Health Information Management AAS Medical Information Coder/Biller Certificate

Transcription

1 Program Review Health Information Management AAS Medical Information Coder/Biller Certificate Submitted by: Brandy Ziesemer, Program Manager Date: April 11, 2011

2 Table of Contents Executive Summary...Page 2 I. Program Overview...Page 3 A. Mission B. Vision C. Program Description D. Program History Summary E. Advisory Committee II. Review of Curriculum...Page 7 A. Curriculum Structure B. Formal Articulation Agreements C. Transfer and Non-Transfer Programs D. Grade Distributions for Program Courses E. Job Prospects III. Faculty Program Data...Page 14 A. Organizational Structure B. Faculty Credentials and LSCC Teaching Summary C. Additional Responsibilities D. Additional Faculty Needed E. Faculty Development F. Faculty Evaluation IV. Student Data...Page 20 A. Enrollment B. Retention C. Graduation D. Success and Completion Rates V. Program Support...Page 26 A. Budget B. Support Services C. Facilities and Equipment VI. Measures of Program Effectiveness...Page 29 A. Student Learning Outcomes B. Employment of Graduates C. National Exam Results D. Program Strengths and Weaknesses VII. Use of Previous Assessment Findings...Page 35 VIII. Recommendations and Action Plan...Page 36 IX. Follow-up...Page 41 X. Appendices...Page 42 Health Information Management Program Review Page 1

3 HEALTH INFORMATION MANAGEMENT CAREER AND TECHNICAL EDUCATION PROGRAMS EXECUTIVE SUMMARY OF HEALTH INFORMATION MANAGEMENT PROGRAM The Health Information Management (HIM) Associate in Applied Science degree program is a stateof-the-art medical technology curriculum offered by Lake-Sumter Community College that is nationally accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). Successful graduates of the LSCC HIM program are eligible to write the national qualifying examination for certification as a Registered Health Information Technician (RHIT). Strong job prospects and competitive salaries await graduates; entry level health information graduates with an A.A.S. degree are in demand and may earn up to $30,000 annually. The U.S. Department of Labor has identified that HIT needs will grow to encompass a variety of new workforce positions including mobile support adoption positions, public health informatics, implementation support specialists, and information management redesign specialists. ( The HIM program at Lake-Sumter enjoys a mutually beneficial partnership with the Lake-Sumter Medical Society and with the Medical Informatics Certificate Program through the University of West Florida. The program also holds affiliation agreements for professional practice experience sites with all Lake-County hospitals, both major hospital networks in Orlando and Vicinity, the two major hospitals in Ocala, Citrus Memorial Hospital in Inverness, the Lake-County Department of Health, Lake Corrections Institute, Thomas Langley Health Clinic, Cornerstone Hospice, LifeStream Behavioral Center and several other Central Florida medical practices. The partnership with the Lake-Sumter Medical Society has resulted in the HIM students being able to research health information technology products and present their findings using donated space at the annual Medical Society Physicians Expo. Physicians and practice managers interact with the students by asking questions and discussing career options with them. The program has experienced a significant increase in interest with job related national health information technology programs, and received two workforce grants to help re-train unemployed citizens for successful emerging career opportunities. Even in difficult economic times our LSCC HIM graduates continue to have very positive career options available to them in obtaining entry-level jobs and beginning their professional lives with rapid growth opportunities. Health Information Management Program Review Page 2

