The introduction of activity-based funding (ABF) models across Australia has impacted profoundly on the clinical coding workforce, but Clinical Coders (CCs) have not always been included in the plans for implementation. Funding model developers and policy units in all our jurisdictions put a lot of effort into ensuring that hospital managers understand the new system and that changed funding models do not adversely influence the continued viability of a hospital. Little system-wide effort goes into ensuring that the clinical coding workforce is ready and able to function in this new environment. Most of the work with this workforce is in fact retrospective and reactive; a crisis management response rather than a strategic response to a recognised issue. In this article I will discuss the impact on the clinical coding workforce of the introduction of ABF models.
Dear HIM-Interchange readers This is my last letter to you! From our next issue Joanne Fitzgerald will be your Editor. Joanne has introduced herself in this issue (Fitzgerald, 2017) for those of you who don’t already know her. Those of you who do know Joanne will agree with me when I say that I am confident she will fulfil her role as Editor very capably. I am looking forward to seeing the journal progress under her leadership and to seeing how she puts her own stamp on its production. Please support Joanne with contributions to the journal!
I am very honoured to accept the role of Editor of HIM-Interchange (HIM-I) and to be writing my first piece in the role of future Editor. I would like to personally thank Jennie Shepheard for her contribution to HIM-I. Jennie has given countless hours to producing the journal, sourcing and editing articles, and making improvements to the journal so that health information management professionals like me can continue to educate ourselves and showcase the work we do.
There are only a handful of tertiary education institutes in Australia that produce Health Information Managers (HIMs), despite the high demand for qualified health information management professionals in the healthcare industry. The high demand in the industry has not been converted into student numbers in tertiary education courses, forcing some institutes to cease offering these courses (McDonald, 2016a). In an era where we are surrounded by technologies and systems that deal with healthcare data, it is puzzling why students are not attracted to health information management or health informatics courses. When I put this question to an open forum at the recent Health Information Management Association of Australia (HIMAA) conference, there were very interesting responses. Some indicated that this profession is ‘not sexy’ and it is rather ‘boring’. The views of some senior academics were that universities should concentrate on converting people already with clinical expertise, such as nurses, into HIMs through postgraduate and research programs, rather than attempting to create HIMs at the undergraduate level.
It would be fair to say that we as a professional entity are at the brink of a precipice. We are witnessing a digital health revolution in Australia and globally. With the recent introduction of open-source web-based EMRs for developing nations such as AMPATH1 and OpenMRS2 e-record systems, we come to understand that healthcare is an information business and its effective management is seen to have transformed healthcare delivery (Hannan, 2014). In addition, the American Health Information Management Association (AHIMA Work Group, 2014) stated that the need for health informatics has never been greater, especially because of the power it can harness from the metadata collected for informed medical decision making and healthcare improvement.
Everyone in a managerial position has an individual style when it comes to doing things such as managing their time, developing their own systems or planning and organising their workload. Styles may differ depending on a variety of factors, including personalities, experiences, or education. Differences in style among individual managers reveal that managing can be done in a dozen different ways, all of which can work perfectly and efficiently for the manager, regardless of the industry. However, in a management role there is one set of skills that must be consistently maintained with no deviations; namely, skills relating to managing people. It is this aspect of management that is the most rigorous and stressful and the techniques to deal with these issues do not normally come naturally. They have to be learned.
The Sydney Children’s Hospitals Network (SCHN) is a special place to work. SCHN incorporates The Children’s Hospital at Westmead, Sydney Children’s Hospital at Randwick, Bear Cottage (the only children’s hospice in New South Wales), the Newborn and Paediatric Emergency Transport Service, the Pregnancy and Newborn Services Network, and the Children’s Court Clinic.
The 33rd National Conference of the Health Information Management Association of Australia (HIMAA), in conjunction with the National Centre for Classification in Health (NCCH), was held in the city of Melbourne from 7 to 10 November 2016. The conference was held at the Crown Promenade and the palatial, grand entrance was a taste of exciting things to come. We were spectacularly greeted by a loquacious gathering of what seemed like 300 health information management professionals as well as impressive vendor exhibits.
An article titled “Australian ‘Code Like a Girl’ program created to foster community & inspire next gen. female coders”, was published in a recent edition of GirlTalkHQ. The article reported that there is a movement in the field of computer science to encourage more women to train as computer programmers and technical engineers. An Australian organisation called “Code Like a Girl”1 has been established to encourage girls into these occupations and to break down the stereotypes in this male dominated industry. This scenario is in contrast to clinical coding, which is a female-dominated industry. The article prompted me to think about Boys Who Code.
The release of “Targeting Zero: Report of the Review of Hospital Safety and Quality Assurance in Victoria”1 in October 2016 seemed a long time coming – but it was well worth the wait. From my perspective, it’s a racy page turner: a good hard look at Victoria’s clinical governance gaps and how to close them, which will be useful for anyone seeking to provide safer, better care. It is fantastic to see authentic safety and quality issues being named and explored, with associated recommendations for real change; exciting to see leadership and culture recognised as key to that change, at both state and health service levels; a relief that out of such tragedy at the Djerriwarrh Health Services comes an honest appraisal of system gaps and clear direction for improvement.
The need for reliable information in healthcare has no geographic boundaries. Around the globe there are healthcare delivery transformation initiatives geared toward improving the safety and quality of care and the health of populations, while at the same time reducing cost. These initiatives cannot be achieved without trusted information. The growth of data, rapid adoption of information technologies, and proliferation of devices and applications are contributing to concerns regarding data and information integrity. These concerns are leading to the recognition that governance practices are essential to achieving a state of trust in healthcare information.
Deborah Green, Executive Vice-President and Chief of Global Innovation at the American Health Information Management Association (AHIMA), delivered the day-long workshop Evolving and Emerging Workforce Roles in Health Information at the HIMSS Asia Pacific Singapore e-Health Innovations Summit on the 8 October 2016. The objective of the workshop was to examine the changes in healthcare that impact on Health Information Managers (HIMs) and Clinical Coders (CCs), how HIMs and CCs can position themselves to take advantage of changing workforce career opportunities, and the AHIMA certification program. This captivating workshop was timely, given the rate at which digital transformations and health reforms are occurring globally. This article summarises the career opportunities identified in the workshop.