MEDICAL RECORD/HEALTH INFORMATION TECHNICIANS AND ADMINISTRATORS Number 134 Interest Area 13 1998
THE JOB
Managing a health information system that meets medical, administrative, ethical and legal requirements involves MEDICAL RECORD/HEALTH INFORMATION TECHNICIANS AND ADMINISTRATORS, clerks and transcriptionists - known collectively as medical records personnel. Their work is crucial to both patients and health care facilities. For patients, carefully maintained records guarantee continuity of care; for the facility, precise coding of diagnoses and procedures can mean timely fee payments by patients and health insurance providers. Databases they create are essential to disease research and control.
Medical Record Coders (also called Health Information Coders) assign diagnostic and procedure codes to records of discharged patients to produce a comprehensive clinical care history (database). To do the coding, they review and screen the entire medical record to create an abstract which summarizes such clinical data as diseases, therapies, surgeries, lab tests and pharmaceuticals. The main coding systems used are: the International Classification of Disease System for statistical reporting and the Diagnostic Related Groupings codes to bill patients or their insurers.
Medical Record Technicians (also called Health Information Technicians) organize, analyze and evaluate medical records. They compile medical care and census data for reports on types of diseases treated, surgery done and rate of hospital bed use. This information is used by law firms, insurance companies and government agencies. Technicians consult with doctors to resolve or clarify codes for conflicting or unclear information and participate in the coding team's regular meetings. They must know coding system regulations and any changes made by official agencies that affect coding information policies. They also need to understand third-party reimbursement regulations--payment procedures of health insurance firms and health maintenance organizations.
Tumor Registrars are medical records specialists who review cancer patient health records to identify, compile and analyze patient data for use in cancer management. They summarize and code other information such as demographics, history and stage of cancers; diagnostic methods and treatments. They contact patients, their families and physicians to gather, evaluate and record follow-up information about the quality of life and length of survival. Statistical, graphic and written reports are prepared by registrars for medical staff, researchers and other registry users. Medical Records Administrators (also called Health Information Administrators) plan, develop, and coordinate systems for managing health information in health services facilities, health financing organizations, and quality review agencies. Administrators direct medical record departments of medical services centers. They advise other staff administrators on procedures for keeping complete and accurate medical records that comply with State and federal standards. As custodians of confidential patient information, administrators are experts in the legal process for releasing medical information. They might testify in court about their information management practices.
Administrators with appropriate experience function as consultants to skilled nursing facilities and small health services firms such as kidney dialysis and ambulatory care clinics that do not need full-time administrators. Some are employed with accounting and computer service companies that manage information systems. Others teach medical record technology in colleges.
WORKING CONDITIONS
Workers in this field have a modern office environment complete with sophisticated and costly computer equipment. There may be pressures from the demand to efficiently run a vast and growing health information system that has quick data storage and retrieval.
EMPLOYMENT OUTLOOK
The following information is from the California Projections of Employment published by the Labor Market Information Division.
Medical Record Coders, Technicians and Tumor Registrars
Estimated number of workers in 1993 6,760 Estimated number of workers in 2005 11,030 Projected Growth 1993-2005 63% Estimated openings due to separations by 2005 2,020
(These figures do not include self-employment or openings due to turnover.)
The relatively small occupation of Medical Records Technicians, which includes Coders, Technicians, and Tumor Registrars, is expected to grow more than twice as fast as the average for all occupations through 2005.
Jobs for Medical Record Administrators will grow faster than average. Opportunities are expected to be favorable because of changes in health care reimbursement based on clinical data from medical records. Jobs will also occur as workers change careers or leave the labor market. Few people are trained to enter this profession. New graduates, especially those willing to relocate, should easily find a job.