4 I. PROGRAM OVERVIEW A. Mission The mission of the HIM degree program is to prepare students for entry-level employment as a health information technician in any healthcare setting. Upon successful completion of this program, the student will be able to perform the following competencies: manage all aspects of healthcare data; health statistics; participate in biomedical research and performance improvement teams; apply knowledge of health services organization and delivery to ensure compliance with health laws; manage health information technology; and manage organizational resources. B. Vision The HIM degree program at Lake-Sumter Community College models the overall vision of the College by fostering excellence and the values of scholarship, respect, honesty and integrity, teamwork, high performance, and service, in order to serve the workforce needs of the diverse and dynamic health information arm of the healthcare community and to be successful professionals. C. Program Description The HIM program at LSCC is a 67-credit hour Associate in Applied Science degree. Within the degree program, there is an option for students to earn a 34-credit hour technical certificate as a medical information coder/biller. A majority of the students who earn this certificate eventually work toward the degree, even when they choose coding as a career option. Graduates of the degree program are eligible to take a national exam qualifying them as Registered Health Information Technicians (RHIT). In addition to the RHIT exam, one of the program graduates earned a Certified Tumor Registrar (CTR) credential. The national coding certification exams do not require specific education but they are specialist-level rather than entry-level exams. Graduates of LSCC s certificate program have successfully taken and passed the Certified Coding Specialist (CCS) and Radiation Oncology Certified Coder (ROCC) exams. Of note is the fact that certain courses in the HIM degree program and the coding certificate are also required courses in LSCC s Office Administration, Medical Office Specialization AAS degree and the technical certificate in Medical Office Management that is part of the full degree program. Although this program will undergo a comprehensive review in 2012, it is important to note the program statistics for certain courses reflect these students in addition to the coding certificate and HIM degree students. Furthermore, many of the courses attract students in three distinct categories outside of certificate or degree-seeking students. These categories include: prerequisites for associate or baccalaureate allied health programs not offered by LSCC but for which the local students attend LSCC for general education and applicable allied health prerequisites before transferring; prenursing students or AA degree students who take some of these courses to satisfy full-time status or as electives even though they aren t required for nursing; and, students who are already in a related position who select certain courses for professional development but don t intend to complete the program. Finally, some of the certificate and degree-seeking students are in such high demand, they are hired in HIM-related jobs part way through the program and decide that they don t need to complete the program because that is the job they want to have as a career. Health Information Management Program Review Page 3

5 In 10 years, the HIM program has had 68 degree graduates, 31 of whom are credentialed HIM professionals. In the 8 years the coding certificate has been in place, 41 students have completed the program and 14 have earned one of the national coding certifications described above. Students in both the degree and the certificate programs are primarily nontraditional students who attend classes on a part-time basis, and some do not complete the program once the acquire marketable skills. D. Program History Summary In 1996, the Office Administration program offered electives in health information. The Advisory Committee at that time recommended the college pursue a grant to develop a full degree program in health information management. At the end of 1997, LSCC received a Capitalization Incentive Grant, based on a proposal that included documentation of need for a local health information workforce, to develop this program. Accreditation requirements included having students in the second year of the program the year the site team conducts an evaluation. Students entering their second year of the program for the academic year graduated from an accredited program. The accreditation agency was subsequently transferred from the Commission on Accreditation for Allied Health Education Programs (CAAHEP) to the newly formed Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). Beginning in 2005, CAHIIM requires a comprehensive annual program review, submitted electronically between the end of February and early May. As CAHIIM identifies any negative trends from one year to the next, the program will be notified to create and submit a corrective action plan and resolve the problem within the amount of time specified by CAHIIM. In the absence of such a notice, the programs automatically retain full accreditation status on a continuing basis, which this program has since initial accreditation in In its 10-year history of being accredited, the program has generated a strongly competent, mostly local, health information management workforce, including several graduates who have gone on to obtain baccalaureate degrees in HIM and related fields. Employer and graduate surveys continually demonstrate the program is keeping abreast the ever-changing demands of health information management and technology. E. Advisory Committee The HIM Advisory Committee is comprised of four program alumni who have become credentialed as health informational professionals and leaders. Additionally, the committee has representatives from a cross-section of work settings and job titles, all relevant to health information management. A formal meeting with the full Advisory Committee every fall is a kick-off to that year s national health information and technology week followed by an Advisory-Student mixer. Throughout the year, the program manager exchanges and phone calls regularly with individuals and the full group regarding curriculum changes, evaluation of hired graduates, needs assessments, support letters for grants, requests for the college to offer continuing education units on a major change, answering questions for each other regarding on-the-job legal, technology or coding issues, Health Information Management Program Review Page 4

