations by posting information on the AHIMA’s South Dakota Community of Practice discussion board, speaking about the program at HIM association meetings, and promoting it in the local HIM newsletter, says Husher.

Catawba Valley Community College in Hickory, N.C., one of Region D’s grant recipients, is targeting alumni from its HIM programs as well as those who have graduated from its computer technology programs and other health services programs, says Thad Sparkman, FACHE, FAAMA, MA, MBA, program director of operations for the HIT workforce development program. In addition, the school mailed eye-catching postcards to every hospital and nursing home in its region—a total of 160 facilities in 37 counties—directing the solicitation to chief information officers, health information managers, and directors of patient care services. A separate mailing was sent to all medical group managers in the area.

Many schools have been relying on regional extension centers to spread the word about the programs. Others have created advisory boards that include HIM graduates as well as working professionals (eg, consultants, hospital executives, medical group managers) who can help steer and promote the programs as well as assist with job placement.

Recruitment Challenges
Efforts to reach out to the HIM community have not been without challenges. One barrier is making HIM professionals understand the importance of these programs, says Husher. “Sometimes people don’t always know they need the training, so getting the message out has been important,” she says.

In terms of marketing the program, compiling lists of all local hospitals, nursing homes, doctor’s offices, and other providers has been a time-consuming task, Husher says.

Sources say cost can be a deterrent to enrollment. However, some schools are offering financial incentives that pay for a portion of the program. Others reimburse students in full if they complete the program within six months. Another option for students who are already working is to seek tuition reimbursement opportunities through their employers.

Time commitment is another factor. “People have to be able to dedicate up to 15 to 20 hours a week to learning. It’s intensive, so just to even take it on is a major commitment,” says Sparkman.

Some schools are offering rolling admissions that allow students to enter the program at any time, making it easier for them to incorporate the training into their lifestyle. Others allow students to enter at specific intervals (eg, every three to six weeks). For example, at Catawba Valley Community College, a new class begins every 28 days. Students have 24 weeks to finish required courses but are given an additional six months to complete any elective classes and prepare for the competency exam.

An HIT competency exam currently under development as part of the Health IT Workforce Development Program will help validate students’ body of knowledge to prospective employers, says Gooding. The exam, which is expected to be available at no charge for the first 27,500 examinees, will be completed and available to students by mid-2011, she says.

Some schools offer programs entirely online while others feature an online program with a periodic on-site requirement. “There really are no geographic boundaries. It becomes a 24/7-available educational opportunity,” says Gooding.

“Many of our students work full time and cannot make it to campus for classes,” says Gary Clark, HIT program coordinator for Columbus State Community College. ”Those who are unemployed are concerned that committing to being in school would hurt their flexibility for finding a new job, and they don’t want to have to choose between schooling and getting a job. Offering the classes as distance learning opens up the program and opportunity to many more potential students.”

Looking Ahead
Although it’s too soon to identify major enrollment trends, several sources say based on preliminary analyses of the first wave of students, HIM professionals have been generally drawn to the roles of practice workflow and information management specialists, implementation managers, and trainers.

“It will be interesting to see whether those with an HIM background or an RHIA or RHIT credential are the ones who move through the programs really quickly,” says Norma Morganti of Cuyahoga Community College in Cleveland. Morganti serves as the executive director of the Midwest Community College HIT Consortium in Region C. The region includes 17 community colleges and was awarded approximately $7.5 million during the first year of the grant.

Once Cuyahoga Community College has taken a closer look at its student demographics and what types of students are drawn to which roles, the school hopes to map certain credentials to each of the six roles. This will help students better understand how they can put their current knowledge, training, and experience to best use in the programs, says Morganti.

HIM professionals should look carefully at each of the six roles and not necessarily discount the more IT-intensive technical/software support staff role, says Husher. Students with an HIM background can easily be cross-trained by taking an introductory course in computer science. Likewise, those with an IT background can take an introductory course in healthcare, she adds.

Something else to keep in mind is that regardless of which role a student pursues, one benefit that any HIM professional can appreciate is the opportunity to learn more about how to more effectively use an EHR, which certainly enhances return on investment, says Husher. “It could also help you save your job,” she says, adding that the skills acquired in the program will likely be in high demand before, during, and after an EHR implementation.

What’s important for HIM professionals to know is that although these programs are currently voluntary, the profession is quickly evolving to the point where IT skills will become a necessary job skill, says Gooding. “This is what we’re pushing for rapidly. We’re all examining our role in medical informatics and how much of this needs to be within the [Commission on Accreditation for Health Informatics and Information Management Education]-accredited program structure,” she says.

For more information about the Community College Consortia Program and each of the colleges offering the HIT training programs, visit http://healthit.hhs.gov/communitycollege. 

— Lisa A. Eramo is a freelance writer and editor in Cranston, R.I., who specializes in healthcare regulatory topics, HIM, and medical coding.