HIMAA warns of workforce crisis putting eHealth at risk

A workforce crisis facing the health information management profession is placing the future of eHealth reform at serious risk, according to the Health Information Management Association of Australia (HIMAA).

HIMAA president Sallyanne Wissmann said the quality improvement that eHealth offers was at risk because government and hospital executives continue to ignore chronic workforce needs in health information management.

HIMAA survey members in December last year following earlier research that strongly identified workforce issues as the leading concern of the profession, including role substitution amongst health information managers (HIM).

“There was also the erosion of the foundation HIM-clinical coder health information services team through split reporting between financial and health information managements,” Ms Wissmann said.

“This is compounded by multiplying discrepancies in industrial classifications between the occupations within and across jurisdictions.”

Ms Wissmann said the Australian Institute of Health and Welfare’s report on the health information workforce in 2009 highlighted the urgent need for substantive and ongoing data on actual industry needs for the HIM and clinical coding workforce.

However, the Health Information Workforce (HIW) report compiled by Health Workforce Australia in 2013 failed to identify the serious plight of the profession’s two major occupations, she said.

While the results of the HIMAA survey are only indicative, what they suggest is “more than worrying,” she said.

There are unfilled clinical coder vacancies in a third of hospitals around Australia and a health information manager shortfall in one in five facilities.

“Respondents indicate demand for both occupations is rising at a rate outstripped by the lack of supply,” she said.

“Over the next three years, HIMAA members in the hospital system expect an attrition of HIM positions at a rate of one for every two retained. Yet over 50 per cent of them expect supply to remain poor.

“Our survey confirms the trend towards role substitution – as high as 58 per cent amongst HIMs – and the dismantling of the HIM-clinical coder foundation of the HIS team through split reporting.”

Ms Wissmann said that based on HWA’s HIW report, hospital executives don’t understand the value of the HIM-coder team to every function in the hospital system.

“The interchange between information and data is important wherever it flows throughout the system,” Ms Wissmann said.

“Health information management may be a niche profession in the health system, but it is crucial to the success of eHealth, both in terms of cost efficiencies and quality of care outcomes.”

Posted in Australian eHealth

Comments   

# Peta 2015-04-22 09:56
Does that mean 58% of the survey respondents are working in roles without the core functions of coding/HIM?

Perhaps there's intergeneration al change in the workforce requirements?

How appropriate are the skillsets in this substitutional cohort?

Where's the much talked about workforce planning at?
# Sue Mol 2015-04-22 16:22
Perhaps it has something to do with the low pay levels where qualified clinical coders are better off finding other jobs.
# Cassandra 2015-04-28 17:26
Health Information Management has remained a small profession and this has affected negotiations at the industrial discussion table.
Clinical Coders are highly skilled and this is essential to code medical records accurately. There is a shortage due to the increasing various demands for coded data.
The core skills of health information managers remain appropriate and are applicable to the eHealth arena also.
Workforce planning is continuous. The University of Western Sydney commenced a B ICT (HIM) degree this year. The University of Tasmania commenced a M (HIM) qualification this year.
# Jenny Gilder 2015-04-29 07:02
Absolutely agree with the writer that HIMs/clinical coders have been overlooked by hospital executives in the their hurry to apply eHealth solutions. They have looked outward to IT companies offering very expensive consultancies when they have had very qualified HIMs with similar competencies who are able to provide advice and support . Why would HIMs remain motivated when they see others without the drive for quality of care outcomes move into their area of competencies?
# Jane Howard HIM 2015-04-30 15:09
My evidence-based opinion is that there is not a shortage of either coders or HIM's. The government focus is on bio- medical- or health informatics; that is, there is a push to upskill clinical professionals in all aspects of information and data capture, storage and flow. I have extensive experience in the selection process on both sides in three states, and I can tell you there is a lack of knowledge as to how these two professions can add multiple value to the organisation today and into the future. HIMAA coder testing focuses on rot learning; not analytics. I challenge present HIM's to examine the UTAS M (HIM) qualification and comment whether they think HIMAA was consulted.
# Ralph La Tella 2015-05-03 12:15
The lack of knowledge about what HIMs can bring to the table stems, in part, from the fact that it is difficult to pidgeonhole the HIM profession along traditional lines. The health information profession is usually thought of as a binary construct: that is, you are either a HIM or a coder. This happens usually as these are the most "visible" of jobs associated with the profession. Given that HIMs may also work in areas not easily described as "traditional" it then becomes difficult to ascertain exactly issues of workforce shortage. In relation to the, excellent, MHIM at UTAS, nearly all of the subjects available in the course are the same subjects HIM have traditionally studied at university, 20 or more years ago. On top of these subjects, HIMs are very well versed in basic clinical sciences having studied anatomy, physiology, basic pharmacology, basic microbiology, psychology, database systems, computer applications in health etc. In 1993 I myself conducted research into mobile heath applications even before the term mHeatlh was coined. I am not alone in going beyond the roles traditionally associated with Health Information Management. Many of my contemporaries occupy "C" level positions in health. Others work in fields as diverse as genomic informatics, and big data analytics in health. In relation to the UTAS MHIM course I might add that HIMAA was indeed consulted for input into that qualification. HIMAA does not test coders. HIMAA provides coder education, course accreditation and professional development to both HIMs and coders. On these facts alone, it is difficult to understand why it is that the value proposition HIMs bring to the table isn't better understood. If it were, there would be no denying the shortfall in supply.
# Susan Smith CHIA 2015-05-07 14:25
This isn't only a problem for HIMs. The problem exist wrt informatics accross the healthcare spectrum and for health informatics specialists in all areas. Medical Records staff - coders and HIMs - traditionally work in back offices away from the influencers. If HIMs are now in C level positions why are they not addressing this issue more strongly? The real influencers in healthcare are the doctors,- medical directors create the positions in health services and influence the direction of money spent at administrative level in health services. But my perception is a lack of engagement with clinicians by HIMs, including at the HWA HIW Workshop which did not include Doctors (and few non-HIMs roles) as stakeholders in the conversation. IMO it is the Medical staff that need to be influenced, so resist publishing in HIMs journals and get your research into MJA or specialist medical journals that doctors read to demonstrate the significance of informatics work to the medical decision makers.
Also, move the courses out of the business/admin schools of universities and into the schools of public health where integration with analytic and research expertise can improve the ability to use the data and increase the value proposition HIMs offer clinicians.

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