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Posted: December 6th, 2022

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Assignment: Develop a trivia game. For this chapter, students could develop 10 to 15 cards on the mission, code of ethics, and current organizational structure of
AHIMA.

HITT 1301 CHAPTER 1
Health Information Management Technology,
An Applied Approach
Nanette Sayles, Leslie Gordon

Copyright ©2020 by the American Health Information Management Association. All rights reserved. Except as permitted under the Copyright Act of 1976, no part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, photocopying, recording, or otherwise, without the prior written permission of AHIMA, 233 North Michigan Avenue, 21st Floor, Chicago, Illinois 60601-5809 (http://www.ahima.org/reprint).

ISBN: 978-1-58426-720-1
AHIMA Product No.: AB103118

This chapter introduces the history of the health information management (HIM) profession and offers insights into the current and future roles and functions of those who manage health information. The role of HIM professionals is even more important now than it was when the Association of Record Librarians of North America (ARLNA) was created in 1928 due to the complexity of today’s information- and technology-driven healthcare environment.

Early History of Health Information Management
The commitment, wisdom, and efforts of HIM pioneers are reflected in what we see today as the HIM profession. Four distinct steps influenced development of the HIM profession. These steps include the hospital standardization movement, the organization of record librarians, the approval of formal educational processes, and an educational curriculum for medical record (now known as health information) librarians.

Hospital Standardization
Before 1918, the creation and management of hospital health records were the sole responsibilities of the attending physician. Physicians of that time often disliked doing paperwork. Unless the physician was interested in medical research, the medical records in the early 20th century were “practically worthless and consisted principally of nurse’s notes” (Huffman 1941, 101).

Health records of that time did not contain graphical records or laboratory reports. Because there was no general management of health record processes, hospitals made no effort to ensure missing or incomplete portions of the health records were completed. Furthermore, no standardized vocabulary was used to document why the patient was admitted to the hospital or the final diagnosis upon discharge.
In 1918, the hospital standardization movement was inaugurated by the American College of ­Surgeons (ACS). The purpose of the resulting Hospital Standardization Program was to raise the standards of surgery by establishing minimum quality standards for hospitals. The ASC realized one of the most important items in the care of every patient was a complete and accurate report of the care and treatment provided during hospitalization. The health record should contain test ­results, identification information, diagnoses, treatment, and more (Huffman 1941).
It was not long before hospitals realized that to comply with the hospital standards, new health record processes had to be implemented. In ­addition, staff had to be hired to ensure the new processes were appropriately carried out. Furthermore, hospitals recognized health records must be maintained and filed in an orderly manner. Cross-indexes of diseases, operations, and physicians must be compiled. Thus, the job position of health record clerk was established.

Organization of the Association of Record Librarians
In 1928, 35 members of the Club of Record Clerks met at the Hospital Standardization Conference in Boston. Near the close of the meeting, the Association of Record Librarians of North America (ARLNA) was formed. During its first year the association had a charter membership of 58 individuals. Members were admitted from 25 of the 48 states, the District of Columbia, and Canada (Huffman 1985). ARLNA was the original name of the American Health Information Management Association (AHIMA), which is discussed later in this chapter.

