What is a HIM?
HIM stands for Health Information Manager, a profession that evolved in the 1980s and 1990s from the traditional schools of Medical Record Management. As medical record technology has (slowly) evolved from card, paper and microfilm to digital forms and Electronic Patient Records (EPRs), the HIM profession has also retained relevance and grown with the industry while still maintaining the ownership of areas such as patient record / file numbering and clinical coding.
From HIM to Product Management
I finished my Bachelor of Applied Science (Health Information Management) degree at Sydney University in 1996. The degree included a huge range of subjects studied such as anatomy, medical terminology, financial management, organisation psychology, data management, research methodology and International Classification of Diseases (ICD) coding. It was also based on the Allied Health faculty so I met, lived (and partied with) physiotherapy, occupational therapy and nursing students. While they were studying various therapies, I was learning terminal digit filing!
My first job was working at The Children’s Hospital in Westmead, Sydney as a Medical Record Department Manager. My duties included processing medico-legal requests, collating information for clinical reviews, writing procedure manuals and managing clerical staff. I had the chance to help in Admissions, the Emergency Department and Outpatient Clinics when required which was a great way to learn how a hospital works. I also spent a lot of time searching for paper medical records that had gone missing (often found in ward cupboards, mis-filed on different shelves or sometime in doctor’s car boots)!
The Children’s Hospital was one of the first sites in NSW to attempt a ‘paperless medical record department’ and while I was there, we were scanning old paper records into an imaging repository in parallel to implementing an early Cerner product called Powerchart in Intensive Care. This was my first exposure to healthcare IT and I immediately saw the benefits – but also how far behind healthcare was given the potential of information technology.
After a couple of years, printing out digital records and re-scanning them started to become frustrating and I decided to move into the private health IT sector. I was lucky enough to get a junior position at CSC Healthcare working on a clinical costing and casemix program called Trendstar. Before I knew it, CSC became iSOFT and I was learning a new ‘windows based, SQL server Patient Administration System (PAS)’ called i.PM from an Englishman named Andy Smallman. I learnt the system and helped implement it in hospitals across New Zealand, NSW and Victoria. During this process, customers identified gaps and we had to deliver enhancements. The medical record number continued to be an area that needed HIM expertise and I even ran workshops explaining how patient IDs are allocated from ‘buckets of numbers’!
Over the years I found I was good at being a translator of sorts – explaining the customer problem and requirements to the designers and developers (in UK and India) and then helping to test and deliver the changes back with the customer. We called this the Product Development Life Cycle (PDLC) and it became my mantra for the next decade!
I continued to work at iSOFT through various acquisitions (IBA, back to CSC), took time off to travel, had two kids and then in 2015 I realised I hadn’t been on ‘the other side’ for a while, so I moved to Calvary Healthcare as their National Clinical Applications Manager across the group of 11+ hospitals and 20+ aged care facilities. This was a great chance to update and solidify my industry knowledge and experience firsthand some of the IT challenges faced in hospitals today (and the ever-present patient numbering on paper versus electronic challenges)!
In 2015, the opportunity of working with MKM Health (and some old friends) arose and I jumped at the chance to help the business grow. I started as Customer Support Manager, then moved to consulting on a range of projects including NSW eHealth notifications to General Practitioners, Australian Commission on Safety and Quality in Health Care medication chart audit, NSW Cancer Institute Breast Cancer Screening IT system review, Chris O’Brien Lifehouse medical imaging repository, St Vincents Health Care Risk IT system review and Genesis Care IT process review.
And now … I am in Product Management looking after enhancements and releases for our Smartpage Clinical Communications and Task Management solution! I even get the chance to talk about patient numbering every now and again with the Miya Precision Team.
HIMs continue to evolve and take on various roles across the healthcare IT landscape. They can still be found in medical record departments but are also often customers in Hospital IT Project roles, business experts in health departments and data analytic academic experts. Yes – we pop up everywhere… So whenever you start thinking that medical record number formats don’t matter, think again!
Athene Alleck is the Smartpage Product Lead at Alcidion