6 arranging professional practice and back-to-industry experiences for students and program faculty/adjunct faculty, job opportunities for graduates and other issues. The following table lists the current committee members along with their contact information. LAKE-SUMTER COMMUNITY COLLEGE ADVISORY COMMITTEE LISTING Name of Committee: Health Information Management Committee Chairperson: Kathleen Leiffort College Liaison: Brandy Ziesemer, Health Information Program Manager Academic Year: Name Term Expires Title, Name of Institution, and Mailing Address Telephone No. Susan Bump, RHIA, CCS June 2013 HIS Systems Specialist CFHA 1451 El Camino Real The Villages, FL Wanda Calhoun, RHIT June 2012 Manager, Health Info. Mgmt. South Lake Hospital 1099 Citrus Tower Blvd. Clermont, FL Rita E. Crews, MHSA, PA-C June 2012 Office Administrator & Phys. Asst. Steven A. Crews, DO 8135 Centralia Ct. Ste. 101 Leesburg, FL (c) Becky Dicus, RHIA, LHRM June 2012 Director, HIM Ocala Regional Med Ctr SW First Ave. Ocala, FL Julie Edmonds, RHIT June 2013 Systems Coordinator, HIS/Transc Florida Hospital Waterman 1000 Waterman Way Tavares, FL (352) X4569 Pat Freeman, RHIA June 2011 HIM Consultant/Adj. Instructor 464 Petunia Drive Fruitland Park, FL (h) (c) Susan Gregory June 2013 Director, HIM LifeStream Behavioral Center PO Box Leesburg, FL (c) Health Information Management Program Review Page 5

7 Health Information Management Advisory Committee (cont d) Name Term Expires Title, Name of Institution, and Mailing Address Telephone No. Diane Howard, RHIA June 2011 Sci. Teacher/Adj, HIM Instructor 1115 Lake Dr. Grand Island FL Kathy Leiffort June 2013 Director, Physicians Services Central Florida Health Alliance LRMC North Campus 700 N. Palmetto St. Leesburg, FL Carol Millwater June 2013 Executive Director Lake Sumter Medical Society PO Box 1578 Mt. Dora, FL (W) (C) Linda Renn, RHIT, CCS, CPC, CPC- H Linda.Renn@gmail.com June 2011 Advocacy Liaison-FHIMA STAT Solutions, Inc Winona Avenue Leesburg, FL Phone & FAX Cell Alphonso Sanders, RHIT Alphonso.sanders@hcahealthcare.com June 2012 Medical Records Contractor 8596 NE 9 th Terrace Wildwood, FL Health Information Management Program Review Page 6

8 II. REVIEW OF CURRICULUM A. Curriculum Structure Health Information Management courses are listed below as in the LSCC Catalog. These courses are ALL requirements of the HIM A.A.S. credentialing process. The required courses are in a basic sequence of ascending skills order and increasing levels of subject complexity. There are only limited electives in this process and they are commonly within the scope of the General Education cluster. Italicized courses are required for the 34-credit Medical Information Coder/Biller certificate. AAS Certificate General Education Courses 17 Credits 8 Credits ENC 1101 College Composition 1 3 BSC 2093 Human Anatomy & Physiology BSC 2093 Human Anatomy & Physiology Elective Humanities 3 Elective Social & Behavioral Sciences 3 Beginning Courses 27 Credits 15 Credits HSC 1531 Medical Terminology HSC 1532 Medical Terminology OST 1854 Microsoft Office Introduction 3 HIM 1003 Foundations of Health Information Management 3 3 HIM 1433 Concepts of Disease 3 3 HIM 1800 Professional Practice Experience 1 2 HSC 1000 Introduction to Healthcare 1 OST 2336 Business Communications 3 HIM 1512 Medical Office Management 3 3 MAT 1033 Intermediate Algebra or QMB HIM 1012 Medicolegal Aspects of Records 2 2 Intermediate Courses 10 Credits 6 Credits HIM 2112 Electronic Health Records & Informatics 3 HIM 2222 Basic ICD-9-CM Coding 3 3 HIM 2253 CPT Coding & Reimbursement 3 3 HIM 2442 Pharmacology & Laboratory Analysis 1 Advanced Courses 13 Credits 5 Credits HIM 2214 Healthcare Statistics 2 HIM 2234 Advanced ICD-9-CM Coding & Reimbursement 3 3 HIM 2510 HIM Compliance & Performance Issues 3 HIM 2810 Professional Practice Experience HIM 2820 Professional Practice Experience 3 2 HIM 2930 Health Information Technician Review 1 TOTAL CREDITS 67 Credits AAS Degree 34 Credits Certificate Health Information Management Program Review Page 7

