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October 24, 2011

HIM Heroes
By Lindsey Getz
For The Record
Vol. 23 No. 19 P. 14

Meet a pool of professionals who have made a difference.

Professionals in the HIM field are a vital part of the healthcare system, yet they’re typically considered more background players than front-and-center performers. That’s why For The Record makes it an annual event to salute 10 “heroes” who’ve done themselves and the profession proud without necessarily being on a national stage. Here’s a glimpse into their achievements and the stories that make them unique.

Maggie Garcia, RHIA
Director of HIM at Nix Health
As a child, Maggie Garcia was in and out of hospitals, where she got a firsthand look at the healthcare system and made the decision to pursue a career in a related field. While she was leaning toward pursuing physical therapy, a school counselor thought her profile made her a great candidate for an HIM career. She “gave it a shot,” not knowing whether it would stick. But it did, and it’s something at which she has excelled.

Of course, Garcia’s HIM career hasn’t been without its challenges.

One of those challenges came early in her career when she faced the task of helping implement an IT system in 90 days following a hospital merger. Lester Surrock, senior vice president and chief financial officer at Nix Health, says paper charts were being replaced, a challenge for anyone, but Garcia was a relative newcomer.

“She was very involved in that transition and made sure all of the patient medical record numbers came across so that we didn’t lose any traction of being able to find any old records,” Surrock recalls. “I was impressed.”

Garcia deflects any praise, claiming she was merely adapting on the fly.

“I was really green but got thrown into this situation,” she says. “I look at it as a great experience though. It offered a lot of opportunity to learn and was a real eye-opener for me.”

Not long after Surrock arrived at Nix, he made a personal request that Garcia join him as assistant director, knowing he’d ultimately promote her to director. Since then, she has helped achieve compliancy and taken charge of updating forms management at Nix, an impressive feat considering there were more than 720 different paper forms in the system.

Garcia traces her recent success to the start of her career when she was thrown into the fire and forced to excel under pressure while maintaining efficiency.

“I wanted to learn everything from the ground up, and that’s what I ended up doing,” she says. “Because I started at a smaller hospital, I had to learn it all. I had to know how to do it, how much time it would take, and what was feasible. Those skills have helped me to manage more effectively.”

Mike Brensinger, RHIA, CPHQ
Principal at e4 Services
Six years ago, Mike Brensinger started a consulting firm specializing in clinical, HIM, and revenue cycle services. He had the requisite experience, having served as assistant director of medical records at Reading Hospital in Pennsylvania and as HIM product line manager at Siemens Healthcare.

Nevertheless, launching a business is always a risk. “I’d definitely call it my biggest challenge,” says Brensinger. “But we started it with the focus on the customers, and we’ve tried to stick with that focus. Hospitals were buying multimillion-dollar systems and not knowing how to install them nor did they have the support they needed. We take over that challenge.”

e4 Services aims to accelerate installations while performing hands-on work and providing support during the entire implementation. More recently, the firm has shifted its focus to ICD-10.

Brensinger says the idea behind e4 Services came when he was helping design EHR systems at Siemens.

“We were building them, but we didn’t have the infrastructure to go out to the sites to install them,” he says. “That’s where e4 was born. We came back to partner with Siemens in order to help their customers. Siemens equips the vendor and then they reach out to us for support.”

The partnership has resulted in quite a few “epic installs.” While business is booming and the company is growing, Brensinger wants the focus to remain on the customer.

“We’re a company that doesn’t want a thousand customers,” he says. “We’d rather our existing customers kept coming back and we’d continue to do good work for them. We’re about building relationships.”

Michelle Cantu, supervisor of HIM at Corona Regional Medical Center in California, says Brensinger’s hands-on approach and personable disposition have made the two-year relationship between the medical center and e4 fruitful.

“He’s really on the up-and-comers list when it comes to the health information technology fields and yet he’s down to earth and easy to talk to,” she says. “I think he’s one of the changers in the field, bringing more awareness to EHRs and creating a bridge to ICD-10. He’s definitely helping advance the field, but I believe he’ll always be approachable because he cares about his clients.”

Kelly Fast
HIM Manager at Hannibal Regional Hospital
Kelly Fast credits her mother with being the catalyst for her career.

“She is my most important mentor,” says Fast, who adds that even in her mid-70s, her mother is still at the computer transcribing nearly every day.

