UPDATES ON NEW CREDENTIAL FOR

THE HIM PROFESSION

PLUS 

RHIA EXAM UPDATES

   

Discussion Document Regarding a New Credential in

Health Data Analytics

Council Recommendation

June 12, 2008

Discussion Document for Health Data Analysis (working title) Credential

BACKGROUND

In 2007, the Council on Certification (COC) was charged with determining the need for a new credential in HIM to increase the size of an AHIMA-certified HIM workforce and to further engage new, non-certified members at a professional level. The COC presented the plan to develop a new credential in the area of Health Data Analytics to the 2007 HOD as an issue forum. Although not presented for a formal vote at the time, a majority of the feedback from these issue forums was positive.

NEEDS ANALYSIS

1. HIM Job Analysis (2006)

In 2006, a job analysis study with respect to “Health Information Managers” was conducted. Results from this study suggested the emergence of a “data analytics” domain as being both substantive and distinct as a full-time role in and of itself, rather than simply a set of tasks one performs occasionally as part of another role. Data from this survey also suggested that this performance domain (and associated tasks and knowledge statements) would increase in both importance and prevalence through the next five to seven years. Indeed, the HIM industry is becoming more data-driven and data dependent than ever, and this trend will only increase further, especially with the eventual wide-scale adoption of the EHR.

As a result, for AHIMA to: 1) Proactively claim the domain of health data analytics as a component part of HIM, and 2) influence the HIM industry to align with our vision and capture the advantage of EHR adoption to best develop data into usable information, the COC determined to formally develop and deploy a certification that validates competence in data analytics. The certification process will ultimately create a cadre of AHIMA-linked experts available to continuously develop supporting resources for this rapidly growing role and performance domain.

2. AHIMA Healthcare Data Analytics Survey ( Q2-Q3, 2007)

As the COC was continuing it’s internal discussion on the feasibility of a new credential in healthcare data analytics, AHIMA’s Business Development staff conducted a separate survey targeting people in the healthcare industry at the health data management and management level from a needs analysis perspective. In summary, data from the 834 respondents:
1) Demonstrated the growing importance of healthcare data analytics, both by role and by setting (tables 1a and 1b),
2) Supported the need for individuals who possess skills and knowledge in this area (table 2), and
3) Demonstrated value for the validation of these skills and knowledge (table 3), and 4) Supported a new AHIMA certification in healthcare data analytics (table 4).

Table 1a: Growing Importance of Healthcare Data Analytics by ROLE

Response Executive/Director/Consultant All Other

“Yes, this area is growing in importance.”

85.6% 81.88%

Table 1b: Growing Importance of Healthcare Data Analytics by SETTING

Response
 
Integrated Healthcare Delivery System

Hospital Setting

Other Care Settings

“Yes, this area is growing in importance.”

93.9% 86.3% 73.9%

Table 2: Support for Competent Individuals in Healthcare Data Analytics

Response

Integrated Healthcare Delivery System

Hospital Setting

Other Care Settings

Strongly Agree 54.1% 48.3% 38.2%

Agree 27.6% 28.7% 35.8%

Neutral 4.1% 12.3% 15.2%

Table 3: Validation of Competencies in Healthcare Data Analytics

Response
 
Integrated Healthcare Delivery System

Hospital Setting

Other Care Settings

Strongly Agree 36.1% 26.2% 20.8%

Agree 24.7% 38.5% 31.2%

Neutral 21.6% 21.7% 29.2%

Table 4: Support for AHIMA Certification in Healthcare Data Analytics

Response
 
Integrated Healthcare Delivery System

Hospital Setting

Other Care Settings

Strongly Agree 32.7% 26.2% 22.1%

Agree 30.6% 33.2% 27.9%

Neutral 22.4% 28.1% 34.3%

3. Data Analyst Job Description Initiative (Q3-Q4, 2007)

In the Fall of 2007, the AHIMA Professional Practices Division created a suite of role-based assessments and accompanying generic job descriptions for different positions emerging in the HIM field, with one of these being a “health data analyst” role. This was done to enable professionals to assess individual proficiencies through a personalized gap analysis and recognize what competencies need to be learned so he/she can meet the current needs of the marketplace for specific positions. Staff analyzed existing job descriptions and conducted focus groups to best delineate common elements from among the job descriptions submitted, as well as feedback from the focus group practitioners.

4. Focus Group at HIMSS (Q1, 2008)

Some focus groups were also conducted at the 2008 HIMSS meeting at which some related questions were asked. Groups of CIOs and other executive level healthcare professionals participated. There was general consensus around the need for increased data analytics and focus group participants were supportive of the idea of a certification to validate competencies. Although there were some differing opinions related to the right mix of experience and knowledge between clinical and data related skills, there was agreement that both are important to understand and provide insight to the data analysis function.

