Research on Training Competent Health Information Management Professionals: Based on a Survey of Field Experts

Introduction

A survey was performed targeting 180 HIMs who attended the 87th KHIMA academic conference on November 27, 2023. Most of the attendees work in hospitals or health-related institutions, including government offices. Similar to US HIMs, Korean HIMs should submit eight hours of continuing education (CE) a year to keep the HIM license, and the attendees can receive six hours of CE from the conference.  

The survey title was “a study on training competent health information management professionals.” A Google link for the survey was sent to the conference participants. Among the attendees, 126 HIMs responded to the survey. All the HIMs who responded to the survey have a Korean HIM license and graduated from a college or university that has a HIM education program.

The survey included a total 17 questions and was composed of four sections. Section 1 included five questions to collect information on demographics and work status. Section 2 had four questions about the future leading jobs of HIM professionals. Sections 3 and 4 included eight questions about the level of importance of competence and education subjects. The Korean HIM education programs, the work group and tasks in Korea and the USA were introduced in the survey, and the respondents could choose future leading jobs and required subjects to raise competent HIMs.  

A summary of the survey composition is below (Table 1).

Table 1: Survey composition

In section III, “Level of importance of competencies for HIM,” and the subject in section IV, “Importance levels of education of each subject for HIM” were the competencies also suggested based on KAHIME.

KAHIME established 10 program outcomes (POs) and let the universities that run HIM education programs match the POs to subjects. Most universities have a map that matches the subjects in their curriculum with the Program Outcomes (POs). These maps are usually similar across different universities. The POs suggested by KAHIME and subject mapping are as below (Table 2). This survey was performed on the condition that the attendees recognized the relationships between POs and related subjects.

Table 2: Program outcomes and related subjects (Jaeneung University HIM program 2020-2024)

To give some relationships between subjects and future leading jobs, we required the survey respondents to select the subjects needed based on the future leading jobs they selected.

The last subject, “Required skills for Korean HIM among job descriptions,” was derived from the job search engine SimplyHired⁷. This is because many students are currently interested in working abroad with certifications such as Certified Tumor Registrar (CTR), Registered Health Information Administrator(RHIA), Certified Coding Specialist (CCS), and Certified Coding Specialist-Physician-based(CCS-P).

Ethics

We received IRB approval before the survey and consent from the survey participants.

Results

Respondent analysis

Most of the respondents were female at 93.7 percent. Regarding age, those in their 30s, 40s, and 50s were evenly divided with 27 percent, and those in their 20s was a relatively small percentage at 19.0 percent. As for the work period, the percentage of respondents who worked for more than 20 years was 46 percent, less than 10 years was 35.7 percent, and 10-20 years was 18.3 percent.

Most of the respondents worked in a hospital, and eight were working in a government institution such as a public health center or social information security service. Among the hospital workers, 28.6 percent worked in a hospital with more than 1,000 beds, and the same percentage (32.5 percent) worked in hospitals with less than 500 beds and 500-1,000 beds (Table 3).

Table 3: Demographics and work status

*Other includes institutions such as public health, and government institutions such as the Korea Disease Control and Prevention Agency.

About 60 percent of the respondents had more than two roles, and 38.9 percent had only one role. Also, 54 percent of the respondents were in charge of the disease and intervention classification and 46 percent were involved in incomplete medical record management, while 36.5 percent were managers (Table 4).

Table 4: Respondent role distribution

Note: A respondent included multiple roles in case it was needed

Questions about the future leading jobs of HIM professionals

The respondents selected data analytics (35.7 percent) as the top leading future occupation among the occupations suggested in the AHIMA career map, followed by data quality (28.6 percent) and informatics (21.4 percent). In the Korean job areas suggested by KAHIME, they chose health data utilization (58.4 percent) as the top leading future job area (Table 5).

Table 5: Leading future job area

Important subjects to raise competent HIMs

Of the respondents, 69.8 percent selected disease and procedure classification as the most important subject for current competent HIMs. As for other opinions, many of the respondents suggested the importance of management areas related to AI, and there were opinions about personality management. (Table 6)

Table 6: Important (core) subjects for current HIMs

As for the most important subject to raise competent future HIMs, they selected healthcare  data management (51.6 percent) (Table 7).