Approval of Formal Education and Certification Programs
Early HIM professionals understood that for an occupation to be recognized as a profession there must be preliminary training. They also understood such training needed to be distinguished from mere skill. This training needed to be intellectual in character, involving knowledge and learning. Therefore, work began on the formulation of a prescribed course of study as early as 1929. In 1932, the association adopted the first formal curriculum for HIM education.
The first schools for medical record librarians were surveyed and approved by ARLNA in 1934. By 1941, 10 schools had been approved to provide training for medical record librarians. This formal approval process of academic programs was the precursor to the current accreditation program managed by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). Accreditation is a determination by an accrediting body that an eligible organization, network, program, group, or individual complies with applicable standards. In the case of CAHIIM, it is academic educational programs.
The Board of Registration, a certification board, was instituted in 1933 and developed the baseline by which to measure qualified health record librarians. “Certification is a credential earned by demonstrating specific skills or knowledge usually tied to an occupation, technology, or industry. Certifications are usually offered by a professional organization or a company that specializes in a particular field or technology” (CareerOneStop 2018). The Board of Registration developed the eligibility criteria for registration and developed and administered a national qualifying examination. Registration is the act of enrolling; in this case, enrolling in AHIMA’s certifications (this process is discussed later in this chapter). Today, AHIMA’s Commission on Certification for Health Informatics and Information Management (CCHIIM) functions as the Board of Registration. CCHIIM’s role and function are discussed later in this chapter.
The professional membership of the association of HIM professionals grew over the subsequent decades. Although the name of the association changed several times, the fundamental elements of the profession—formal training requirements and certification by examination—have remained the same.

Evolution of Practice
The various names given to the health record association and its associated credentials reveal a lot about the evolution of the profession and its practice. A credential is a formal agreement granting an individual permission to practice in a profession, usually conferred by a national professional organization dedicated to a specific area of healthcare practice; or the accordance of permission by a healthcare organization to a licensed, independent practitioner (physician, nurse practitioner, or other professional) to practice in a specific area of specialty within that organization. It usually requires an applicant to pass an examination to obtain the credential initially and then to participate in continuing education activities to maintain the credential thereafter. The health record association was known as ARLNA until Canadian members formed their own organization in 1944. At that time, the name of the professional organization was changed to the American Association of Medical Record Librarians (AAMRL). In 1970, the professional organization changed its name again to eliminate the term librarian. The professional organization’s name became the American Medical Record Association (AMRA). The professional organization underwent another name change in 1991 to become American Health Information Management Association (AHIMA).
The changes in the professional organization’s name in 1970 and 1991 reflected the changing nature of the roles and functions of the association’s professional membership. In 1970, the term administrator mirrored the work performed by members more accurately than the term librarian. Similarly, in 1991, association leaders believed that the management of information, rather than the management of records, would be the primary function of the profession in the future.

In 1999, AHIMA’s House of Delegates (HOD) approved a credential name change. Registered Record Administrator (RRA) became Registered Health Information Administrator (RHIA), and Accredited Record Technician (ART) became Registered Health Information Technician (RHIT). These certifications are discussed later in this chapter. This section will address the traditional practice of HIM, the current information-oriented management practice, as well as the future of HIM.

Traditional Practice
The original practice of HIM emphasized the need to ensure that complete and accurate health records were compiled and maintained for every patient. Accurate records were needed to support the care and treatment provided to the patient as well as to conduct various types of clinical research.
Traditional practices of HIM involved planning, developing, and implementing systems designed to control, monitor, and track the quantity of record content and the flow, storage, and retrieval of health records. In other words, activities centered primarily on the health record or reports within the record as a physical unit rather than on the data elements that make up the information within the health record.
In 1928, very few standards “addressed issues relating to determination of the completion, significance, organization, timeliness, or accuracy of information contained in the medical record or its usefulness to decision support” (Johns 1991, 57).
Traditionally, HIM professionals worked in a hospital HIM department. Today, HIM professionals are found in many settings and in many roles. Some of the more common settings and some HIM roles are listed in table 1.1.

Table 1.1 HIM profession’s job setting
Setting Roles
Acute-care hospital HIM director
Cancer registrar
Discharge analyst
Systems analyst
Privacy officer
Compliance
Integrated healthcare delivery sytem
HIM director
Privacy officer
Coder
Compliance officer
Other provider setting (such as long-term care and psychiatric) HIM director
Privacy officer
Coder
Compliance officer
Vendor Sales
Systems analyst
Consultant
Systems implementation
Trainer
Insurance companies
Claims coordinator
Auditor
Privacy officer
Consulting Consultant
Educational institution Professor
Law firm HIM director
Government agency
Reimbursement specialist
Data manager
Data mapper
Pharmaceutical companies Research Helpant
Source: ©AHIMA.

