What’s in a name? AHIMA votes on title changes
HIM professionals say industry needs education
What’s in a name? A lot, if you listen to the debate about the possible change in certification titles for health information management (HIM) professionals.
This month, the 1999 House of Delegates for the American Health Information Management Association (AHIMA) in Chicago will likely vote on new HIM certification titles. The current titles are registered record administrator (RRA) and accredited record technician (ART).
Making the title fit the job
Last spring, the AHIMA board of directors, along with the council on certification, decided upon new titles: registered health information administrator (RHIA) and registered health information technician (RHIT). The word "registered" was chosen as the most appropriate designation for HIM certifications. "Health information" was said to describe the domain of the profession’s knowledge and expertise, and "administrator" and "technician" were added to lend a sense of continuity to the new titles.
Before voting on the acceptance of the new titles, the association and its 186 delegates will hear the opinions of AHIMA members on the issue. If the changes are affirmed, current RRAs and ARTs would not have to reapply for their credentials, retake a certification examination, or participate in classes.
Many members support a change because they feel that the current titles don’t accurately reflect the scope of emerging HIM roles, the association says. Ever since AHIMA changed its name from the American Medical Record Association in 1991, members have also shared concerns that the certification titles don’t match the association’s name.
Participants in focus groups also echoed dissatisfaction with the current titles. The groups, comprised of professionals who represent the employers of HIM personnel, said the titles were inaccurate in representing the skill sets and roles of today’s HIM professionals. The RRA and ART titles implied paper records, the participants said. They thought that these titles were out of date, difficult to understand, and limiting in their description of the work performed.
Many who work in the HIM field applaud the possible certification title changes, saying that the term "health information" makes more sense in today’s HIM world. Others, however, say the term "records" is not as limiting as it may seem.
Records or information?
Using the federal definition of "record," RRA and ART best define and capture the many faces or specializations of the profession, says Godwin Odia, MBA, RRA, director of health information management with the U.S. Public Health Service. Odia is currently assigned with the Indian Health Service in Whiteriver, AZ.
"Federal records regulations are contained in Title 36, Chapter 12 of the Code of Federal Regulations and are administered by the National Archives and Records Administration of the United States. A record is defined as all books, papers, maps, photographs, machine-readable materials, or other documentary materials, regardless of physical form,’" Odia says.
The definition further defines "physical form" or characteristics as including records created on magnetic tape, punch card, disks, computer, core, microfilm, maps, and tab cards as well as paper. "To those who say the word record in our credential is limiting, the definition above says otherwise," he adds.
Instead, RHIA and RHIT are the limiting credentials, Odia adds. "These proposed names do not take into account members of the profession who engage in other areas."
Another HIM professional, though, says he can see why the term information may be preferred to record. Information is also the "organization of raw data," which is a large part of what HIM professionals do, says Doug Zwiebel, RRA, assistant director of health information management at New York Presbyterian Hospital — Columbia Center.
"Isn’t information at the soul of [our responsibilities]? Don’t all the individual pages of notes, reports, and summaries — written or virtual — combine to give information?" he asks. "And don’t all those thousands of individual [patient record] data points combine to give researchers knowledge?"
In the last 10 months of his previous job, Zwiebel says he designed more than 175 different electronic reports that required sifting through records to yield the desired information. At his current position, he says he is doing more of the same. "It’s my belief that this is the thrust of the initiative for a modified credential.
"The job skill set is advancing in terms of technological ability. What we manage or administer results in information, which yields knowledge. Keeping records for the sake of an archive alone or for the individual patient’s needs adds nothing to the growth of knowledge," explains Zwiebel.
A primary concern is that the HIM profession hasn’t done a thorough job of educating the health care industry on the value of the current credentials. "How many of us have had people ask what we do and then had to explain for 20 minutes what health information was?" asks Jennifer Conner, of Valley View Surgery Center in Dallas. Conner is taking the credentialing exam this month.
Some gains of recognition in the industry have been made, though. If the credentials are changed, will these gains now be lost?
To address this concern, AHIMA is developing a multi-year image marketing campaign that will promote the HIM profession to the health care industry, says Belinda Brunner, MS, RRA, director of certification for AHIMA. The campaign will begin next year, regardless of the outcome of the credential vote. In addition, AHIMA members will be asked to promote their credentials through advocacy and education at their workplace.
One HIM director who has worked to develop and foster an awareness and recognition of the current professional credentials says she is finally seeing some results from her efforts.
"A very short time ago, few people, including most personnel department staff, knew what the credentials stood for — or for that matter, what a credentialed individual could provide to the organization," says Audrey L. Semrow, MS, RRA, of Waukesha (WI) Memorial Hospital.
"Now, I am very confident that our personnel department and most other departments know our credentials and are aware of their associated expertise. However, I also believe that very few people, if any, know or care what each individual letter represents or stands for," she says.
Semrow adds she doesn’t want to spend the energy and time needed to educate these people about the new credentials just because "some folks think that the newly proposed credentialed initials more accurately reflect what we exactly do.
"That name, letter recognition, is what we have all strived for within our own circles; changing it, just because it doesn’t fully identify what we do, makes little sense to me," she says.
The individual, not the credentials, has to perform to project the image of the profession, Odia says. "The question we must ask ourselves is what do we as a profession expect to benefit from this change? Will the change enhance our profile? Will the change make members take on additional responsibilities that are likely to project the image of the profession?"
Semrow would like AHIMA to put its efforts into several areas. These include:
• promotional and educational efforts aimed at the general public with the focus on what current HIM credentialed personnel offer;
• the education and development of relationships with other professional organizations, which are facing many of the same issues, such as electronic medical records development and management, confidentiality and security-related issues, and database and system development/management;
• additional research into other avenues of opportunities that HIM professional expertise, education, and training would lend itself to by using already developed skills.
AHIMA members should let the association know where they stand on the credential title change issue. Members can voice their opinions at Summer Team Talks, in the Vision 2006 issue forums on the association’s Web site, and through their state HIM associations.
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