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July 2015

Consider a Career as a Patient Advocate
By Lesley Kadlec, MA, RHIA
For The Record
Vol. 27 No. 7 P. 6

In today's patient-centric health care system, patients are insisting on more information and answers from their providers. They're beginning to ask more questions, while expecting more value for their health care dollars. Overall, the industry continues to be driven more by patients who want to have a voice in their health care decisions. This desire for increased participation has given rise to demand for a new type of health care professional: the patient advocate.

What Is a Patient Advocate?
Patient advocates typically act as liaisons working in partnership with patients and their health care providers. To be successful, patient advocates must be well-versed and trained on HIPAA standards such as privacy and security; be able to maintain strict confidentiality; understand patient rights, including informed consent; and provide continuing education to patients and their caregivers on health-related topics, including medical treatment options and general wellness.

Patient advocates may attend outpatient appointments and provide a list of questions or concerns to the provider at the time of the visit. Patient advocates also help facilitate communication between the patient and the health care provider. In fact, they may take notes to be shared with the patient or caregiver after the appointment to facilitate ongoing aftercare at home. Having notes to reference after the visit makes it more likely the patient will comply with a treatment plan.

Other responsibilities include helping with daily living activities such as arranging transportation to and from appointments and assisting with insurance claims or paperwork.

Patient advocates are responsible for reviewing medical records for accuracy and helping to explain their contents in layman's terms. Creation and maintenance of a PHR, which may prove critical in an emergency, is another potential task on a patient advocate's to-do list. According to the MyPHR website, a PHR "can reduce or eliminate duplicate procedures or processes, which saves health care dollars, your time, and the provider's time."

Where HIM Comes In
At the core of the patient advocate's responsibilities is an adherence to regulations regarding patient privacy, as well as knowledge of and an ability to maintain compliance with all state, local, and national laws related to patient advocacy and patient rights. Patient advocates must treat all information as privileged and ensure it's kept confidential. This includes making certain that any authorizations to disclose information are completed carefully and reviewed. It's also the patient advocate's duty to confirm that the patient follows up any referrals for medical, financial, legal, or other needed types of assistance. This ensures the patient is kept safe and informed throughout the health care and wellness processes.

Appendix A of the AHIMA credentials recertification guide lists the following as HIM professional domains:

• Technology: "Application of existing and emerging technologies for the collection of clinical data, the transformation of clinical data to useful health information, and the communication and protection of information," including PHRs.

• Management Development: "Application of organizational management theory and practices in addition to human resource management techniques to improve departmental adaptability, innovation, service quality, and operational efficiency." Clearly, management skills are an essential component of being an effective patient advocate.

• Clinical Data Management: "Applications and analysis of quality and clinical resources appropriate to the clinical setting. Includes database management to ensure quality and cost effectiveness of the rendered services (ie, data integrity, quality of documentation, clinical efficiency)." As mentioned, patient advocates play a key role in managing clinical data on behalf of the patient, including reviewing the accuracy of medical record documentation.

• Performance Improvement: "Development and application of quality processes to ensure quality data is generating consistent, timely information. Developing systems that are flexible and adaptable in a constantly changing health care environment." The day-to-day responsibilities of patient advocates include continually identifying opportunities for improvement.

• External Forces: "Study of regulatory requirements and the development of appropriate compliance initiatives for policies, procedures, protocols, and technology for hospitals, specialty facilities, and other health care providers." Patient advocates must monitor HIPAA compliance and all other legal or regulatory guidelines.

• Clinical Foundations: "Understanding of human anatomy and physiology, the nature of disease processes, and the protocols of diagnosis and treatment of the major diseases to include common drugs and laboratory and other tests used for the diagnosis and treatment of disease." Patient advocates must be familiar with disease processes, medications, and laboratory tests to satisfy patient needs.

• Privacy and Security: "Understanding and application of current health care regulations that promote protection of medical information and the electronic transmission of health information." In fact, the guidelines specifically mention advocacy when it describes one of the responsibilities as "acting as the patients' advocate, helping them understand their rights with regard to protected health information on any applicable analog or digital medium."

These core domains make it evident that HIM professionals have the right combination of knowledge and skills to transition successfully into the role of patient advocate.

Expected Salary Range
According to Simply Hired, the average annual salary of a patient advocate is $44,000. In comparison, the average annual salary for HIM positions is $53,000. However, keep in mind these figures can vary greatly due to company size, location, individual experience, and noncash compensation such as benefits. Therefore, while the average salaries for the two positions are similar, local demand, a desire to assist patients more directly, or a yearning to veer from the traditional HIM career path can make the patient advocate option more attractive.

Anyone who elects to pursue a career as a patient advocate will be joining a select population. Although it's difficult to obtain an exact number, the Alliance of Professional Health Advocates (APHA) estimates there are only a few thousand private advocates, which is hardly enough to meet current and future needs.

A Noble Pursuit
Trisha Torrey, founder and director of AdvoConnection.com and the APHA, says there's a burning need for patient advocates. "The world of patients needs you! They are frustrated and confused. They know that doctors can't keep up. They know that money has an influence on the care they receive, and when they realize that help is available, they want it," she wrote on the alliance's website.

In choosing to pursue a path as a patient advocate, HIM professionals can serve to advance their skills while ultimately assisting in achieving the "Triple Aim" of improving patient experience (including quality of care and satisfaction), boosting population health, and reducing the per capita cost of health care.

— Lesley Kadlec, MA, RHIA, is a director of HIM practice excellence at AHIMA.