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Selecting a School Academic Pathways
Planning Guide -------------------------------------------------------------------
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Academic Pathways and Planning Guide ==================================== As you map out your education strategy, use these tools to help you:
Determine at what level you should enter into the academic process Outline the length of time you can expect to be in school
Consider what type of credential you will qualify to test for after graduating from your program Match your career goals with the appropriate level of education, and consider what your future educational plans may look like
Academic Pathways ================= How to use the Pathways: The flowcharts below depict the four academic choices in health information management and health information technology. Each category provides a visual map to become a coder, RHIT, RHIA, or informaticist.
CoderClick for a larger viewSee a larger view RHITSee a larger view
RHIASee a larger view Health InformaticsSee a larger view
For a complete description of each of these educational routes to health information management and health information technology careers please select the Planning Guide for that level (from the "Planning Guide" section on this page). There you will see time frames to graduate, admission criteria, and the curricula that each program is required to maintain according to CAHIIM accreditation standards. Planning Guide ==============
Determine what level of education you should seek The following diagram depicts the academic options to pursue a career in coding, health information technology, health information management, and health informatics. Choices include an entry level pre-degree (certificate) option for coding, an associate degree for health information technology, a baccalaureate degree for health information administration, and a master’s degree in health informatics. The actual title of individual school programs may be different than what is listed in the plan, but the curricula for each academic level is standardized to a national model curriculum.
Pre-degree: (certificate in coding) + Learn More
Main Focus: Prepares student to become an entry level medical coder
Possible Roles: Medical Coder (Physician Practice),(Inpatient), (Ambulatory), Medical Biller, Claims Analyst
Number of programs in the US: 37
Length of schooling:
- – 12 months, Distance Education Option Available
Seeking certification as: CCA: Certified Coding Analyst
Competitive Selection? No, typically students experience open enrollment
Pre-requisite Degrees? No, students encouraged to have a HS degree
Search for Approved Coding Education Programs here. Search for Approved Coding Education Programs here AHIMA Approved Coding Programs Curriculum =========================================
Biomedical Sciences ------------------- Anatomy & Physiology
Medical Terminology Pathophysiology
Pharmacotherapy Introduction to Health Information Management & Health Data Structure, Content and Standards ----------------------------------------------------------------------
Data versus information Structure and use of health information (individual, comparative, aggregate)
Health information medial (such as paper, computer, web-based) Health record data collection tools (such as forms, screens)
Data sources (primary, secondary) Data definitions, vocabularies, terminologies, and dictionaries
Data storage and retrieval Data quality and integrity
Healthcare data sets (such as OASIS, HEDIS, DEEDS, UHDDS) Data monitoring and medical coding compliance reporting
Healthcare Information Requirements and Standards ------------------------------------------------- Introduction to Computers
Computer software applications in healthcare Health record monitoring and compliance reporting
Healthcare delivery systems and eHIM Clinical Classification Systems -------------------------------
Introduction to Coding: Classifications, taxonomies, nomenclatures, terminologies, and clinical vocabularies Principles and applications of basic diagnostic coding systems (ICD-9-CM: Volumes I,II,III)
Principles and applications of basic procedure coding systems (CPT-4, HCPCS, and HCPCS II) Application of Intermediate (or Advanced) diagnostic coding using case studies and patient records
Application of Intermediate (or Advanced) procedure coding using case studies and patient records Case mix analysis and indexes (such as DRG, APC, RUGs, SNOMED-CT)
Severity of illness systems Coding compliance strategies, auditing, and reporting (such as CCI, plans)
Coding quality monitors and reporting Reimbursement -------------
Commercial, managed care and federal insurance plans Payment methodologies and systems (such as capitation, prospective payment systems PPS, RBRVS)
Billing processes and procedures (such as claims, EOB, ABN, electronic data interchange) Chargemaster maintenance
Compliance strategies and reporting Medical Office Procedures (may be optional) -------------------------------------------
