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The Making of an HIM Leader:
Building Strong Leadership Beyond HIM Walls

By Beth Friedman, RHIT, BSHA

Joseph J. Gurrieri, RHIA, CHP, president of H.I.M. ON CALL, has more than 20 years of experience in the HIM profession. Before joining the company in April 2006, he held various management positions in hospitals in New York and New Jersey and performed consulting in interim management/director roles. During that time, he developed and implemented software applications focused on medical coding productivity, quality measurement, discharged-not-final-billed management, and HIPAA accounting of disclosure tracking. I recently had the opportunity to talk with Gurrieri about his remarkable journey and the qualities that make an outstanding leader.

Friedman: Talk about your early experience in the HIM industry. What led you to HIM?

Gurrieri: I first enrolled in the physician assistant program at SUNY Downstate Medical Center. In a joint venture with St. Francis College, I was set to complete the first two years at St. Francis and then transfer to SUNY. After a year and a half of working nights and spending days in class, I enrolled in medical records administration evening classes. I had the prerequisites and saw an interesting opportunity to combine work and school on a more normal schedule.

The first week of class, a student who worked in the medical records department at Long Island College Hospital referred me for an opening in his department. I went for an interview and landed a job as coordinator of document control—my very first job in HIM.

Friedman: What were some of the challenges you encountered?

Gurrieri: This was back when all medical records were paper. We had problems getting discharge records from nursing units. Records were constantly getting lost or held up by physicians. Each day, I reviewed the discharge census and went around the hospital to physically track down records. For the finance department, lost or delayed records meant lost or delayed reimbursement.

Friedman: Over a seven-year period, you quickly advanced within Long Island College Hospital—from coordinator of document control to assistant director of HIM, to associate director, and finally to director of HIM at Continuum Health Partners. What contributed to such a steady professional progression?

Gurrieri: Early on, I was eager to learn and apply that knowledge to real life. I was interested in knowing about all functions in HIM and how our work affected other departments. I learned how information management was tied to the billing department, reporting, patient access, [and] how patients were registered and admitted. I wanted a comprehensive view beyond the walls of HIM. I’ve always had a tendency to do more than is required, so I guess I stood out in that way. My director involved me in all that he was doing and eventually placed me in charge of compliance, which was becoming very important in the industry. There was a sense of trust [and] feeling acknowledged and valued.

Friedman: You say the most extensive experience in your career came during your six-year position as assistant vice president of the New Jersey Hospital Association (NJHA). Why was this period of your career so important?

Gurrieri: I was hired by NJHA’s senior vice president who provided extraordinary opportunities for me to expand my experience. She brought in directors under my supervision in three areas: coding, HIM services, and education. We provided services for all hospitals in New Jersey, performing interim management for 15 hospitals as part of our service line. I’d had the one director position at Long Island College Hospital, and now I was interim director in all these different hospitals—from small community hospitals to large teaching hospitals. I gained invaluable knowledge of HIM during that time.

Friedman: You were also involved in entrepreneurial endeavors while performing interim management and consulting for NJHA. Describe that aspect of your journey.

Gurrieri: While at NJHA, I branched out and opened my own companies. I was already in the beginning stage of a medical transcription company before joining NJHA. I ran the company for about four years, managing at night with others working for me. We expanded to include forms design (electronic and paper), opened a release of information company, and offered storage management of medical records.

Friedman: With so many opportunities at NJHA and successful business ventures, what prompted the transition to H.I.M. ON CALL?

Gurrieri: I had moved to Pennsylvania and was offered a position as vice president of operations at H.I.M. ON CALL. At first I was hesitant to take the leap, but after careful consideration of my career direction, I realized it was the right decision. I would be part of an established, progressive company providing technology-enabled coding, audit, revenue, and documentation improvement services for the health care industry. The new position would require my full-time attention. So, I sold my interest in my companies and joined H.I.M. ON CALL in 2006.

Friedman: Assuming leadership roles is more important than ever for HIM professionals. Talk about your evolution as a leader in the field. Do you consider yourself to be a born leader?

Gurrieri: I may not be a born leader, but I’ve always aspired to more than was given to me. I want the most out of life—to learn, grow, and make a difference. My success is the result of dedicated effort and finding the right role models. I found a mentor early on, a leader I looked up to, listened to, trusted. He inspired the confidence, knowledge, and commitment I needed to lead people.

People skills are essential—leading by example and offering full support. I’m not a “crack the whip” kind of leader. I believe in an experiential, motivational, teamwork approach—a culture of open communication where people feel valued. Throughout my career, it’s been my experience that people trust me, believe in me, and follow me through.

Friedman: As health care organizations realize the value of multidisciplinary collaboration, the walls of silos are coming down. Can you say more about the importance of teamwork?

Gurrieri: I realized early in my career there were silos in hospitals—finger-pointing, [with] each department blaming another department. I was able to bring departments together through collaboration. It’s a matter of all departments working together under strong leadership to get the job done. Everyone has the same mission. I’ve organized many committees and task forces in hospitals, and now with my clients, to promote communication, pull everyone together, acknowledge their priorities, and get to the heart of the matter with an organized plan to achieve the best possible outcomes.

Friedman: What are the most important lessons learned about leadership along your journey?

Gurrieri: Don’t take anyone for granted. Value each person and role. Make sure people are suited to their roles—follow a thorough hiring process. Organize the company [and] each department to achieve optimal performance. Collaborate, communicate—teamwork is critical. Practice sound decision making, with the right people, processes, information, technology. Never lose sight of the big picture.

Friedman: As new opportunities arise for HIM professionals, how can they move into leadership roles within their organizations?

Gurrieri: HIM professionals are the experts when it comes to managing and governing health care information. From a financial standpoint, coding gives HIM credibility. Coding integrity drives data integrity and accurate revenue. HIM must prove they are most qualified to lead by taking charge of the various aspects of information management.

HIM directors must be proactive, establish themselves as experts in the industry by being vocal and visible in the workplace. I’ve seen successful colleagues assume the lead ahead of the game, take a seat at the table, speak up at meetings, set up committees, initiate multidisciplinary teams.

To survive and thrive, our profession must stay involved, constantly changing with the times—networking, attending trade shows, engaging senior leadership, keeping pace with technology and globalization of information management.

Friedman: What are some leadership roles that HIM professionals should pursue?

Gurrieri: The push for information governance provides an excellent opportunity for HIM leaders. It is ours to take, along with compliance, privacy, security, coding analytics, and more. HIM can definitely take a leadership role in IT, given the growing demand for meaningful, trusted information. The two departments must work together, along with other departments, to ensure quality data. With that in mind, 50% of HIM training programs should be focused on technology that prepares HIM professionals for IT leadership.

Friedman: As an HIM professional in a hospital, I worked with different departments, including lab, pharmacy, and radiology. Learning their systems and information needs gave me a more comprehensive view of the organization. It’s becoming increasingly important for HIM to learn the information needs of each department. Gaining a stronger hold on departmental level needs will help prepare our profession for leadership going forward. Based on your experience and knowledge of emerging trends, what advice can you offer HIM professionals as the future of health care unfolds?

Gurrieri: I think the key message is to focus on information governance, knowledge of all departments, and the IT side of industry. Currently at H.I.M ON CALL, 98% of revenue is coding, but it’s moving rapidly into the IT application and development side. There are major plans and investments to take it a step further in 2017 as we transition to systems that provide coding services. The direction is technology and HIM must be ready to take the lead.

— Beth Friedman, RHIT, BSHA, is founder and chief content officer of Agency Ten22.