Health Information Manager: Helping People Through Technology

Even during the economic downturn, there’s one industry in which technology has massive growth potential. What is that industry, you might ask?

Consider this: The recently passed U.S. economic stimulus package has set aside $17 billion to provide incentives for health care providers to adopt technology. And one study found the U.S. will need at least 40,000 more health care IT professionals to make the investments worth it.

“We’re looking at a change in the next four years, [as] 95 percent of the hospitals in the United States will become 80 percent digitized,” said Lior Blik, chief information officer for Hoboken University Medical Center in New Jersey. “[Currently], they’re 30 percent digitized, maybe 40 percent if they’re lucky. People will store everything on their IT. The medical records staff will probably have to become IT staff.”

During a time when IT professionals are vying for jobs, a career in health care IT might be just the ticket.

“I don’t see [demand] getting any smaller,” Blik said.

So what are the skills required to work one’s way up through hospital IT? The No. 1 asset is basic IT knowledge, Blik said.

“I’m a true believer that you need to come from the technical part of the business,” he said. “It’s more important to know IT first. It’s like assuming the lawyer who does health care doesn’t need to know law. You have to know IT to manage IT.”

In fact, when he’s hiring health information managers (HIM) — those who “are responsible for the development and administration of health care data-collection and reporting systems,” according to a description on Temple University’s Web site — Blik said he wants to see experience working hands on in server rooms, on networks or with applications.

“I want to see some programming background, I want them to know the code, because I think the fear of technology drives a lot of the decisions [otherwise],” he said. “What happened over the years in health care is [the industry] decided to take people from within — nurses, doctors — and promote them to IT positions, relying on the application vendors to basically tell them what they need. This created a problem.”

Since a vast majority of the HIM’s job is to vet purchases, a thorough knowledge of the technology is required to make the best possible decision.

“[Without it], you’re buying features a lot of the time without understanding the real costs that stand behind those features,” Blik said. “Anybody can look at a contract and make sure that it’s OK, but not a lot of people can look at a contract and understand the statement of work with it. The statement of work is key. It’s where you find the biggest gaps between the vendor’s presentation and really what’s going to be delivered in the end.”

That’s not to say that people on the clinical side can’t transition into health care IT. Blik said the main paths to the role of health information manager are through the IT world, coming typically from a software company, or from the hospital side — in which the person might formally be a nurse or an accountant in the billing department.

How would the latter type get into the tech side?

“If you’re interested in going into IT, definitely become a super-user,” Blik said. A super-user is an individual with unlimited access privileges in a certain application.

“So if you’re a nurse in a hospital and you’re looking to grow in your [IT] skills, become a super-user in the application that you’re managing — through that, you’re introduced into the IT department,” Blik said. “I have two users in my analyst department who used to be super-users. They actually got their knowledge directly from being down in the department levels and knowing the internal department processes and being the super-user of the application. It was just a matter of filling the gap with technical studies, and they were ready to go.”

That said, while firsthand IT experience is key, industry-specific knowledge is less crucial. After all, the hospital or clinic is full of industry experts, Blik said. What an aspiring health information manager will need to know, however, is how a standard business works.

“What I do believe you need is operational knowledge of an enterprise,” Blik said. “[In the past], CIOs in health care were not able to deliver the right messages to the executives in the business level. It’s because of the presentation.”

That’s because a good portion of the job is supporting not just the clinical, but the financial branch of the organization.

“The analogy that I like to give to what I do most of the time to my department is, essentially, it’s basically the roads where the cars are running on,” Blik said. “A lot of it is being creative and having a lot of initiative, and then acting essentially as the gateway to this facility as far as growth is concerned.”

A typical day for Blik involves managing everything from electronic medical records (EMRs) to billing, as well as reviewing new applications and programs, assessing budgets and meeting with the executive staff. For this reason, he said another key component of being a successful health information manager is commendable soft skills — specifically communication, management and leadership skills.

“It’s saying ‘no.’ It’s saying, ‘No, we don’t want to do this.’ It’s saying, ‘No, we do want to do this but we can’t.’ It’s really standing behind your decision,” he said.

Further, being able to build and maintain strong vendor relationships is important, as is being a good listener.

“Ninety-nine percent of what I do is provide services to the hospital. So [you need] understanding [of] what the customer is going to require,” Blik said. “Know what you’re trying to achieve, listen, review, try to understand — know what you don’t know.”

Blik said the typical academic background for someone who goes into health care IT is a college degree in computer science, followed perhaps by an MBA.

However, actual IT experience still trumps book smarts, he said.

“The experience is far more important than your educational level. And I think that’s what’s going to be important as we go forward through the organization.”

When it comes to certification, HIM professionals can work toward the Registered Health Information Administrator (RHIA) credential. They also would do well to get certified in the integration language Health Level 7 (HL7). That’s because “the Health Level 7 (HL7) version 2 messaging language has become a standard framework for the exchange, integration, sharing and retrieval of electronic health information that supports the management, delivery and evaluation of health services,” according to a 2006 report on the “Trends Influencing the Cost of Care and Patient Safety.”

“I think the future will bring in the .Net and will bring in interfaces that are outside of HL7. But for now, HL7 is the key,” Blik added.

Other important skills for the role of HIM include project and storage management.

“Because of EMRs, storage management will grow because people will store everything on their IT now. [And] project management [will grow], definitely, for the next two to three years because of big implementations that are going to come about,” Blik said. “It’s a matter of how the stimulus funds will take effect and how fast. The sooner they start it, the better.”

Perhaps most important, however, getting involved in health care IT requires a dedication to helping people. Case in point: A recent project Blik helped out with involved the implementation of “telemedicine.”

“We had a baby [sent] into a different hospital because of an emergency situation, and the mom was able to see her newborn over a screen,” he explained. “[She] was able to talk to the doctors in another hospital. They completely explained to her the procedures that the kid had, and how is he doing. She was shocked.

“Your delivery system helps people,” he continued. “People’s lives are on these floors in these hospitals. And that is an added value you won’t get in another industry.” 

– Agatha Gilmore, agilmore@certmag.com

 

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