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EDITOR’S NOTE: This is the first in a series of articles from Mollie Niznik a senior in the Health Information Management (HIM) program at The College of St. Scholastica in Duluth, MN. Writes Niznik, “I look forward to my future in the HIM field after graduation in May.” 

As a young girl, thinking about my future was overwhelming. I have known since the third grade that I wanted to be a medical professional, and I had no choice but to trust that I would find a place in a sustainable field. As I embark on my final semester of college, I have no doubt in my mind that I have found exactly that.

The health information management program at St. Scholastica strikes me as elite. I can only hope that my passion for the practice of healthcare shines through in everything I do after I graduate in May.

During my studies in health information management, I have developed particular interest in the fields of compliance and quality. Yet there is also a significant healthcare industry need for professionals in data analytics; I could see myself excelling in this area as well. Being able to analyze healthcare data is an essential part of quality improvement planning and recognizing where a facility needs to improve the delivery of care they offer. 

My future in healthcare excites me greatly because of the fact that I am trained in so many different areas. Several times throughout my life, I have been identified as a leader. I have been taught to effectively manage in a variety of settings. The healthcare field intrigues me so greatly because I know it will never be underutilized, and the need for healthcare professionals will grow as the population ages and technology advances.

With that being said, because of the size of our healthcare system, there is an abundance of daunting concerns. The top concern in the delivery of healthcare at this time is, obviously, the cost. The cost of simple check-ups and procedures is skyrocketing, and only a select population of Americans can afford the necessary insurance to cover them. In some situations, patients wait until it is too late for more routine medical attention, meaning a trip to the emergency room. Because of the Emergency Medical Treatment & Labor Act (EMTALA), the emergency room is unable to turn away any patient for treatment, regardless of the ability to pay. This is a wonderful way for a patient to obtain proper medical treatment in an emergency, but it does not make sense in this context. The Patient Protection and Affordable Care Act may be the answer, even though its effectiveness is yet to be determined. Ideally, there will be affordable health insurance available to every American and family.

Another emerging issue in healthcare is technology, which can be viewed as a blessing and a curse within the healthcare industry. Technology is making surgeries and procedures less invasive, but that also plays a part in the rising costs. The implementation of electronic health records (EHRs) at many facilities raises plenty of issues of its own.

Providers need to know and understand the security rules present within the Health Insurance Privacy and Accountability Act of 1996 (HIPAA). This, of course, focuses on the fact that the information the patient reveals to the provider is kept private. Unless otherwise specified, and the patient has consented, information is not to be shared with anyone outside the healthcare facility – not even the patient’s family members. There are so many positive attributes to having ample information within an electronic system, but the biggest downfall is the issue of security breaches. Facilities also need to be “meaningfully using” their electronic health record. The documentation standards and procedures in each facility need to be clear to every provider and professional who has appropriate access to the record. Thorough and accurate documentation is essential to coding the service(s) provided for proper reimbursement. With that being said, the future implementation of ICD-10 is essential to healthcare’s future. Millions of dollars have been spent on training for coders and providers on the specificity of the documentation that ICD-10 requires. 

I, along with my classmates, have only learned ICD-10 in the realm of theory. Once the news of the most recently enacted delay became evident, as students, we were concerned for our future in the industry. I am thankful that my education has given me insight into the latest coding system, although the curriculum associated with ICD-10 may have been a little before its time. As I embark on my career, I have a feeling that future government-driven delays are going to be common.

I know that as far as health information management education goes, concern about the delay is typical. The last thing a program within an education institution wants to do is to send its students into the field ill prepared. Institutions are stuck between a rock and a hard place, because they want to teach the latest technology, but are unable to predict such delays. Coding is such an essential part of our learning, there needs to be concrete understanding of the coding system being used now. I have been fortunate enough to work with ICD-9, interning as a clinical documentation specialist at a mental health facility here in Duluth, Minn. I have seen firsthand the documentation issues that go along with coding, especially as it pertains to documentation lacking the specificity needed for ICD-10. Because of the ICD-10 delay, the United States is years behind other healthcare industries in other countries. Also, we have been losing millions of dollars in reimbursement because of the continued use of ICD-9. Within the near future, several elements need to be taken seriously and changed in order to improve healthcare.

All Americans should have access to health insurance and affordable healthcare; hence the implementation of the Patient Protection and Affordable Care Act. Emerging technology has the potential to enhance the healthcare industry in ways we have yet to discover — if electronic health records are used properly, that is.

Soon-to-be graduates are being greatly affected by the continued delay of ICD-10. Yet I am sure this is nothing compared to the frustration current professionals feel. I look forward to my future in the industry, which will hopefully be closely tied to compliance, quality improvement, and/or data analytics. 

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