March 2009 Article

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Who Will Do the Work?
by Don Fallati 
 
The Stimulus Bill and the prospect of healthcare reform have recently overshadowed discussion of just about every other topic in healthcare. Yet, even in the midst of an economic recession, we have a coming labor shortage in healthcare that deserves our attention.

For several years, providers and vendors have slowly but steadily moved toward the vision of electronic health records (EHRs). The new Administration is also pushing EHRs.  Besides the goal of better, more coordinated patient care, other payoffs of EHRs are easily visualized. One is granular data in a complete, structured, and accessible form, which may be used by payers and providers to drive efficiencies in the system and ultimately substantial cost savings.

Beyond that, healthcare can begin to develop what analysts call “clinical intelligence,” using the rich data repositories being built by provider organizations and the payer community. This allows for the generation of new, and the enhancement of existing, guidelines for caregivers, robust disease management protocols, and other care quality improvements.  Realizing this vision will allow healthcare to reap the analytical benefits seen by other transactional industries that have invested in data mining.

While that prospect is exciting, questions naturally follow. Who will be qualified to work with the data in an intelligent, productive manner? Where will we find staff capable of interpreting raw financial, administrative, and clinical data? How will we achieve uniform acceptance of these interpretations?

These questions point us toward the traditional keepers of the data, the Health Information Management (HIM) profession, and they have strong implications:

  • We will need more people selecting HIM as a career. The transition to EHRs and using data productively will require a larger specialized workforce.  Projected needs for HIM workers generally far outstrip the supply of graduates in this area. This is exacerbated by the aging of our workforce. This point is obscured by our current recession. As with any recession, the aggregate unemployment numbers have been climbing.  However, when the economy recovers, some of the conversation will likely turn to growing labor shortages…conversations that were beginning but were put on hold when the recession hit.
  • HIM is undergoing change.  No longer the traditional “Medical Records Department,” the function is becoming the steward of critical health information, and work processes are changing accordingly.  Evidence of the transformation can be found in the recent creation by the American Health Information Management Association (AHIMA) – the profession’s leading membership organization – of a new credential: the Certified Health Data Analyst (CHDA).  This certification requires skills development in data management, analytics, and reporting.
  • The expected growth in pay-for-performance (P4P) initiatives will intensify the need for data integrity. Data integrity goes hand in hand with data management and analytics. From a practical perspective, neither is of much use without the other.
  • As HIM moves beyond the traditional Medical Records Department, there will likely be emerging needs for HIM professionals in payer, retail healthcare, and other non-traditional environments.

Many say a recession is a time of opportunity in disguise. For healthcare executives, as well as those evaluating career options, the new EHR-centric world presents opportunities that may not yet be obvious.

Don Fallati is currently a consultant in healthcare information technology and is acting Senior Vice President of Marketing at Amkai LLC, an early-stage company providing EHR software for the outpatient surgery space.  Previously, Don spent ten years as Executive Vice President of Dictaphone Corporation.
 

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