In 1989, when the medical transcription industry was arguably at its peak, Fast owned her own transcription company. Two years ago, however, work began to decline as the effects of more widespread EHR adoption took hold.

Fast was willing to adapt, although she admits it was a challenge. At first, she struggled with accepting the fast-paced changes technology was bringing to the industry. A heart-to-heart with a career mentor helped her realize the value of technology, and Fast decided to seek additional education through the master’s of HIM program at the College of St. Scholastica.

Around the same time, she moved into the technical side of HIM to become a manager. “The appeal has been having a dynamic work environment,” she says. “I also feel gratification knowing that my work helps patients.”

Fast continues to see the value and opportunities coming down the pipeline through EHR adoption.

“It is exciting to see the power of information channeled into more definite streams,” she says. “This is creating a robustness of healthcare data applications not seen with granular narrative information of years before. However, healthcare clinicians are still treating people. We must not lose the exactness of texture that allows us to see the entire picture of each patient with a high acuity of quality.”

While the future looks bright, Fast can’t help but look back at the beginning of her career. She gives credit to her husband, Roger, who was her “roadie” and “technician” in the early days.

“If we were adapting to a new software, Roger would drive two hours on a Saturday to St. Louis to the used software bookstore where we would find the manual for the software,” she recalls. “He would spend his weekend off from his job to help me orient myself to the new technology. Things have certainly changed since those days.”

Maudy Sherer, CCS, CPC-H, CPCS, CPHM
HIM Supervisor and Medical Staff Coordinator at Modoc Medical Center
Maudy Sherer was practically destined to work in healthcare. Coming from a small community in northern California where both of her parents worked at the local hospital, she was introduced to the profession at a young age. At 15, she applied for a position in Modoc’s dietary department and has since worked her way up through housekeeping and laundry to the medical records department.

She quickly transitioned from file clerk to transcriptionist, then to coder, and finally to certified medical coder. In 2005, she earned a promotion to HIM supervisor and medical staff coordinator. She has a full plate with two demanding positions but manages to make things work despite dwindling resources. She works long, hard hours but doesn’t look at it that way.

“I don’t really consider the long hours I work; I consider the livelihood of an underserved, rural area that would be devastated if our hospital wasn’t here to provide the services we do, even if they are limited,” she says. “It gives you a real sense of community—of being part of the bigger picture.”

While it’s a lot to manage, Sherer has no trouble staying motivated. “I love knowing that because of our hospital, a new life has been brought into the world and into our community,” she says. “I love that we have helped patients in their last hours to be as comfortable as possible. We build relationships with our patients and even though I am only in the back end of it all, when I see these things, it makes me proud to be a part of it. We have an exceptional group of people here who go above and beyond for our patients and our hospitals. With all of these wonderful things, it’s hard not to stay motivated.”

Andrea Clark, RHIA, CCS, CPCH
President and AHIMA-Certified ICD-10-CM/PCS Trainer at Health Revenue Assurance Associates, Inc
Today Andrea Clark is a nationally known expert in the HIM field, but like so many others who have wound up in this industry, it was some early childhood experiences that led her in this direction. During the summer between sixth and seventh grade, Clark’s mother sent her to a medical terminology class.

“I think it was just something to keep me occupied,” she says.

It turned out to be an introduction to a whole new world. “I think my mother may have known that I was right for this field before I did,” continues Clark. “I used to play school and enjoy pretending to check and grade papers. Now as an auditor, that’s what I get to do every day. I check and grade papers as a friendly RAC [recovery audit contractor] auditor.”

Early in her career, Clark gained experience at several reputable firms. As she grew her knowledgebase and expanded past HIM into revenue cycle management, she unearthed a desire to provide a comprehensive service and solution for clients. That’s when she decided to branch out on her own.

“It wasn’t long before I divorced myself from being an employee and began that trek of being an entrepreneur and ultimately the owner and president of a company,” she says.

Clark is passionate about HIM’s future and bringing more newcomers into the field. She believes the industry needs to be guiding and mentoring future leaders considering the fact that HIM is known for its aging, retirement-gazing workforce. Clark is doing what she can to generate new interest, striking up relationships with schools to help get students excited and ready to enter the profession.