Information-Oriented Management Practice
The traditional model of practice roles is not appropriate for today’s information-intensive and automated healthcare environment. The traditional model of practice is department focused with an emphasis on tasks. These tasks include the processing and tracking of records rather than processing and tracking information.
In today’s information age, information crosses departmental boundaries and is broadly disseminated throughout the organization and beyond. Because of the focus on information, information governance is crucial. Information governance is “an organization-wide framework for managing information throughout its lifecycle and for supporting the organization’s strategy, operations, regulatory, legal, risk, and environmental ­requirements” (IG Advisors 2018). In other words, the information must be managed to ensure the needs of the organization are met. See chapter 6, Data Management, for more on information governance.

Information grows out of data manipulation using data from a variety of shared data sources, both internal and external to the healthcare organization. For the HIM professional to manage this information, informatics skills, data analytics skills, and data use skills are required (Dooling et al. 2016). Informatics is a field of study that focuses on the use of technology to improve access to, and utilization of, information. Informatics uses software applications, databases, managing processes, and more (Dooling et al. 2016). To learn more about informatics, refer to chapter 13, Research and Data Analysis. Data analytics is the science of examining raw data with the purpose of drawing conclusions about that information. For example, the data may be analyzed to determine what services increase revenue for the healthcare organization and which ones incur a loss. Data analytics includes healthcare statistics, research methods, and interpretation. Data use is the ability to use technology to collect, store, analyze, and manage information, including the ability to use data visualization methods (Dooling et al. 2016). For example, a graph or chart may be created to show the trends of inpatient admissions over time. Information on graphs and charts is found in chapter 13, Research and Data Analysis.

The Future of HIM
Research shows the HIM profession is continuing to evolve from the traditional HIM roles to roles focused on information. Many of these changes result from the conversion to the electronic health record (EHR), but other factors including regulations, new technologies, and engaged consumers also influence the changes (The Caviart Group 2015). The EHR is an electronic record of health-related information about an individual that conforms to nationally recognized interoperability standards and can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization. The EHR has dramatically increased the amount of information available and the ability to manipulate and interpret information. With a paper health record, collecting and analyzing data is very resource intensive so there are many limitations. Data analytics and informatics, discussed earlier in the chapter, will be important in the future for managing the increased data and information created by the EHR and other changes, such as changes in regulations and in technology. The 2015 Work Force Study, a research study on the roles and opportunities for HIM professions, identified the top 10 skills required by HIM professionals both today and into the future (The Caviart Group 2015). Table 1.2 shows these skills in order of importance.
Table 1.2 Comparison of the most important present and future HIM skills
Today’s most important skills Future’s most important skills
1. Medical record coding 1. Electronic health record (EHR) management
2. Managing information privacy and security 2. Managing information privacy and security
3. Analytical thinking 3. Analytical thinking
4. Ensuring data integrity 4. Critical thinking
5. Critical thinking 5. Ensuring data integrity
6. Clinical documentation integrity 6. Problem solving
7. Electronic health record (EHR) management 7. Communication (written, spoken, or presentation)
8. Communication (written, spoken, or presentation) 8. Clinical documentation integrity
9. Problem solving 9. Leadership
10. Developing and promoting HIM standards 10. Analyzing big data
Source: Adapted from The Caviart Group 2015.

Today’s Professional Organization
AHIMA is a membership organization representing more than 103,000 health information professionals. These professionals serve the healthcare industry and the public by managing, analyzing, and utilizing information vital for patient care and making it accessible to healthcare providers when and where it is needed.
AHIMA strives to foster the professional development of its members through education, certification, and lifelong learning. AHIMA also ­advocates for the HIM profession by working with legislators, stakeholders, and others to address issues ­related to HIM. The intent of this advocacy is to promote the development of high-quality ­information that benefits the public, healthcare consumers, healthcare providers, and other users of clinical data. The organization has certification programs that set high standards to ensure the minimum qualifications of the individuals who practice as health information managers and technicians. In addition, AHIMA supports numerous continuing education (CE) programs to help its credentialed members and others maintain their knowledge base and skills.
As previously described, AHIMA’s name has changed several times over the years to reflect changes in the organization and the profession. The sections that follow discuss the mission, membership, and organizational structure of AHIMA.