Physician payment systems: scheduling, series billing, filing appeals End of month reporting, insurance processes, EOB explanations
Auditing and monitoring of medical coding for regulatory compliance Professional Practice Experience (Practicum) (Internship) ---------------------------------------------------------
May be field based or virtual Provides the student with practical medical coding experiences in a hospital, physician office, clinic, or other healthcare setting with projects directed by a clinical coding specialist on the job
--------------------------------------------------------------------- Undergraduate: Associate (2 year option)
+ Learn More Main Focus:
Prepares student to become a health information technician Possible Roles:
Clinical Coder/Auditor, Clinical Data Collection & Reporting Specialist, Data Integrity Specialist, Document Imaging Coordinator, Quality Improvement Specialist, Instructor/Trainer, Supervisor Number of programs in the US:
194 Length of schooling:
- years if attending full time, longer if attending part time,Distance Education Option Available
Seeking certification as: RHIT: Registered Health Information Technologist
Competitive Selection? Some community colleges have open door policies, others have a selection process with students accepted annually or bi-annually
Pre-requisite Degrees? Students must have a HS degree or GED
Search for Accredited Associate (HIT) Programs here Search for Accredited Associate (HIT) Programs here CAHIIM Accredited Associate Degree Program Curriculum =====================================================
Biomedical Sciences ------------------- Anatomy & Physiology
Physiology Medical Terminology
Pathophysiology Pharmacotherapy
Health Data Structure, Content and Standards -------------------------------------------- Data versus information
Structure and use of health information (individual, comparative, aggregate) Health information medial (such as paper, computer, web-based)
Health record data collection tools (such as forms, screens) Data sources (primary, secondary)
Data definitions, vocabularies, terminologies, and dictionaries Data storage and retrieval
Data quality and integrity Healthcare data sets (such as OASIS, HEDIS, DEEDS, UHDDS)
Data monitoring and coding compliance reporting National Healthcare Information Infrastructure (NHII)
Healthcare Information Requirements and Standards ------------------------------------------------- Type and content of health record (paper, electronic, computer-based, e-health-personal, web-based)
Computer software applications in healthcare Health record documentation requirements (such as accreditation, certification, licensure)
Health record monitoring and compliance reporting Clinical Classification Systems -------------------------------
Classifications, taxonomies, nomenclatures, terminologies, and clinical vocabularies Principles and applications of basic diagnostic coding systems (ICD-9-CM, ICD-10, CPT/HCPCS, DSM-IV)
Diagnostic and procedural groupings (such as DRG, APC, RUGs, SNOMED-CT) Casemix analysis and indexes
Severity of illness systems Coding compliance strategies, auditing, and reporting (such as CCI, plans)
Coding quality monitors and reporting Reimbursement -------------
Commercial, managed care and federal insurance plans Payment methodologies and systems (such as capitation, prospective payment systems PPS, RBRVS)
Billing processes and procedures (such as claims, EOB, ABN, electronic data interchange) Chargemaster maintenance
Regulatory guidelines (such as LMRP, peer review organizations) Reimbursement monitoring and reporting
Compliance strategies and reporting Healthcare Statistics and Research ----------------------------------
Indices, databases and registries Vital statistics
Healthcare statistics Descriptive statistics (such as means, frequencies, ranges, percentiles, standard deviations)
Statistical applications with health care data Institutional Review Board (IRB) processes
National guidelines regarding human subjects research Research protocol monitoring
Data selection, interpretation, and presentation Knowledge-based research techniques (such as library, Medline, web-based)
Quality management and Performance Improvement ---------------------------------------------- Quality assessment and improvement (such as process, collection tools, data analysis, reporting techniques)
Utilization management, risk management, and case management Regulatory quality monitoring requirements
Outcomes measures and monitoring Healthcare Delivery Systems ---------------------------
Organization of healthcare delivery in the United States Healthcare organizations structure and operation
External standards, regulations, and initiatives (such as licensure, certification, accreditation, HIPAA) Payment and reimbursement systems
Healthcare providers and disciplines Healthcare Privacy, Confidentiality, Legal and Ethical Issues -------------------------------------------------------------