Table 7: Important subjects to raise competent future HIM

Table 9: Correlation results

Discussion

Respondent composition

Almost half the respondents worked for less than 20 years. Regarding age, the respondents who were less than 40 years old were 46 percent. When the age was less than 40 years and working period was less than 20 years, and many of them worked in hospitals with less than 1000 beds, it could affect the results. 

About 50 percent of the respondents were involved in more than two roles. In these cases, they were in charge of disease, procedure classification, incomplete medical record checking and statistics, because many hospitals do incomplete record checking along with disease and procedure classification work. In small hospitals, statistics were performed with classification.

Survey result analysis

Among the four fields of health and medical information managers that will grow in Korea in the future presented by KAHIME, 58.4 percent of respondents chose the field of medical information utilization, and among those in the AHIMA career tools, 35.7 percent chose data analysis and clinical research coordinator. It means that the respondents think the data management field is important. The government also presented strategies for using healthcare data, such as a healthcare data standardization roadmap (2021-2025), and accordingly, the role of HIM professionals as data-based healthcare managers who can also manage the local community is emphasized¹¹. In order to perform this role well, it is needed to add a practical data management subject to the accreditation requirements courses¹².

Among the core competencies currently emphasized in university education, 69.8 percent answered that disease and procedure classification was the most important, and the importance of basic knowledge such as medical terminology, anatomy, and pathology was also relatively higher than other competencies. It appears to be an expression of the importance of basic knowledge in practical work³.

In the correlation analysis, a negative relationship was found between disease and procedure classification and working period. HIMs working in hospitals with less than 1000 beds placed more emphasis on disease and procedure classification. HIMs under 30 also chose disease and procedure classification, but managers and workers in hospitals with more than 1000 beds chose health data management. It shows that there is a slight difference in importance depending on experience and work environment. In big hospitals, disease and procedure code is often selected through an automatic program, and HIMs are concentrating on terminology management, CDI and research support for clinicians using health data. We think it affected the survey results.

Correlation analysis showed a positive correlation between healthcare database management education, age, and working period. As age and working period are longer, the respondents answered that healthcare database management is more important. It means that workers who work longer are experiencing the importance of healthcare database management, since experienced workers are usually involved in areas other than disease and procedure classification roles and work using already coded data.

Among the skills presented by SimplyHired, 77 percent chose data warehousing and 69.8 percent chose data management, skills that are currently widely used in Korea and are the most needed, and many also chose skills such as data mining and SQL.

Currently in Korea, languages such as SQL are basically included in data management, but it seems that practical training is needed to be able to apply it in the workplace.

Limitations

Workers in small hospitals such as clinics do not participate in academic conferences often. Instead, they usually obtain continuing education units from online materials provided on the KHIMA website. So the ratio of workers in large hospitals with 500 beds or more was relatively high. There are some differences in the survey results depending on the number of workers in large hospitals or related work, so it is necessary to conduct a survey centered on hospitals and clinics in the future.

The subjects and program outcomes in this survey were mainly from the curriculum of KHIME, and the relationship between future leading jobs and subjects was determined in a comprehensive manner. Each subject, future job relationship and required changes according to the environment of the working institution should be looked at in the next survey.         

There were no survey items about the respondents' current job satisfaction, level of education, and salary by job. If a comprehensive survey of the working situation of Korean HIMs had been conducted including the above items, it would have been possible to make more direct suggestions on future education issues.

Conclusion

Korean HIMs selected health data utilization as the top future leading job group from among four major job groups in Korea, and health data management as the most important subject to raise competent future HI professionals. When comparing the job groups and required skills between Korea and the US (AHIMA career tool and SimplyHired), the US suggested job groups and skills more focused on data management. Still, disease and procedure classification was selected as a current important subject for competent HIMs in Korea and future leading jobs were related to computerized data management. We found that views on important subjects and future leading jobs differed depending on the hospital size and work period. It would be effective to provide customized training depending on the institution where the students will work.

Declaration of conflicting interests

The authors declare that there is no conflict of interest.