HEALTH INFORMATION TECHNICIAN

When assembling patients' medical records, health information technicians first make sure the medical chart is complete. They ensure all forms are present and properly identified and signed, and all necessary information is on a computer file. Sometimes they talk to physicians or others to clarify diagnoses or get additional information.

Technicians assign a code to each diagnosis and procedure. They consult a classification manual and rely on their knowledge of disease processes. Technicians then use a software program to assign the patient to one of several hundred "diagnosis-related groups," or DRG's. The DRG determines the amount the hospital will be reimbursed if the patient is covered by Medicare or other insurance programs using the DRG system. Technicians who specialize in coding are called health information coders, medical record coders, coder/abstractors or coding specialists.

Technicians also use computer programs to tabulate and analyze data to help improve patient care or control costs, for use in legal actions, or in response to surveys. Tumor registrars compile and maintain records of patients who have cancer to provide information to physicians and for research studies.

Health information technicians' duties vary with the size of the facility. In small facilities, an accredited health information technician may manage the department. In large to medium facilities, technicians may specialize in one aspect of health information, or supervise health information clerks and transcribers while a health information administrator manages the department.

Health information technicians generally work a 40-hour week. Some overtime may be required. In hospitals where health information departments are open 18-24 hours a day, 7 days a week, they may work on day, evening and night shifts.

Health information technicians work in pleasant and comfortable offices. This is one of the few health occupations in which there is little or no physical contact with patients. Health information technicians who work at video display terminals for prolonged periods must guard against eyestrain and muscle pain.

Health information technicians need a strong clinical background to analyze the contents of medical records. Accuracy is essential, therefore concentration and close attention to detail is required.

Health information technicians entering the field usually have an associate degree from a community or junior college. In addition to general education, coursework includes medical terminology, anatomy and physiology, legal aspects of health information, coding and abstraction of data, statistics, database management, quality assurance methods and especially computer training. Applicants can improve their chances of admission into a program by taking biology, chemistry, health and computer courses in high school.

Technicians may also gain training through an Independent Study Program in Health Information Technology offered by the American Health Information Management Association (AHIMA). Hospitals sometimes advance promising health information clerks to jobs as health information technicians, although this practice may be less common in the future. Advancement generally requires 2-4 years of job experience and completion of the hospital's in-house training program.

Most employers prefer to hire Accredited Record Technicians (ART), who must pass a written examination offered by AHIMA. To take the examination, a person must graduate from a 2-year associate degree program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) of the American Medical Association, or from the Independent Study Program in Health Information Technology that requires 30 semester hours of academic credit in prescribed areas. Technicians trained in non-CAAHEP accredited programs, or on the job, are not eligible to take the examination. In 1997, CAAHEP accredited 157 programs for health information technicians.

Experienced health information technicians generally advance in one of two ways—by specializing or managing. Many senior health information technicians specialize in coding, particularly Medicare coding, or in tumor registry. In large health information departments, experienced technicians may advance to section supervisor, overseeing the work of the coding, correspondence or discharge sections. Senior technicians with ART credentials may become director or assistant director of a health information department in a small facility. However, in larger institutions the director is a health information administrator with a bachelor's degree in health information administration.

According to a 1996 survey by the American Health Information Management Association, the median annual salary for accredited health information technicians was $31,200 a year. The average annual salary for health information technicians employed by the Federal Government was $25,570 in early 1997.

Health information technicians are projected to be one of the 20 fastest growing occupations nationwide. Health information technicians held about 87,000 jobs in 1996. Less than one half of the jobs were in hospitals. Most of the rest were in nursing homes, medical group practices, clinics and home health agencies. Insurance, accounting and law firms that deal in health matters employ a small number of health information technicians to tabulate and analyze health information. Public health departments also hire technicians to supervise data collection from health care institutions, and to assist in research.

Job prospects for formally trained technicians should be very good. Employment of health information technicians is expected to grow much faster than the national average for all occupations through the year 2006, due to rapid growth in the number of medical tests, treatments and procedures which will be increasingly scrutinized by third-party payers, regulators, courts and consumers.

Hospitals will continue to employ the most health information technicians, but growth will not be as fast as in other areas. Increasing demand for detailed records in offices and clinics of physicians should result in fast employment growth, especially in large group practices. Rapid growth is also expected in nursing homes and home health agencies.