5. Health Data Analyst Job Analysis Task Force (Q1-Q3, 2008)

As a result of the above findings, the COC decided to move forward with formally exploring a new credential in Health Data Analytics. In March 2008, AHIMA convened a job analysis task force meeting consisting of fourteen subject matter experts representing various healthcare industries who work in the area of health data analytics.

During the two-day meeting, the subject-matter experts reached consensus on the definition of the target audience statement and indentified the domains, tasks, and knowledge they believed were important to the work performed by a Health Data Analyst.

PRELIMINARY TARGET AUDIENCE STATEMENT AND JOB

COMPETENCIES DEVELOPED BY THE JOB ANALYSIS TASK FORCE

The Certified Health Data Analyst (working title) professional provides expertise to acquire, manage, analyze, interpret, and transform data into accurate, consistent, and timely information. This individual balances the “big picture” strategic vision with the details of the project. Duties include communicating with individuals and groups at multiple levels internal and external to the organization. Therefore, this professional possesses broad knowledge of the processes and outputs of many departments within the organization. In addition, this professional possesses the ability to prioritize and manage multiple projects.

The following job competencies are identified as fundamental skills for a Certified Health Data Analyst:

1. Data Management

o Assist in the development and maintenance of the data architecture and model to provide a foundation for database design that supports the business’ needs.

o Establish uniform definitions of data captured in source systems to create a reference tool (data dictionary)

o Formulate validation strategies and methods (i.e., system edits, reports, and audits) to ensure accurate and reliable data.

o Evaluate existing data structures using data tables and field mapping to develop specifications that produce accurate and properly reported data.

o Integrate data from internal and external sources in order to provide data for analysis and/or reporting.

o Facilitate the update and maintenance of tables for organizations’ information systems in order to ensure the quality and accuracy of the data.

2. Data Analytics

o Analyze health data using appropriate testing methods to generate findings for interpretation.

o Interpret analytical findings by formulating recommendations for clinical, financial, and operational processes.

o Validate results through qualitative and quantitative analyses to confirm findings.

3. Data Reporting

o Design metrics and criteria to meet the end users’ needs through the collection and interpretation of data.

o Generate routine and criteria to meet the end users’ needs through the collection and interpretation of data.

o Generate routine and ad-hoc reports using internal and external data sources to complete data requests.

o Present information in a concise, user-friendly format by determining target audience needs to support decision processes.

o Provide recommendations based on analytical results to improve business processes or outcomes.

6. Job Analysis Pilot Survey (May 2008)

Results from the pilot study conducted in May validated the work done by the Task Force. The respondents strongly supported the domain and tasks included in the survey.

PROPOSED STANDARDS FOR INTITIAL CERTIFICATION

(Open for Discussion)

Qualifications for Initial Certification as Certified in Health Data Analytics Candidates must meet one of the following eligibility requirements for the Certified in Health Data Analytics examination:

I. Baccalaureate degree or higher and a minimum of five (5) years of healthcare data experience; or

II. Healthcare Information Administration credential (RHIA) and a minimum of one (1) year of healthcare data experience. Experience in healthcare data will be verified through the application, which requires a resume describing work related experience in healthcare data management, analysis, and reporting.

PROPOSED REQUIREMENTS FOR MAINTENANCE OF CERTIFICATION

Assuming that the minimum educational requirement for the new credential is set at the baccalaureate degree level, there are no proposed changes to the requirements for maintenance of certification. The current requirements for baccalaureate-based credentials and higher are as follows: Requirements for the Maintenance of Certification for a Baccalaureate-based Credential and higher.

A. Completion of acceptable CEUs during a two-year period (cycle). Individuals with a minimum of one baccalaureate-based AHIMA credential must complete 30 CEUs. Eighty percent of all continuing education units must be earned within the HIM Domain. To receive credit, activities must be completed within the assigned cycle period. All cycles begin on January 1 and end on December 31 the following year.

B. Payment of CEU assessment fees. AHIMA members are charged a CEU assessment with annual membership dues. Nonmembers pay a CEU fee at the end of each cycle set previously by the AHIMA Board of Directors.

C. Validation of CEU Report. Participants must submit their CEU Report Forms to AHIMA by January 31, following the end of the CEU cycle. (It is suggested that participants keep a photocopy of the CEU Report Form.) Participants who are not audited will receive a CEU Validation Certificate to retain as evidence of meeting CEU requirements. Participants selected for audit do not meet requirements until they have complied with the audit procedures. A CEU Validation Certificate will be forwarded to audited participants after documentation has been received and approved. Requirements for the Maintenance of Certification for Multi-Credentialed Individuals for a Baccalaureate-based Credential and higher.