9 Curriculum Note: In analyzing performance of students in the HIM associate degree, the following graphic depicts the importance of realizing that many of the HIM core courses are taken by students who are not seeking the HIM degree so this mix needs to be considered in analyzing student performance in specific HIM courses. Organization Graphic of The Health Information Management CORE COURSES Showing Variation of Student Population A.A.S. HIM - Core Course Student Mix Office Administration (Medical Office Management Track ) Certificate Coder/ Biller Medical Office Mgmt Individual Courses Nursing Electives & Prerequisites for other Allied Health Programs Professional Development B. Formal Articulation Agreements Formal Tech Prep/Career Pathways agreements are in place with Lake and Sumter County Schools. Although there isn t a formal articulation in place with any universities, the University of Central Florida (UCF) awards credits toward several program-specific courses in addition to the general education courses, toward a bachelor s degree in HIM. Another CAHIIM and regionally accredited university, the University of Cincinnati offers a fully online baccalaureate degree to those students who have graduated from a CAHIIM associate degree program (AAS or AS) AND passed the national RHIT examination. Finally, University of West Florida is working with the LSCC HIM Health Information Management Program Review Page 8

10 program manager on an articulation agreement for a bachelor s in health sciences medical informatics track. C. Transfer/Non-Transfer Programs The AAS degree in HIM is not designed to be a transfer program, however, a growing number of graduates have transferred to universities and obtained baccalaureate degrees in HIM and related fields. As a result, effective fall of 2010, LSCC implemented an Associate in Science degree in HIM as an option to the AAS to make it easier for students to transfer while still being workforce-ready upon completion of the AS. One issue related to transfer versus non-transfer status of the AAS degree that we are making some progress on resolving is the fact that traditionally our academic advisors are a potential or newly registered student s first point of contact. Many of these students are unsure of exactly what they want but they ask some general questions about the degree. For years, the general philosophy in our advising department was to encourage students to work toward an AA degree even if they didn t think they wanted to pursue a bachelor s upon completion of an associate degree. Therefore, these students are more difficult to track as far as success because if they are initially registered as AAseeking, the correct program often does not get discovered until they are well into the AAS in HIM and either someone in Financial Aid catches the discrepancy (every semester the student is evaluated on progress toward their chosen major for renewal of financial assistance but since the AAS has general education in it and students can take a certain number of general electives in an AA degree, the discrepancy isn t often discovered until the student s second year), or the HIM program manager checks the program code when students are seeking advice for their intermediate and advanced courses. This problem impacts the ability to accurately report the number of new enrollees and attrition using system reports. It doesn t impact completion because, if not before, the grad check includes changing a student s program code to the degree being sought. D. Grade Distribution for Program Courses GRADE DISTRIBUTIONS HSC 1000: Introduction to Healthcare (1credit hour) Academic Year Passed A, B, or C D, F, or I Withdrew Total Enrolled % Passed % Withdrew 2005/ / / / / Total This 1-credit hour course is required for: the degree in HIM, the degree in office administration, medical office and the certificate in medical office management. Other students who are interested in healthcare take this course as an elective. A detailed analysis of the last two academic years reveals: 5 students earned an F in the academic year including 1 student who was taking the class as personal enrichment 2 AA-Transfer Students, and 2 Medical Office Health Information Management Program Review Page 9