ENTRANCE REQUIREMENTS AND TRAINING
Medical Record Coders earn a certificate to become certified coders through a one-year community college program or through adult education, Regional Occupation Programs (ROP) or private schools. Medical Record Technicians need an associate degree. Graduates are eligible to take the test given by the American Health Information Management Association (AHIMA) to be certified as Accredited Record Technicians (ARTs). California requires certification only for those technicians who actually manage medical record departments.
Tumor registrars are Medical Record Technicians who were trained on-the-job to be specialists.
According to the California Health Information Association the eight accredited Medical Records Technician programs in California are:
City College of San Francisco San Francisco, CA (415) 561-1818
Cypress College Cypress, CA (714) 826-2220
Chabot College Hayward, CA (510) 786-6898
East Los Angeles College Los Angeles, CA (213) 265-8884
Charles R. Drew University Los Angeles, CA (213) 563-5888
Loma Linda University Loma Linda, CA (909) 824-4976
Consumnes River College Sacramento, CA (916) 688-7244
San Diego Mesa College San Diego, CA (619) 560-2606
Medical Record Administrators must be certified as registered record administrators (RRAs) by the AHIMA or already be certified ARTs. Most RRAs have a BA degree in the field.
Loma Linda University is the only accredited California school with a BA degree program in health information administration. Concentration studies begin in the final years, making it possible for sophomores or juniors to transfer from other four-year institutions or community colleges. Graduates with other BA degrees that include required science courses may be admitted to a one-year post-graduate certificate.
Contact the California Health Information Association for a list of accredited out-of-state schools offering BA degrees programs. Most BA programs are independent study and non-residential programs that can be completed through correspondence and pre-arranged student/instructor conferences.
WAGES, HOURS, AND FRINGE BENEFITS
Wages vary with size, kind and location of health care centers, and worker experience levels. Medical Record Technicians, Coders and Tumor Registrars in California earn a median wage of $9.67 hourly. Coders tend to earn less.
Registered Record Administrators earn an average salary of over $49,000 a year.
The typical work week is 40 hours. Fringe benefits almost always include paid vacations, holidays, and sick leave, in addition to paid health and retirement plans.
ADVANCEMENT
The natural career path for ARTs, Coders and Tumor Registrars is advancement to RRAs after getting the needed education and experience. After required training and experience, Coders move up to ARTs and, ultimately, RRAs.
Medical Record Administrator advancement depends on the size of the health care facility. In large centers, they may start as assistant administrators and advance to director of medical record departments. Some become consultants to a cluster of small clinics, to health researchers, or to contractors that manage health information systems. Graduate degrees are becoming more important for advancement in this field.
FINDING THE JOB
Networking through professional associations and using professional health industry search firms are the most common ways to find job leads. Job seekers should also apply directly to health services centers, health research firms, computer and accounting companies specializing in health information, and State and federal agencies and private contractors responsible for managing the Medicare Health Insurance program. Recent graduates should apply with their school placement office.
Medical Record Administrators often get hired before graduation through instructor recommendation and placement.
ADDITIONAL SOURCES OF INFORMATION
American Health Information Management Association 919 North Michigan Avenue, Suite 1400 Chicago, IL 60611-1683 (312) 787-1540
California Health Information Association 5108 East Clinton Way, Suite 113 Fresno, CA 93727 (209) 251-5038
National Cancer Registrar 505 E. Hawley Street Mundelein, IL 60060-2458 (847) 566-0833 Fax: (847) 566-7282
RELATED OCCUPATIONAL GUIDES
Medical Secretaries No. 177 Hospital and Health Services Administrators No. 235
OCCUPATIONAL CODE REFERENCES
DOT (Dictionary of Occupational Titles, 4th Ed.,1991) Medical Record Administrator 079.167-014 Medical Record Technician 079.362-014 Tumor Registrar 079.362-018
OES (Occupational Employment Statistics) System Medicine and Health Services Managers 150080 Medical Record Technician 329110
Source: State of California, Employment Development Department,
Labor Market Information Division, Information Services Group,
(916) 262-2162.
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