AHIMA Mission and Vision
Before studying AHIMA’s structure, it is important to understand why the organization exists and what contributions it makes to its members and the healthcare system in general. The mission of an organization explains what the organization is and what it does. In other words, it describes the organization’s distinctive purpose. A vision is a futuristic view of where the organization is going. Figure 1.1 shows AHIMA’s current mission and vision.
Figure 1.1 AHIMA’s mission and vision
Mission Vision
Empowering people to impact health A world where trusted information transforms health and healthcare by connecting people, systems, and ideas
Source: AHIMA 2019a.

All organizations have values but these values may or may not be written. The values provide guidance to the organization when making decisions and establishing a culture (Tutorialspoint nd).

To accomplish its mission, AHIMA expects its members to follow a code of professional ethics (a complete discussion of ethical principles and AHIMA’s Code of Ethics is provided in chapter 21, Ethical Issues in Health Information Management.) A code of ethics is a statement of ethical principles regarding business practices and professional behavior. The AHIMA Code of Ethics ­requires members of AHIMA, CCHIIM, credentialed nonmembers (certificants), and students enrolled in a formal certificate- or degree-granting programs directly relevant to AHIMA’s purpose to act in an ethical manner and comply with all laws, regulations, and standards governing the practice of HIM. Just as professionals, members, certificants, and students are expected to continually update their knowledge base and skills through CE and lifelong learning, HIM professionals and managers are expected to promote high standards of HIM practice, education, and research. Additionally, they are expected to promote and protect the confidentiality and security of health records and health information.

AHIMA Membership
To accommodate the diversity in AHIMA membership, the organization has established the following seven membership categories: active membership, premier membership, student membership, new graduate membership, emeritus membership, global membership, and group membership (AHIMA 2019b).
Active membership is open to all individuals who are interested in AHIMA’s purpose and willing to abide by the code of ethics. Active members in good standing are entitled to all membership privileges including the right to vote and to serve in the House of Delegates (discussed later in this chapter). Active membership provides HIM professionals the opportunity to participate in the organization and to offer input to the current and future practices of the profession.
Premier membership provides all the benefits described in active membership plus additional benefits such as unlimited recertification and ­additional discounts.
Student membership includes any student who does not have an AHIMA credential, has not previously been an active member of AHIMA, and who is formally enrolled in a Professional Certificate Approval Program or an Approved Committee for Certificate Program, or in a CAHIIM-­accredited HIM program. The student membership category gives entry-level professionals an opportunity to participate on a national level in promoting sound HIM practices. Student members can serve on committees and subcommittees in designated student positions with a voice, but they do not have a vote.
New graduate membership is for student members who are recent graduates of accredited associate, bachelor’s, and master’s degree programs as well as AHIMA-approved coding programs. This membership level allows the students to continue their membership at a reduced rate for one year. This membership level has all membership rights including voting.
Emeritus membership allows AHIMA members who are 65 years or older to be a member at a reduced rate. This membership level has all membership rights including the right to vote.
Global membership is for people who are interested in HIM but live outside of the United States.
Group membership allows multiple individuals from an organization to join at one time. Student and business groups are eligible for this membership type.
New to AHIMA membership offers those who have never been a member of AHIMA a discounted rate for two years. This membership receives the same benefits as the Active Member (AHIMA 2019b).