11 Management Tech Certificate students. Of these 2, this was the only course they took in that semester which means they probably did not seek academic advising for that term and one of those was on her second attempt after failing this course the previous academic year. The one D was an Med Off Mgmt tech student who has since finished the full certificate and graduated with a 3.0 GPA but had to miss 2 of the 5 class meetings due to being dislocated from his home he got Bs in his online courses that same semester. Note: If the pass rate in is adjusted to remove the 2 students who never attended (Zs), the pass rate increases to an acceptable 80.5%. The lowest pass rate, in was an anomaly in that enrollment was 10 in the fall. The one F and the one D in the fall were both AA general transfer students. In the spring, there were 14 students registered of which 6 received F or D, 4 were AA transfer students, 1 a fire science AAS student and 1 is an office admin certificate student who took this course as a first attempt and failed and was one of the students who failed a second attempt in fall 2010 above. This course is challenging but it is apparent that the HIM degree students are all passing with at least a C grade. The higher pass rate in 2005/06 reflects the last year we used a textbook that was less complex than the current text that is used today but adopted fall 2006 for the first time. HIM 1003: Foundations of Health Information Management (3 credits) Academic Year Passed A, B, or C D, F, or I Withdrew Total Enrolled % Passed % Withdrew 2005/ / / / / Total This course is required for all students in either the HIM degree and its certificate or Office Administration, Medical Office and its certificate. An 85.8% pass rate is acceptable for a strong foundational course. Overall enrollment was low on the years the withdrawal rate was over 7.5 percent. HIM 1012: Medicolegal Aspects of Records (2 credits) Academic Year Passed A, B, or C D, F, or I Withdrew Total Enrolled % Passed % Withdrew 2005/ / / / / Total This course was moved from seated to fully online and taught by a different instructor in the academic year making it attractive to other health program students (AA or Pre-nursing) as an elective. Although overall enrollment dropped in some of the students were other than the HIM/Med Office students who take this required course. Another change that same year was a Health Information Management Program Review Page 10

12 change from a more basic text used almost exclusively by associate level students to a comprehensive text used extensively by graduate, baccalaureate and associate level students nationwide. Some of these programs have this course set as 3 credits due to the amount of information students must learn to be successful as a result of recent increases in health law. The academic year was unique because the HIM program started students in a grant-funded certificate program (spring and summer 2010). In addition to students who would have taken this course anyway, approximately 20 students were grant funded, unemployed workers, several of whom had limited computer skills. Due to the grant structure, the first semester consisted of fully online courses (HIM1012, HSC1531 and HSC1532). In retrospect, not having the cohort group in at least one seated course was not a good student success decision. Of the 9 D/F/I grades in 09-10, 3 Fs were grant students and of the 10 withdrawals, 5 were grant students. If you remove the grant students from the mix, the pass rate increases to 73%. The goal is to increase the pass rate to a minimum of 80%. The program manager will work with the instructor to determine how we can achieve this goal. HIM 2442: Pharmacology & Lab Analysis (1 credit) Academic Year Passed A, B, or C D, F, or I Withdrew Total Enrolled % Passed % Withdrew 2005/ / / / / Total This course is only required for HIM degree students but is sometimes taken as an elective by other students. Although the pass rate average is acceptable, the drop in percent passed in was due partially to a change in instructors and partially due to moving the class from seated to fully online. Additionally, this course did not require a textbook as it had previously. The further drop in was due to a combination of low enrollment and the fact that there was another change in instructors plus a complete re-design of the first online version of this course. A textbook was required and was quite comprehensive for a 1-credit hour course. The current instructor has analyzed the issues students reported and has already substantially improved course structure and content for fall (This course is only offered one time per year). HSC 1531: Medical Terminology 1 (2 credits) Academic Year Passed A, B, or C D, F, or I Withdrew Total Enrolled % Passed % Withdrew 2005/ / / / / Total It is important to note that although it takes both HSC1531 AND HSC1532 to learn all of the body systems, almost twice as many students take the first level as the second. The reason for this anomaly is that the students who don t go on to level 2 are mostly students who took level 1 as an Health Information Management Program Review Page 11