Legislative and regulatory processes Legal terminology
Health information/record laws and regulations (such as retention, patient rights/advocacy, advanced directives, privacy) Confidentiality, privacy, and security policies, procedures, and monitoring
Release of information policies and procedures Professional and practice-related ethical issues
Information and Communication Technologies ------------------------------------------ Computer concepts (such as hardware components, operating systems, languages, software packages)
Communication and Internet technologies (such as networks, intranet, standards) Common software applications (such as word processing, spreadsheet, database, graphics)
Health information systems (such as administrative, patient registration, ADT, EHR, personal health record (PHR), lab, radiology, pharmacy) Voice recognition technology
Health information specialty systems (such as ROI, coding, registries) Application of systems and policies to health information systems and functions and healthcare data requests
Data Storage and Retrieval -------------------------- Document archival, retrieval, and imaging systems
Maintenance and monitoring of data storage systems Data Security and Healthcare Information Systems ------------------------------------------------
System architecture and design System acquisition and evaluation
Screen design Data retrieval and maintenance
Data security concepts Data integrity concepts
Data integrity and security processes and monitoring Data recovery and risk management
Work process design (such as ergonomics, equipment selection Organizational Resources ------------------------
Roles and functions of teams and committees Teams/consensus building and committees
Communication and interpersonal skills Team leadership concepts and techniques
Orientation and training (such as content, delivery, media) Workflow and process monitors
Performance monitors Revenue Cycle monitors
Organizational plans and budgets (framework, levels, responsibilities) Resource allocation monitors
--------------------------------------------------------------------- Undergraduate: Baccalaureate (4 year option)
+ Learn More Main Focus:
Prepares student to become a health information administrator Possible Roles:
HIM Director, Assistant Director, Data Quality Manager, Clinical Research/Trials Associate, Compliance Officer, Privacy & Security Officer, Data Sets, Nomenclature & Classification Standards Manager, Educator, Quality Improvement Number of programs in the US:
47 Length of schooling:
- years if attending full time, longer if attending part time, Distance Education Option Available
Seeking certification as: RHIA: Registered Health Information Administrator
Competitive Selection? Most universities have competitive placement for professional programs, and typically admit students on an annual basis
Pre-requisite Degrees? Students must have a HS degree or GED
Search for Accredited Baccalaureate (HIA) Programs here Search for Accredited Baccalaureate (HIA) Programs here CAHIIM Accredited Baccalaureate Degree Program Curriculum =========================================================
Biomedical Sciences ------------------- Anatomy & Physiology
Physiology Medical Terminology
Pathophysiology Pharmacotherapy
Health Data Structure, Content and Standards -------------------------------------------- Structure and use of health information (individual, comparative, aggregate)
Health information medial (such as paper, computer, web-based) Type and content of health record (paper, electronic, computer-based, e-health-personal, web-based)
Data quality assessment and integrity Secondary data sources (registries and indexes; databases – such as MEDPAR, NPDB, HCUP)
Healthcare data sets (such as OASIS, HEDIS, DEEDS, UHDDS, UACDS, NEDSS, NMMFS) Health information archival systems
National Healthcare Information Infrastructure (NHII) Data collection tools (such as forms; computer input screens; other health record documentation tools
Healthcare Information Requirements and Standards ------------------------------------------------- Standards and regulations for documentation (such as JCAHO, CARF, COP, AAAHC, AOA)
Health information standards (such as HIPAA, ANSI, ASTM, LOINC, UML, MESH, Arden Syntax, HL-7) Clinical Classification Systems -------------------------------
Healthcare taxonomies, clinical vocabularies, terminologies/nomenclatures (such as ICD-9-CM, ICD-10, CPT, SNOMED-CT, DSM-IV) Severity of illness systems
Reimbursement Methodologies --------------------------- Clinical data and reimbursement management
Compliance strategies and reporting (e.g. National Correct Coding Initiative) Chargemaster maintenance
Casemix management Audit process (such as compliance and reimbursement)
Payment systems (such as PPS, DRGs, APCs, RBRVS, RUGs) Commercial, managed care and federal insurance plans
Healthcare Statistics, Biomedical Research and Quality Management – Healthcare Statistics and Research ------------------------------------------------------------------- Statistical analysis on healthcare data
