About a year and a half ago I took a position with a company that specializes in electronic medical record (EMR) conversions. When first approached, I wasn’t crazy about the idea because my interest lies more in coding than EMRs, but I agreed once I was assured that my position would be that of a coding and revenue cycle educator. Since that time, though, I’ve worked with clients in various stages of EMR conversion and like it or not, it’s something we, as users of health information, have to deal with. I recently read a blog about understanding clinician workflows and it really resonated with me after a week in a cardiac catheterization lab that trained nurses and techs on proper documentation and charging practices.
It’s very easy in a hospital to become “siloed” since we spend our time in departments. And even though HIM has always been the dumping ground for all clinical documentation relating to a patient, it’s not immediately obvious how clinician workflow impacts the management of that health information until we try to automate it. The automation of data affects not only accessibility to data, but also completion, routing of work load, and even patient billing. And it’s a big part of what my coworkers deal with in EMR conversions.
My job as an educator in the realm of revenue cycle is a great example of how crossing departmental lines and understanding other departments’ workflows is key. One of my clients hired me to assist with the education and auditing of their cardiac catheterization lab coding, documentation, and charging. While I started with the coders in the HIM department, I knew before the ink was dry on the contract that I would also be engaged in discussions with cardiac cath lab management, revenue integrity, and even physicians. My education efforts have resulted in presenting the same information in three different ways to three different audiences: coders, nurses and techs, and physicians.
For me, as a coder, training the coders is the easiest, albeit the most technical and time consuming due to the nature of the detail involved. Training the nurses and techs was a bit more challenging as I had to convert my thinking from coding to charging and documentation. This meant presenting them only with what they needed to know and understanding how their system for selecting charges works. Finally, I had to meet with the physicians to determine the best way to educate them on the documentation requirements needed for coding.
For me, this interdepartmental dialogue is what I like best about a career in HIM. HIM professionals are no longer relegated to a dark dingy basement near the morgue, but are becoming more involved in systems that use protected health information. If you have any interest at all in health informatics, now is a great time to start your career in HIM. And if your interests, like mine, fall more to coding and revenue cycle, there’s nothing but opportunity. I know it’s tough to get that first foot in the door, but look for any opportunity that will allow you to gain experience with health information and workflows. If you can understand how to assess workflows and find solutions to organizational challenges, you will be worth your weight in gold.