13 elective but not a requirement. All HIM and Med Office students must take both levels to stay in the program. The only year this course pass rate was below an acceptable 80% was That year had two factors influencing this course both of which will not influence student pass rates again. First, of the 19 who withdrew, 4 were grant students described above under HIM. Second, due to the increase in popularity of health programs brought about by health being a growing career in a sluggish economy and by federal funding for HIT programs, we hired a second adjunct instructor to start teaching both levels of terminology beginning spring Although this instructor participated in the seated portion of LSCC s Blackboard Training, she did not complete training and was not able to get her online course ready in time for the first day of class. It turns out there was a breakdown in communications which was not remedied until students had already fallen behind in an intense 7- week course. Although several people helped resolve the issue and the students were given relief on the first major deadline, many students couldn t keep up with such a rigorous pace after getting off to a rocky start through no fault of their own. The second time this instructor taught the course, the student performance was similar to that in the sections taught by the more experienced medical terminology adjunct instructor. All other years this course has acceptable pass rates. HSC 1532: Medical Terminology 2 (2 credits) Academic Year Passed A, B, or C D, F, or I Withdrew Total Enrolled % Passed % Withdrew 2005/ / / / / Total The pass rate in this course is very strong and reflects the fact that the students taking this course had to pass the first level plus the fact that the majority of students in the second level require this course for either HIM or Medical Office Admin/Management. The new instructor described under Level 1 taught 2 sections of Level 2 in the academic year and had resolved the issues she had with the first section of level 1 described above by the time level 2 began halfway through each semester. Please see Appendix A for tables of courses with acceptable pass rates that will be monitored to ensure the success rate continues but do not need detailed analysis at this time including HIM2930 HIT Review which is a capstone course effective Fall E. Job Prospects The Bureau of Labor Statistics cites medical records and health information technicians as one of the 20 fastest growing occupations in the US and this growth is projected to continue at about 20% per year through ( Nationally, job titles for entry-level graduates of an associate degree program (especially with an RHIT) include: health data analyst, insurance claims analyst and data quality analyst paying an average of $20, $30, per year. As the health information technician gains experience, Health Information Management Program Review Page 12

14 career growth includes titles such as records technician specialist, clinical coding specialist, compliance specialist, patient information coordinator, medical staff coordinator, DRG/APC coordinator, physician practice manager or health information services department manager. Salaries for an experienced health information professional with an associate degree range from $25, $60, per year. Locally, graduates have experienced temporary jobs paying $20 per hour to full-time jobs ranging from $10-$14 per hour. Many graduates promote rapidly and make between $24,000-$50,000 per year after 3-5 years of experience. For example, one recent graduate started working as a health information analyst while still a student at $10.60 per hour. At her first annual review, she had earned her associate degree so she received a larger than usual increase. She subsequently volunteered in the department s tumor registry and studied for the national exam as a certified tumor registrar. After passing the exam, she was promoted to tumor registry and paid nearly $40, per year after only having her degree for 2 years. Another recent graduate had obtained the coding certificate and gained some medical office coding and billing experience before deciding to come back to LSCC and earn the degree in HIM. She worked in a temporary position for about six months after graduation and then was hired as an HIM supervisor for a hospice center at a rate of about $29, per year. The most recent graduate of this degree (May 2010) passed her RHIT and is being interviewed by a software company to work as a health informatics specialist a liaison between the end user and the software developers. If hired, she ll earn $13 per hour to start. Health Information Management Program Review Page 13

15 III. FACULTY PROGRAM DATA A. Organizational Structure Vice President of Academic and Student Affairs - Dr. Barbara Howard Dean of Career and Technical Programs - Dr. Mary Jo Rager Dean of General Education and Transfer Programs - Dr. Gary Sligh Program Manager (50%) and Program Full-Time Instructor (50%) - Brandy Ziesemer Program Adjunct Instructors The HIM program manager reports directly to the Dean of Career and Technical Education Programs. The HIM program manager has 50% release time from teaching responsibilities to manage the program but often teaches overload. There are no other full-time positions in the HIM department. The adjunct faculty who have taught in the program during the period of this program review ( through ) report to the program manager directly but with oversight by Dean Mary Jo Rager. B. Faculty Credentials and LSCC Teaching Summary For a complete list of credentials for HIM faculty who taught in the spring or fall of 2009, please see Appendix B. All current HIM faculty who were teaching any classes during these semesters or subsequently have been alternatively credentialed to meet SACS requirements. Previous HIM faculty members teaching in the five-year period covered by this program review were all eligible under the alternate credentialing criteria established in The following tables list course load by year for the five-year period for each person who has taught or is currently teaching in the HIM program. Full-Time Faculty with Number of Credit Hours Taught in Health Information Management Courses Full-Time Faculty Degree or Certification Courses Taught 2005/ / / / / 10 Haugabrooks# Alt. Cred* Introduction to Healthcare Ziesemer B. Alt. Cred Most HIM Courses Total # Full-time Nutrition faculty member Health Information Management Program Review Page 14