“I feel very strongly about mentoring and bringing in coders that may not have that extensive experience but they’re bright, shiny, and new and are the ones to lead us into the future,” she says. “Internally, we’re hiring these newcomers and bringing them up through the ranks. Even though we’re a consulting and technology firm, there is so much they can learn from us and so many ways they can hone their coding skills. I’m so excited about the opportunities out there, but I believe we need those bright shining stars to bring us forward.”

Amarah K. Dawes, RHIA
Assistant Chief of Medical Administration Service at the VA
Amarah Dawes knew she wanted to work in the healthcare field but wasn’t prepared to deal with tasks such as drawing blood. As a business-minded individual, the HIM industry was a perfect fit.

After college, Dawes applied for an internship with the VA and sought opportunities in several states. Accepting a position in Arizona, where she spent three years, turned out to have long-lasting effects.

“I had the best mentor in Phoenix who taught me everything I know today about HIM,” says Dawes.

In 2007, Dawes became director of medical records at a VA facility in Denver. “Again I had a mentor that supported me and helped me learn,” she says, alluding to a recurring theme on her career path. “I attribute so much of my success to my mentors. I realize I had opportunities that many don’t get, and I feel fortunate for that.”

Moving quickly through the ranks, Dawes is currently in West Palm Beach, Fla., working in a fast-paced environment.

“We’re constantly trying to find new ways to improve,” she says. “And in this most recent move, I once again have supportive leadership to lean on. I have been amazed by the VA as an organization. It’s the biggest healthcare organization in the world, yet it’s small in the sense that it seems everyone gets to know each other and there’s tons of support available. It’s also an organization that thrives on continued learning. The opportunities available through the internship program are incredible.”

Today, Dawes is the one interviewing interns and striving to be as much help to newcomers as her mentors were to her.

“Coming out of school, many wind up stuck in a supervisor job without much experience, and they just have to learn as they go,” says Dawes. “But that’s not how the VA does things. They promote learning. That’s largely because they’re committed to replacing the baby boomers that are set to retire in the near future.”

Dawes is fully committed to expanding the scope of the HIM profession at a time of great opportunity.

“Life is short. Why spend it doing something you don’t love? I like to be inspired, and I like to try and inspire people. That may not sound like something you can do with medical records, but it’s what I strive to do. I believe in this industry, and I’m 100% committed to it,” she says.

Melissa M. Martin, RHIA, CCS
Director of HIM and Chief Privacy Officer at West Virginia University Healthcare
In the more than 13 years Melissa Martin has served as HIM director at West Virginia University Healthcare (WVUH), she’s guided the department through enhanced work standards, technology makeovers, employee empowerment, and accountability, says Christine Metheny, RHIA, the department’s manager of technicians.

Among Martin’s accomplishments is her ability to hold the HIM staff to a zero-tolerance policy for backlogs in all areas of the department—a concept she introduced in 2003. Martin says the standard was put in place at a time when the department was assessing its goals in preparation for optical imaging and before EHR implementation.

“As we talked about standards and put some things down on paper, it became clear that the staff had their minds wrapped around the idea that being no more than 30 days behind was the goal,” she recalls. “In reality, being 30 days behind is further than we should ever be and was the worst-case scenario. So it came down to a difference of a goal vs. a disaster point. It was really a matter of getting the staff to change their mindset.”

The idea of developing new goals led to the realization that staff might operate more efficiently with flexible hours. Martin says implementing a more elastic schedule has made a huge difference in productivity.

“One day you may get 20 charts to deal with, and the next it might be 40 or 50,” she says. “We want staff to know they have the ability to flex their schedule so that things can get done in real time every day.”

The new policy has kept WVUH’s delinquency rate below 12%, and transcription turnaround processes have drastically cut the time between dictation and transcription.

“Many times the surgeon will hang up from dictating the operative summary, remove his surgical wear, and log in to sign off the transcription that quickly,” Metheny says. “That’s largely thanks to Melissa’s diligence. She’s also helped bring HIM to the forefront and helped others realize why HIM is so important. She makes sure we’re seen at the table even though we’re typically behind closed doors.”

Suzanne Meiskey, MSA, RHIA
Professor and Coordinator of the HIM Program at Montgomery College
Like many of her students, Suzanne Meiskey entered HIM as a second profession. Wanting to be involved with healthcare but not necessarily on the clinical side, HIM turned out to be a perfect fit.