AHIMA Structure and Operation
Every organization needs a management structure to operate effectively and efficiently. AHIMA is made up of two components—volunteer and staff. The volunteer structure establishes the organization’s mission and goals, develops policy, and provides oversight for the organization’s operations. Figure 1.2 shows AHIMA’s volunteer structure. The staff component of the organization carries out the operational tasks necessary to support the organization’s mission and goals. The staff works within the policies established by the volunteer component.
Figure 1.2 AHIMA’s volunteer structure

Source: AHIMA 2019b.

Association Leadership
As a nonprofit membership association, AHIMA depends on the participation and direction of ­volunteer leaders from the HIM community. ­AHIMA’s members elect those who serve in the governing bodies of the organization.
The AHIMA board of directors governs the ­association. They set the organizational strategy, maintain fiscal oversight, and act as trustees of the organization (AHIMA 2019c). The business and affairs of AHIMA are managed by or under the direction of the Board of Directors. Its members include the president/chair, the president/chair-elect, the past president/chair, speaker of the House of Delegates, nine elected directors, the chief executive officer of the organization, and the advisor to the board. Except for the chief executive officer and the advisor, who are selected by the board of directors, all members of the board of directors are elected by the membership and serve three-year terms of office; members must be active members of the association. The ­president/chair must be a certificant and the majority of the directors must also be certificants.
In addition to the board of directors, CCHIIM is elected by the membership. CCHIIM is an AHIMA commission that is dedicated to assuring the competency of professionals practicing HIIM. It is a standing commission of AHIMA that is empowered with the responsibility and authority related to certification and recertification of HIIM professionals (AHIMA 2019c).

Engage
Engage is a community website managed by ­AHIMA for members to communicate on HIM topics. Engage has communities open to all HIM professionals and some specific for AHIMA members only. Engage provides the following benefits:
• Opportunities for members to contact other members to gain knowledge, share information, and learn best practices
• Opportunities to identify members with similar interests and backgrounds
• Gives members the ability to share and retrieve resources (AHIMA 2019d)

National Committees
AHIMA’s president/chair oversees the appointment of members of the association’s national committees, practice councils, and workgroups. These groups support the mission of the organization and work on specific projects as designated by the president/chair and the board of directors. Examples of the national committees include the Conference Program Committee, the Fellowship Committee, and the Professional Ethics Committee. Practice councils are established as thought leadership groups to develop HIM content for a specific topic. Examples of practice councils include clinical classification and terminology, clinical documentation integrity, and privacy and security. Practice councils and committees are created to meet a specific need and may continue for years. In addition, AHIMA addresses challenges by establishing workgroups for short-term projects and then disbanding them. An example of a workgroup is the LGBTQ (lesbian, gay, bisexual, transgender and queer equality) Volunteer Workgroup.

House of Delegates
The House of Delegates governs the profession of health information management by providing a forum for membership and professional issues and to establish and maintain professional standards of the membership. For this reason, it is an important component of the volunteer structure (AHIMA 2019c). The House works virtually year-round with one annual face-to-face business meeting held in conjunction with AHIMA’s conference.
Each component state association, defined later in this chapter, elects or appoints representatives to the House of Delegates to serve for a specified term of office. For this reason, the House of Delegates is similar to the legislative branch of the US government. Under the House are two teams: House Leadership and Envisioning Collaborative. The teams are made up of one delegate from each state. The Envisioning Collaborative serves as a “think tank.” It is composed of delegates, subject matter experts, and industry leaders. Their role is to bring forward an exchange of viewpoints, innovation, and ideas. The outcomes of these discussions are the development of strategies used to ­advance the profession (AHIMA 2019d).
The House Leadership team ensures effective House operations through alignment with strategy and fosters the overall delegate experience and provides oversight of task force progression. Ad hoc task forces are created under the House to address topics that are important to the profession. These task forces change over time as the needs of the profession change.
The House of Delegates is responsible for establishing the position of AHIMA on issues related to HIM and taking action on a number of topics, including the following:
(a) “The standards governing the health information management profession, including:
• AHIMA Code of Ethics
• Standing rules of the House of Delegates
• Development of positions and best practices in health information management
(b) Election of six (6) members of the AHIMA Nominating Committee in accordance with the process set forth in the AHIMA Policy and Procedure Manual.
(c) Any other matters put before the House of Delegates by the AHIMA Board of Directors for final consideration and action” (AHIMA 2019d, 14).