Descriptive statistics (such as means, standard deviations, frequencies, ranges, percentiles) Inferential statistics (such as t-tests, ANOVAs, regression analysis, statistical process control, reliability, validity)
Vital statistics Epidemiology
Data reporting and presentation techniques Computerized statistical packages
Research design/methods (such as quantitative, qualitative, evaluative, outcomes) Knowledge-based research techniques (such as Medline, CMS, libraries, web sites)
National guidelines regarding human subjects' research Institutional review board process (IRB)
Research protocol data management Quality management and Performance Improvement ----------------------------------------------
Quality assessment and management tools (such as benchmarking, ORYX, SQC) Utilization and resource management
Risk Management Disease management process (such as case management, critical paths)
Out comes measurement (such as patient, customer satisfaction, disease-specific) Health Services Organization and Delivery -----------------------------------------
Organization of healthcare systems Components and operation of healthcare organizations including e-health delivery
Accreditation standards (such as JCAHO, AOA, NCQA, CARF, CHAP, URAC) Regulatory and licensure requirements (such as COP, state health departments)
Healthcare Privacy, Confidentiality, Legal and Ethical Issues ------------------------------------------------------------- Legislative and legal system
Privacy, confidentiality, security principles, policies and procedures Health information laws, regulations, and standards (such as HIPAA, e-health, JCAHO, state laws)
Elements of compliance programs Professional and practice related ethical issues
Information Technology and Systems ---------------------------------- Computer concepts (hardware components, systems architectures, operating systems and languages, and software packages and tools)
Communications technologies (networks-LANS, WANS, VPNs; data interchange standards – NIST, HL-7) Internet technologies (Intranet, web-based systems, standards – SGML, XML)
Data, information and file structures (data administration, data definitions, data dictionary, data modeling, data structures, data warehousing, database management systems) Data storage and retrieval (storage media, query tools/applications, data mining, report design, search engines)
Data security (protection methods – physical, technical, managerial, risk assessment, audit and control program, contingency planning, data recovery, Internet, web-based, and e-health security) Applied Health Informatics --------------------------
Leading development of health information resources and systems Brokering of information services
Clinical, business and specialty systems applications (administrative, clinical decision support systems, electronic health record and computer-based health record systems, nursing, ancillary service systems, patient numbering systems at master and enterprise levels) Systems development (planning, analysis and design, customization, selection/procurement, implementation, integration, support, testing and evaluation, auditing and monitoring)
Human factors and user interface design Organization and Management ---------------------------
Principles of management Negotiation techniques
Communication and interpersonal skills Team/consensus building
Professional development for self and staff Problem solving and decision making processes
Human Resources Management -------------------------- Employment laws
Principles of human resources management (recruitment, supervision, retention, counseling, disciplinary action) Workforce education and training
Performance standards Financial and Resource Management ---------------------------------
Healthcare finance (payer mix, bond rating, investment, capitalization) Accounting principles
Budget process (capital and operating) Cost/benefit analysis
Strategic Planning and Organizational Development ------------------------------------------------- Strategic leadership, management and planning, Teamwork
Organizational behavior Business building (entrepreneurialism – building your own business; championing best practices, processes, services within your organization)
Change management Organizational assessment and benchmarking
Project and Operations Management --------------------------------- Process reengineering and work redesign
Project management ---------------------------------------------------------------------
Graduate: Master’s (2 year post bacc) + Learn More
Main Focus: Prepares student to become a health informatics executive
Possible Roles: Academic Faculty, Applied Health Informatics Researcher, Corporate Health Information Officer, Chief Compliance Officer, Data Analytics/Data Mining Engineer, Data Sets, Nomenclature & Classification Standards Developer, Practice Consultant, Health Informatics Advocate, Public Health Information Officer
Number of programs in the US: 3+
Length of schooling:
