HEALTH INFORMATION & OFFICE ADMINISTRATION

Health information management (HIM) personnel maintain, collect, and analyze data that doctors, nurses, and other health providers need to provide quality patient care. They are responsible for information systems that meet medical, administrative, ethical, and legal requirements for hospitals, medical group practices, health maintenance organizations (HMOs), nursing homes, clinics, and other facilities that deliver healthcare.

The central focus for the health information management staff is the medical records of patients. Medical records contain the permanent histories and progress of each patient’s illness or injury. Each individual record is a compilation of observations and findings recorded by the patient’s physician and other members of the healthcare team. The medical record is essential for clinical purposes, but is also used to provide documentation for insurance claims, Medicare reimbursements, legal actions, professional review of treatment and medications prescribed, and for training healthcare personnel.

Health information management professionals are experts in managing patient health information and medical records, administering computer information systems, and coding diagnosis and procedures for healthcare services provided to patients.

This healthcare area offers a broad selection of job opportunities and options.

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HIM POSITIONS
REQUIRING A BACHELOR’S DEGREE

  • HIM Department Director
  • Data Quality Manager
  • Chief Privacy Officer
  • HIM College Instructor

 

CONSULTANT HIM POSITIONS
REQUIRING AN ASSOCIATE’S DEGREE

  • Health Data Analyst
  • Insurance Claims Analyst
  • Records Technician Specialist
  • Clinical Coding Specialist
  • Physician Practice Manager
  • Patient Information Coordinator

MORE ABOUT MEDICAL CODING

One of the key health information management department’s responsibilities is capturing accurate and timely medical data. The transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations is known as health information coding. Originally, coding was used to classify cause-of-death data on death certificates but has changed to encompass diagnoses, services, and procedures provided to patients. Today, coders assign a code to each diagnosis and procedure the patient undergoes, following a recognized classification system. The patient is then assigned to one of several hundred diagnosis-related groups and the data is used for clinical decisions and documentation for monetary reimbursements from insurance companies and government agencies. Compliance with official coding guidelines is crucial if medical providers are to receive reimbursements. Coded data is also used for quality management activities, case-mix management, planning, marketing, and other administrative and research activities by healthcare institutions.



MORE ABOUT MEDICAL RECORDS TECHNICIANS

Medical records and health information technicians organize and evaluate patient information concerning their symptoms and medical history, the results of examinations, reports of x-rays and laboratory tests, diagnoses, and treatment plans for completeness and accuracy. Tasks associated with these responsibilities include the following:

  1. Reviewing initial medical charts to ensure they are completed, properly identified, and signed
  2. Communicating with physicians or other health professionals to clarify diagnoses or obtain additional information
  3. Completing the coding process
  4. Using computer programs to tabulate and analyze data to help improve patient care, for research studies, use in legal actions, or to respond to surveys

WORK ENVIRONMENT

Health information departments in hospitals are open 24 hours a day, 7 days a week, and professionals in this area may work day, evening, night, or weekend shifts. Their offices are normally pleasant and comfortable. Other information specialists work in physicians’ offices or are self-employed. Professionals in this healthcare field have little or no physical contact with patients. Technicians may work at computer stations for prolong periods and may need to take periodic breaks to prevent eye and muscle strain. Accuracy is essential and attention to detail is critical.


CAREER OUTLOOK

Employment of medical records and health information technicians is expected to grow much faster than the average for all occupations in the upcoming years. This growth is being driven by rapid growth in the number of medical tests, treatments, and procedures ordered by professionals, and their increased scrutiny by third-party payers, regulators, courts, and consumers.

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