Figure 1.3 shows the formal governance structure of AHIMA.

Figure 1.3 Governance structure of AHIMA
Source: AHIMA 2019b.

State and Local Associations
In addition to its national volunteer organization, AHIMA supports a system of component organizations in every state, plus Washington, DC, and Puerto Rico. Component state associations (CSAs) are professional associations that support the mission and views of AHIMA in their state (AHIMA 2019d). CSAs provide their members with professional education, networking, and representation.
Many states also have local or regional organizations. For newly credentialed professionals, the state and local organizations are ideal avenues for becoming involved with volunteer work within the professional organization. Most HIM professionals who serve in the House of Delegates or serve on AHIMA’s Board of Directors began their volunteerism by serving at the local, regional, and state associations.

Staff Structure
The AHIMA headquarters is located in Chicago, Illinois. The chief executive officer (CEO) is given the authority and responsibility to operate AHIMA in all its activities, subject to the policies and directions of the Board of Directors. The CEO undertakes his or her duties in accordance with a job description approved by the Board (AHIMA 2019d). The CEO is responsible for overseeing day-to-day operations. A team of executives, managers, and staff support the CEO. These executives include a chief knowledge officer and chief operating officer. Examples of the staff departments include, among others, member services, professional practice services, AHIMA Press, marketing, and policy and government relations.

Accreditation of Educational Programs
AHIMA has a long tradition of commitment to HIM education. As discussed previously, the first prescribed educational curriculum for the training of health record professionals was proposed in 1929. The first educational programs were accredited in 1934. Since then, the association has developed and maintained a rigorous accreditation process for academic programs, continuously developed up-to-date curriculum models, and supported educational programs in a variety of ways. Accreditation is discussed in more detail later in this chapter.

Certification and Registration Program
As the field of HIM became more complex, the association recognized the need to regulate its credentialing program. In 2008, CCHIIM was established. CCHIIM is dedicated to ensuring the competency of HIM professionals. CCHIIM serves the public by establishing, implementing, and enforcing standards and procedures for certification and recertification of HIM professionals. CCHIIM provides strategic oversight of all AHIMA ­certification programs. This standing commission of AHIMA is empowered with the sole and independent authority in all matters pertaining to both the initial certification and ongoing recertification (certification maintenance) of HIM professionals.
Today, AHIMA’s certification program encompasses several credentials, including the following:
• Registered Health Information Technician (RHIT)
• Registered Health Information Administrator (RHIA)
• Certified Coding Associate (CCA)
• Certified Coding Specialist (CCS)
• Certified Coding Specialist—Physician-based (CCS-P)
• Certified in Healthcare Privacy and Security (CHPS)
• Certified Health Data Analyst (CHDA)
• Clinical Documentation Improvement Practitioner (CDIP)

Each of these credentials has specific eligibility requirements and a certification examination. To achieve certification from CCHIIM, individuals must meet the eligibility requirements for certification and successfully complete the certification examination.
Because the HIM profession is constantly changing, certified individuals must demonstrate they are continuing to maintain their knowledge and skill base. Therefore, to maintain their certification, individuals who hold any of AHIMA’s credentials must complete a designated set of continuing education units (CEUs). Activities that qualify for CEUs include participation in workshops and seminars, taking college courses, participating in independent study activities, and engaging in self-assessment activities. The CCHIIM website provides information on the most recent requirements for maintenance of certification.