A. Completion of acceptable CEUs during a two-year period (cycle). Individuals with a minimum of one baccalaureate-based AHIMA  credential must complete 30 CEUs. Every individual who obtains an AHIMA credential thereafter must complete an additional 10 CEUs, not to exceed 60 CEUs during the two-year cycle, plus a mandatory annual selfassessment for each coding credential. Eighty percent of all continuing education units must be earned within the HIM Domain. To receive credit, coding self-assessments must be completed annually and all other activities must be completed within the assigned cycle period. All cycles begin on January 1 and end on December 31 the following year.

B. Payment of CEU assessment fees. AHIMA members are charged a CEU assessment fee with annual membership dues. Nonmembers pay a CEU fee at the end of each cycle set previously by the AHIMA Board of Directors.

C. Validation of CEU Report. Participants must submit their CEU Report Forms to AHIMA by January 31, following the end of the CEU cycle. (It is suggested that participants keep a photocopy of the CEU Report Form.) Completed self-assessments must be returned to AHIMA no later than the due date posted on the instructions that are included within the assessment material. CEUs earned from the self-assessments should be reported on the CEU Report Form. Participants who are not audited will receive a CEU Validation Certificate to retain as evidence of meeting CEU requirements. Participants selected for audit do not meet requirements until they have complied with the audit procedures. A CEU Validation Certificate will be forwarded to audited participants after documentation has been received and approved.

NEXT STEPS

The job analysis survey will be disseminated to a wider audience for validation and feedback. The objective of this study is to verify and finalize the domains, job tasks, and knowledge required to perform the work of a Certified Health Data Analyst.

Alternate Paths to RHIA Exam

Eligibility

Council Recommendation

April 2, 2008

Page 1 of 4

RECOMMENDATION

The AHIMA Council on Certification recommends that individuals with a minimum of a baccalaureate degree and documented five years of full-time HIM experience be considered eligible to sit for the RHIA exam. This proposal outlines the background and rationale supporting this recommendation, along with more specific guidelines for exam eligibility consideration.

BACKGROUND AND OPPORTUNITY

The driving force behind this recommendation is the unmet workforce demand for HIM professionals at the managerial level. Because professional certification programs exist to meet workforce demand through validation of competency, this driving force is of utmost importance to the Council on Certification. Supplementing the HIM workforce with individuals who work in the HIM domain, have demonstrated experience in the HIM field, and who consider attainment of the RHIA credential of great professional value is an additional mechanism to meet this demand.

The concept of examining RHIA eligibility for this purpose arose at the 2006 House of Delegates, which voted in favor of amending the bylaws to give non-AHIMA credentialed HIM practitioners the right to be an active member of AHIMA. The House recognized the need for a certification channel at a higher academic level requirement, to compliment and solidify these members’ professional home with AHIMA. In addition, AHIMA frequently receives inquiries from individuals working in the HIM field requesting an opportunity to write the RHIA exam. While the volume is estimated to be modest initially, the need is real. Finally, the opportunity to connect with non-credentialed individuals holding HIM-related managerial positions will positively impact AHIMA membership by embracing their experience, higher education and involvement in the ongoing transition to e-HIM®.

RATIONALE FOR THE RECOMMENDED EDUCATION AND EXPERIENCE

To determine the expanded eligibility requirements to write the RHIA exam, the Council started by reviewing the current standard:

• Successful completion of a baccalaureate program in HIM at a CAHIIMaccredited academic institution, OR,

• Successful completion of a non-HIM baccalaureate degree, plus, attainment of a post-baccalaureate certificate from a CAHIIM-accredited program, OR,

• Successful completion of an HIM program in a foreign country with which there is an agreement of reciprocity with AHIMA.

• Successful completion of a Master’s degree from a program that has been approved by CAHIIM for the optional portion of the curriculum that meets the Accreditation Standards for Baccalaureate Degree Programs in HIM.

Following considerable dialog regarding the merits of allowing individuals with a Master’s degree and significant HIM experience the opportunity to sit for the RHIA exam, the Council ultimately determined that the baccalaureate degree builds an essential foundation for successful practice and as such, should be maintained as the minimum educational level for all RHIA eligibility.

In the pursuit of determining the length of experience in the field that would be equivalent to the standard course of RHIA study, the Council considered three important factors.

• First, the RHIA exam today is developed to test entry level competencies in the health information management field.