For 13 years, she did just that at a local hospital until a promising opportunity emerged at Montgomery College in Takoma Park, Md., where she earned the honor of becoming the school’s first HIM program coordinator. More than two successful decades later, she’s calling it a day, having influenced the lives and careers of countless students.

“She is so dedicated to her students, and it’s obvious she would do anything for them,” says Stuart Shepherd, a former student. “I feel that her dedication as a teacher has impacted the entire profession, not just the school. She’s producing tomorrow’s leaders.”

Meiskey says that has always been one of her main objectives.

“I think it’s important to bring the next group of qualified people into the arena of healthcare,” she says. “It goes back to wanting to help people, which is the reason so many get into the HIM field in the first place. It’s how I felt working in the hospital and how I feel as a teacher—I want to help.”

Over the years, Meiskey has witnessed a slew of changes in the industry, but it’s been the rapid rise of technological advances that’s been most imposing. Still, she’s managed to keep pace with more than two decades of overhaul.

“When I came on board back in 1987, the room I shared with the business department was a room full of typewriters with two computers gathering dust in the corner,” she says. “Now I’ve got a room with 30 computers and seven different software packages. I’ve always had to keep myself up on technology and stay one step ahead of my students. But it’s new and exciting, and it’s something I really love.”

Celeste McCarty, MBA, RHIA
Supervisor of Medicare Risk Adjustment at Advocate Medical Group
For a time, Advocate Medical Group used an outside company to review charts to make certain staff weren’t missing any diagnoses.

“We were continually paying them to look over things, but we weren’t missing anything,” says Celeste McCarty. “In fact, I was doing a quality check on their work and found errors there. That was when we made a decision to bring it in-house.”

McCarty basically built the new department from the ground up. She handpicked everyone to ensure the best possible staff. Since then, the department has increased its risk score by 10% in just two years.

Like others who’ve become HIM heroes, McCarty chose a career in HIM as an alternative to working directly in patient services. In fact, she started working in that arena before she realized it wasn’t the right path for her.

“I worked in a pediatric area and found it was too heart wrenching for me to handle,” she says. “It was too much of an emotional toll for me, so I decided if I couldn’t deliver care in that way, I wanted to find another way to help patients. That’s how I ended up where I am today.”

McCarty’s caring heart is just as obvious in her behind-the-scenes work as it was during her short stint rendering direct patient care. She has become a patient advocate, making it a top priority to see that those in need receive the appropriate attention.

“Our entire population is seniors and even though they’re not paying copays, they have travel issues,” she says. “Medicare allows for about six transportation visits each year, but one appointment counts as two visits—one for each way. That’s why we look to maximize the patient’s visit and work as hard as we can to make sure we’re meeting their needs.”

Lori Marks, RHIA, CCS
Associate Director of Outpatient Coding at Parkland Health & Hospital System
It was practically by chance that Lori Marks stumbled on the HIM profession. After perusing a college handbook, she felt the need to find out more about what an HIM career entailed. Before long, it started to feel as if fate were calling her to an occupation that seemed to be a perfect fit.

“It was enough of the medical side of things without the blood and guts,” she says, laughing. “I liked the idea of getting to learn about some of the medical procedures without actually having to deal with the gory parts.”

In her current role at Parkland Health and Hospital Systems, Marks manages the coding of outpatient encounters that total $1.2 million annually. A list of her achievements includes the creation of a fully functional team that began as a group of unsupervised workers; achieving and maintaining a successful drop in unbilled outpatient encounters from $18 million per day to $1.7 million; and hiring, training, and developing an in-house coding staff, a move that led to a 70% reduction in outsourced employees.

On top of these accomplishments, Marks maintains an ever-present positive attitude that spills over onto her staff.

“She really gives her coders so much inspiration,” says Kathy McCalley, CCS, ambulatory payment classifications coordinator at Parkland. “She encourages them through any task and always has an open-door policy for all of her coders to come in and ask questions. And no matter what, she always has a smile.”

Marks is cognizant of the effect her demeanor can have on a staff looking to make a difference.

“I believe if you give somebody an opportunity to put their best day forward, they’ll be inspired to do better and produce outstanding work,” she says.

While her HIM career may have emerged from humble beginnings in a college handbook, Marks says it’s much more than that today.

“It has really become my passion,” she says. “I feel like I stumbled upon it and didn’t know much about it, but now it’s something I truly love.”

— Lindsey Getz is a freelance writer based in Royersford, Pa.