Fellowship Program
AHIMA’s fellowship program is a program of earned recognition for AHIMA members who have made significant and sustained contributions to the HIM profession through meritorious service, excellence in professional practice, education, and advancement of the profession through innovation and knowledge sharing (AHIMA 2019e). Individuals who earn fellowship use the designation Fellow of the American Health Information Management Association (FAHIMA).
Fellowship is open to any individual who is an active or Emeritus member of AHIMA and who meets the eligibility requirements. Fellows must have a minimum of 10 years full-time professional experience in HIM or a related field, a minimum of 10 years continuous AHIMA membership at the time they submit their application (excluding years as a student member), hold a minimum of a master’s degree, hold an active CCHIIM credential and provide evidence of sustained and substantial professional achievement that demonstrates professional growth and use of innovative and creative solutions. AHIMA members who desire to apply for fellowship but do not yet meet the eligibility requirements may apply for candidacy. Candidacy is a period of time where the HIM professional, who is not currently eligible, works toward the recognition. Once conferred, fellowship is a lifetime recognition as long as the individual remains an AHIMA member and complies with AHIMA’s Code of Ethics. At the time of this writing, 200 members have been awarded fellowship status.

AHIMA Support of Training and Education
AHIMA supports training and education in a number of ways including educational webinars and face-to-face meetings for HIM professionals. AHIMA has also created self-assessments for HIM professionals to evaluate their skills in comparison to the skills required for current HIM practices.
AHIMA provides HIM educational programs with a number of resources. For example, the Virtual Lab provides HIM educational programs access to a number of information systems, such as the EHR and data visioning, that students will see in practice. AHIMA publishes HIM textbooks and creates entry-level competencies used in HIM ­educational programs. AHIMA also provides courses in a number of topics related to HIM.
AHIMA created the Council for Excellence in Education (CEE) to bring together representatives of the HIM education stakeholders, including industry representatives, to address issues related to the future of the profession and HIM education. The CEE works to “ensure that education is positioned as the cornerstone of health information professions through communication, collaboration, ­innovation, and research” (AHIMA 2019f). The CEE board is elected by the AHIMA membership for a three-year term.
The CEE has a number of workgroups to ­conduct the work of the council. These workgroups include curricula, educational programming, graduate resources, student advisory, and workforce (AHIMA 2019f). These workgroups help strengthen members by identifying the future needs of the profession and then setting the college curriculum required to ensure future HIM professionals have those skills. They also Help educators by helping educators keep skills current and by Helping with establishing standards for professional practice experiences.

AHIMA Career Map
AHIMA created the interactive Career Map. This Career Map provides a synopsis of current and emerging HIM careers (roles) in four categories: Coding and Revenue Cycle, Data Analytics, Informatics, and Information Governance. These roles are categorized into four tiers: entry, mid, advanced, and master level. The Career Map shows common paths a HIM professional might take as he or she moves from entry-level roles to master-level roles. This path may jump from category to category. For example, the Informatics mid-level of implementation support analyst can jump to the Information Governance advanced role of HIM manager (AHIMA nd). The Career Map is shown in figure 1.4. To access the Career Map, visit http://www.ahima.org/careermap.

Figure 1.4 Career Map

Source: AHIMA 2019g.

AHIMA Foundation
Founded in 1962, AHIMA Foundation is a separate entity from AHIMA but supports AHIMA in a multitude of ways. AHIMA Foundation supports people (including HIM professionals, HIM students, and others), research, and resources that enhance the HIM profession.
The HIM profession is based on the belief that high-quality healthcare requires high-quality information. AHIMA Foundation provides leadership in research, workforce development, ­scholarships, and competency-based education for the HIM professional. One of the ways that it supports workforce development is through an apprenticeship program that allows recent HIM graduates to obtain real-world experience. Its role is to envision the future direction and needs of the field and to respond with strategies, information, planning, and programs that will keep the HIM profession on the cutting edge.