• Second, individuals entering the field by earning a post-baccalaureate certificate do so by completing approximately two additional years of study.

• Third, and perhaps most compelling, are the comparative eligibility requirements in other professions with voluntary credentials. While the HIM profession has defined academic programs, our certification exams are voluntary. This means that HIM professionals are not regulated by either the state or federal government and individuals can enter the HIM workforce without a credential. This is a different paradigm than that which protects other healthcare professionals, such as doctors, nurses, etc, in which the professional credential is regulated. As a result, individuals in these professions cannot enter the workforce without their respective credential (i.e., license).

Review of other professions’ voluntary certification standards illustrates multiple eligibility paths for individuals pursuing these professional credentials. Typically these paths involve a combination of work experience and academic degree attainment; often higher academic degrees are combined with shorter periods of work experience. Ultimately, the specific relationship between years of work experience and academic study is dependent on the profession.

For the HIM profession, the Council has determined that one year of academic study is equivalent to 2.5 years of work experience. Therefore, five years of work experience was selected as the requirement.

PROPOSED EXPANDED RHIA ELIGIBILITY PATHWAYS

This proposal expands eligibility to write the RHIA exam from the existing four to six pathways.

ROUTE 1:

• EDUCATION: Minimum bachelor’s degree.

• EXPERIENCE: Five (5) years of full-time management-level work experience in the HIM field, or, as a full-time educator in a college or university either currently accredited by CAHIIM or in candidate status.

Management-level experience is typically defined as a salaried position involving substantive responsibility for people, functions, processes, or projects. Job titles will typically consist of descriptors including, but not limited to: director, manager, analyst, specialist, and in some cases, coordinator.

Candidates will be required to demonstrate competence in all five HIM domains through successful completion of the standard RHIA examination, regardless of their specific work experience.

• ENDORSEMENT: The endorsement of two RHIA-credentialed professionals will be required.

In addition to a certified transcript from the college or university granting the bachelor’s degree, applications of this type will be required to submit their current resume to demonstrate relevant experience in the HIM domain, as well as current job description detailing HIM-related duties and responsibilities.

As noted above, the review and endorsement of the applicant’s work experience by two RHIA-credentialed professionals will also be required. In the event the candidate does not have access to two RHIA professionals, this verification of eligibility will be completed by an independent panel appointed by the Council on Certification.

ROUTE 2:

• EDUCATION: Master’s degree in an HIM-related curriculum, or, in Education.

Examples include but are not limited to: Master’s in Health or Medical Informatics, MBA in Healthcare Management or Health Services, MHA, M.Ed., and MHSA.

• EXPERIENCE: Two (2) years of full-time management level work experience in the HIM field, or, as a full-time educator in a college or university either currently accredited by CAHIIM or in candidate status.

Management-level experience is typically defined as a salaried position involving substantive responsibility for people, functions, processes, or projects. Job titles will typically consist of descriptors including but not limited to: director, manager, analyst, specialist, and in some cases, coordinator.

Candidates will be required to demonstrate competence in all five HIM domains through successful completion of the standard RHIA examination, regardless of their specific work experience.

• ENDORSEMENT: The endorsement of two RHIA-credentialed professionals will be required.

In addition to a certified transcript from the college or university granting the master’s degree, applications of this type will be required to submit their current resume to demonstrate relevant experience in the HIM domain, as well as current job description detailing HIM-related duties and responsibilities.

As noted above, the review and endorsement of the applicant’s work experience by two RHIA-credentialed professionals will also be required. In the event the candidate does not have access to two RHIA professionals, this verification of eligibility will be completed by an independent panel appointed by the Council on Certification.

FINAL THOUGHTS

The Vision 2016 Blueprint document, which was first released in mid-2007, included numerous rich discussions that underscore the workforce implications and provided fresh momentum to this endeavor. The following quotations from that report are especially cogent:

“The data still demonstrate moderate to high vacancy rates in HIM jobs across the nation.”

“There will be other professions who will try to fill HIM niches.”

“HIM professionals with a baccalaureate degree have knowledge that is critical to many decisions that are made at the EHR decision table. Better educated HIM professionals will be better positioned to contribute ideas, knowledge, and experience, and will be more likely to be invited to the decision-making table.”

The subject of alternate paths to RHIA exam eligibility has surfaced at various times in the past. During 2007, the Council on Certification spent considerable time discussing and debating the topic, ultimately deciding to make a proposal and pursue membership adoption in 2008. Therefore, to fulfill its primary responsibility – that is, to recognize qualified professionals and address workforce demands through a high quality certification program – the Council on Certification proposes this change to RHIA exam eligibility.