- years
Seeking certification as: RHIA: Registered Health Information Administrator if the program offers a credentialing track, not all Informatics programs provide the option for seeking a credential as a RHIA
Competitive Selection? Yes, and typically students are admitted on an annual basis
Pre-requisite Degrees? Students must have baccalaureate degree
Search for Approved Master's Programs here Search for Approved Master's Programs here CAHIIM Approved Master Degree Program Curriculum ================================================
Health Care Data ---------------- Evaluate, maintain and apply reference/interface/messaging terminologies
Map terminologies to each other and to classification systems Develop and maintain data dictionary to meet the needs of the enterprise
Insure data integrity internal and external to the enterprise Maintain the data architectural model for the enterprise
Personal Health Record to Electronic Health Record Aggregate data reporting
Manage information as a key strategic resource and mission tool Enable decision-makers to use data
Support evidenced-based practice Ensure compliance with current approved data standards
Develop enterprise wide policies for collection, use and maintenance of health care data Efficiently retrieve data through advanced knowledge of the unique data model/architecture against the standard classification systems and reference terminologies
Apply NLP and other data capture technologies Health Information Analysis ---------------------------
Assess information needs of customers Design and use research methodologies
Data analysis (evidence-based) Advanced database management (access proficiency)
Advanced information presentation (e.g. information mapping) Advanced statistical analysis
Health Services Organization and Delivery ----------------------------------------- Design and evaluate the processes and systems that ensure compliance with regulatory, governmental, legal, accreditation and certification requirements for health information technologies
Knowledge of standards and requirements such as those of HIPAA, CCHIT, OSHA Engage in policy development, analysis, and advocacy as related to the uses, protection and dissemination of health information
Ensure the strategic and operational relevance of clinical information resources important to the healthcare industry and public health sector Information Technology and Systems ----------------------------------
Utilize technology and data standards for information systems design Know the standard setting organizations and their efforts related to clinical data and health information technology such as HL7 (functional model), ASTM (CCR), ANSI
Differentiate between the computer-based patient record and an electronic health record Apply the principles of decision analysis for decision support system design and development
Apply knowledge management techniques to health information work process improvements Ensure effective security management practices and applications
Understand artificial intelligence applications and user interface design concepts Organizational Management -------------------------
Leadership Competencies Develop and exercise a personal leadership style using contemporary leadership theory and principles
Master effective negotiating (influence/power) skills for obtaining results Understand the ethical impact of decision making
Develop performance management strategies (benchmarking) Develop business plans
Utilize techniques for successful project management Organizational Behaviors
Understand organization design (and the impact of information technology) Apply motivation and reinforcement theories to organizations
Demonstrate knowledge of organizational theories, organizational culture, and diversity Apply concepts of change management theories and techniques
Plan develop, and manage teams (team building, trust building) Monitor team work
Demonstrate knowledge of resource development Resource planning
Prepare and evaluate budgets – budget management (develop capital, annual operating, and project budgets) Analyze cost and benefits
Manage resources appropriately Understand benefits realization concepts
Strategic planning Develop strategic and operational plans for health information management systems
Develop strategic management skills in analyzing strengths, weakness, opportunities and threats to organizations Forecast operational and technical needs
Education and training Develop, implement and evaluate the effectiveness of training programs for executive level communications
Develop effective communication through project reports, business reports and professional communications Utilize appropriate software to enhance communication
Develop methods for conflict resolution and reaching consensus Understand the need to cultivate partnerships inside and outside of organizations
Demonstrate executive decision making ---------------------------------------------------------------------
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