Commission on Accreditation for Health Informatics and Information Management Education
In 2004, AHIMA’s House of Delegates voted to establish an independent accreditation commission, Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM), with sole and independent authority in all matters pertaining to accreditation of educational programs in health informatics and information management. CAHIIM serves the public interest by establishing quality standards for the educational preparation of future HIM professionals. When a program is accredited by CAHIIM, it means it has voluntarily undergone a rigorous review process and has been determined to meet or exceed the ­accreditation standards established by CAHIIM. CAHIIM accreditation recognizes and publicizes best practices for HIM education programs.

CAHIIM reviews formal applications from college programs that apply for candidacy status, which is a preliminary approval process. After a successful review of the application documentation, a program may be deemed a candidate for accreditation for up to two years. Students enrolled in programs placed in candidacy status are eligible to join AHIMA as student members. The steps of the accreditation process are the following:
1. The college program prepares a self-assessment document that helps the college identify its strengths and weaknesses.

2. Accreditation site visitors visit the campus to review documents and interview faculty, students, and administration.

3. A final determination is made as to the ability of the college program to meet the accreditation standards for curriculum, facility, resources, and other requirements.

The accreditation of educational programs is important because only those individuals who graduate from an approved program may sit for the national credentialing examinations for the RHIT and RHIA. At the time this chapter was written, an exception has been made that allows RHITs who have a bachelor’s degree in any subject to qualify to sit for the RHIA exam.

Health Information Management Specialty Professional Organizations
Health information management professionals frequently specialize in an area of the HIM ­profession. Examples of these specialties include clinical documentation integrity, coding, tumor registry, medical transcription, information governance, privacy and security, standards, and information systems. A number of specialty organizations support these areas.

Healthcare Information and Management Systems Society
Healthcare Information and Management Systems Society (HIMSS) is a not-for-profit organization that supports “the information of health through the application of information and ­technology” (HIMSS 2018a). The HIMSS sponsors exams for health information and information systems professionals—the certified professional in Healthcare Information and Management Systems (CPHIMS) certification and Certified Associate Professional in Healthcare Information and Management Systems (CAHIMS). The CPHIMS exam covers topics such as healthcare environment, technology environment, system analysis, system design, system selection and implementation, privacy and security, and administration (HIMSS 2018b). The CAHIMS certification covers administration, healthcare information and systems management, organization environment, and the technology/organizational environment (HIMSS 2018c).

Association for Healthcare Documentation Integrity
The Association for Healthcare Documentation Integrity (AHDI) is a professional organization dedicated to the capture of health data and documentation (AHDI 2018a). AHDI sponsors the Registered Healthcare Documentation Specialist (RHDS) and Certified Healthcare Documentation Specialist (CHDS) credentials. The RHDS is the entry-level certification sponsored by AHDI. The CHDS determines if the candidate is qualified to be a transcriptionist in a multidisciplinary environment. Both certification ­exams address basic transcription concepts including transcription standards and style, clinical medicine, and health information technology (AHDI 2018b).

American Academy of Professional Coders
The American Academy of Professional Coders (AAPC) educates and certifies medical coders, billers, medical auditors, revenue cycle managers, and other administrative specialties. The AAPC sponsors certifications in these specialty areas. Some of the certifications include the following:
• Certified Professional Coder (CPC)
• Certified Professional Medical Auditor (CPMA)
• Certified Professional Compliance Officer (CPCO)
• Certified Inpatient Coder (CIC)
• Certified Outpatient Coder (COC)
• Certified Risk Adjustment Coder (CRC)
• Certified Documentation Expert Outpatient (CDEO)
• Certified Physician Practice Manager (CPPM)
(AAPC 2018)

National Cancer Registrars Association
The National Cancer Registrars Association (NCRA) represents cancer registrar professionals. Their mission is to “serve as the premier education, credentialing, and advocacy resource for cancer data professionals” (NCRA 2018). The NCRA sponsors the Certified Tumor Registrar (CTR) certification. This exam includes information on registry organization and operations, abstracting, coding, follow-up, data analysis, and interpretation as well as coding and staging.

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