Health Care Informatics

LESSON 13 Health Information Staffing LECTURE NOTES ______________________________________________________________________________________

Staffing and Organizing the Health Information Management Department

The personnel needed to operate a health information management system require specialized

training for this field of employment. Regardless of whether the department is using a paper-

based health record, has converted to a partial electronic health record, or has made the

commitment to a full electronic health record, health information systems has become a highly

specialized field with many sub-specialties.

Each health care organization creates policies, procedures, and protocols for using their health

care information records, regardless of whether it is paper-based or electronic. While the

organization and their health information specialists follow professional and governmental

requirements, each system is created and modified to meet the specific needs of the organization.

As the saying goes, “If you have seen one health care information system... you have seen only

one health care information system.” The newly hired health care information specialist will

need to be trained and oriented to the organization’s system, the policies and procedures, and the

other internal protocols of the organization.

For the paper-based record, the individual should possess skills and knowledge of the structure

and organization of the health record, patient privacy and confidentiality, state and federal laws

and regulations, storage and retention of records, organization of the health care delivery system,

and medical terminology. The individual also needs to be meticulous and detailed oriented since

the record is the primary legal document that supports the services rendered to the patient. In

some positions, the ability to use statistical tools is needed, especially for quality assurance and

other review and quality audit systems. If the individual is in a leadership or supervisory

position, additional skills in management theory and supervisory experience would be necessary

for success.

For the organization that uses an electronic health record, all of the above mentioned skills are

necessary along with computer expertise. Individuals need some technical skills on how the

electronic system operates, but not highly specific knowledge on information technology.

Specialized training on hardware, software, and operating systems would be critical for the

individual in the information technology (IT) department.

While the functioning of electronic health records is similar, every system and vendor has

programs and operations that are unique to their software. Having worked or trained on other

software systems is helpful, but most likely individuals will need to have detailed and specific

training on their health care organization’s software and protocols for health information.

Ongoing Training for HIM Professionals

Once individuals have been hired, orientated, and trained on the health information system for

their employer, the training and learning process is merely a beginning. Systems and

requirements change on a routine basis. Governmental payment systems also change and are

updated regularly, and HMOs and insurance carriers make changes to coding, reimbursement,

and other conditions for treatments to patients. All of these require additional training and

knowledge.

Software vendors typically have normal maintenance changes to their software systems to

correct bugs, malfunctions, and changes in rules or regulations. Additionally, vendors are

constantly improving and upgrading their software giving users the ability to enhance their use of

the system.

Health care information specialists also make suggestions to vendors for system enhancements to

their software. This type of feedback is very valuable to vendors since health care staff members

are using their systems on a regular basis and know the challenges, issues, and any opportunities

for improvements.

Strategies for HIT Staffing

As health information positions become specialized, salaries have been growing at a rapid pace,

especially for those who have skills with electronic health records. During the past few years,

however, the recruitment for HIT and IT staff positions has not been a major challenge for

employers, primarily due to the recession. As the recession gradually ends, salaries for IT

positions will continue to increase and the competition for qualified staff by employers will again

be a problem.

Some employers create programs to develop qualified HIT staff in-house, using various on-the-

job programs to train individuals in their health information system. This can be an excellent

strategy for addressing staffing needs and shortages. It also provides a career path for the

organization’s staff, which can improve staff satisfaction and enhance loyalty to the organization.

As salaries increase and competition for hiring becomes intense, employers look for alternative

staffing strategies to consider for their HIT needs. One option is to use temporary or contracted

staff to fill in during vacations or leaves of absence. They can also be used to supplement

existing health care information staff when there are special projects or when an increase in

productivity is required due to increased occupancy or other circumstances. This strategy gives

the employer supplemental staffing when needed, and they do not have the long-term cost of

hiring and training new staff.

Another option for HIT is to outsource much of the storage and network function of their

electronic information system. However, this needs to be carefully evaluated since privacy and

security issues are still the responsibility of the health care organization. It becomes an issue of

balancing off the cost of permanent hiring with the use of contract staffing.

Professional Organizations Representing HIM Professionals

There are a number of organizations that provide training, advocacy, support, and certification

for health information specialists. The names of those associations are listed in the Gartee

textbook. If you have an interest in any of the health information positions, please go to the

website of the organization for detailed information.

There is value to the health information specialist and the employer in having highly qualified

and competent individuals operating the HIM system. A certification process can provide a

certain level of competency for individuals. Typically, the process includes training sessions,

written assignments for evaluating knowledge, and the testing of skills.

In the health care field, most of the direct care positions (i.e., nursing, medical, laboratory,

imaging, etc.) are required to have both a license and a credential that demonstrate competency.

At the present time, the government and other payers have not mandated the certification of

health information specialists. As health information technology becomes the norm for health

care organizations, it is predicted that some form of credentialing or certification process will be

required to assure the competency of individuals who are operating and accessing the system.

There is currently a voluntary form of certification managed by the American Health Information

Management Association. The certification is available at both the administration and technical

levels.