16 Adjunct Faculty with Number of Credit Hours Taught in Health Information Management Courses Adjunct Faculty Degree or Certification Courses Taught 2005/ / / / / 10 Bakuzonis K, Alt. Cred* Ph.D, RHIA Medicolegal Aspects of Records 2 6 Bird J, BSN ** Medical Terminology I 4 2 Bowe H, MS, ** RHIA Foundations of HIM 3 Calhoun W, Alt. Cred AS, RHIT Medical Terminology I & II Craine R, AS, ** RHIT Foundations of HIM 3 Crews R, Alt. Cred MHSA, PA-C Medical Terminology I & II Daniel S, MS ** Medical Terminology I 2 Dicus R, MS, Alt. Cred RHIA, LHRM Medical Terminology I & II 4 Freeman P, ** BA, RHIA Medicolegal Aspects of Records Howard D, MS, RHIA Alt. Cred Foundations of HIM; Healthcare Statistics; CPT Coding & Reimbursement; Medical Terminology Iⅈ Pharmacology Lab Stowe C, MS ** Medical Terminology II 2 Zerbe M, BA, Medical Terminology I & II; Concepts of Alt. Cred RN Disease Total The majority of full and part time faculty in the associate degree for HIM have alternate credentials for regional accreditation purposes because the discipline has only had approved (CAHIIM-accredited) master s degree programs for the past few years. HIM is a multidisciplinary field involving primarily allied health, technology and business expertise. Therefore, the RHIA or RHIT credential with directly related industry experience or an RN for medical science courses is acceptable for SACS accreditation. The minimum credential for teaching in this program is the associate s degree with related work experience and appropriate industry credentials. These adjunct instructors would qualify for alternate credentials but the program does not plan to use them again due to retirement, relocation or the program manager s discretion. 6 C. Additional Responsibilities The program manager receives 50 percent release time (fall and spring) from teaching duties and an annual stipend for the hours worked on program management that fall outside the regular full-time faculty contract. For example, the program manager officially works 10 days in the summer and unofficially works substantial hours beyond those required under contract. The program manager is responsible for: academic and career advising to some degree for all HIM degree-seeking students, Medical Information Coder Biller certificate students and a large percent of the Medical Office program students (degree and certificate). Health Information Management Program Review Page 15

17 Preliminary graduation checks Budgeting and managing the budget for HIM and for any HIM-related grant budgets and also requesting funding from the HIM endowment (Laura Clark Memorial HIM Book Collection) as needed to keep the HIM references current Curriculum development, approval and improvement Hiring and scheduling adjunct faculty with oversight by the dean Course scheduling and book orders for all HIM courses Annual HIM related catalog maintenance PPE, guest speaker and physician expo (student participants) coordination Assisting graduates with job placement Program marketing and community relations activities Statewide participation on frameworks committees and other HIM-specific coordination with colleagues including serving on committees for workforce-related activities such as a special FHIMA task force on Health Information Exchange Pursuit, implementation and maintenance of HIM-related grants with support from CTE staff and administration Advisory Committee Liaison activities Articulation agreements both formal and informal Assisting with Tech Prep activities Maintaining program accreditation (CAHIIM) which requires specific surveys to be distributed, returned and analyzed (students, graduates and employers), analysis of results of graduates taking the national exams, an annual online program review, ensuring adjunct faculty are appropriately credentialed including maintenance of CEs (program manager requires 30 hours every 2 years for RHIA credential maintenance plus an additional 10 for CCS credential maintenance), ensuring adequate resources for students, academic and career advising, implementing changes as applicable based on industry trends and CAHIIM initiated changes and tracking program demographics College Committees (during the review period, served as faculty liaison to Admin Council, Distance Learning Subcommittee, Department Chair, Teaching and Learning, Human Resources, SACS Subcommittees, Foundation Liaison, Enrollment Development, and assisted with Catalog Committee. D. Additional Faculty Needed The following tables show the percent of HIM credits taught by adjunct and full-time faculty. Number of Health Information Credit Hours Taught by Faculty Status and Academic Year Academic Year Total Credits Full Time Adjunct Percent Full Time Percent Adjunct 2005/ / / / / Total Health Information Management Program Review Page 16

18 Number of Health Information Credit Hours Taught by Faculty Status and Level of Course Level of Course Total Credits Full Time Adjunct Percent Full Time Percent Adjunct Beginning Intermediate Advanced Total For the past five years, about half of the HIM credits have been taught by adjuncts, but as the program continues to grow, that percent is increasing to catch the national trend. Nationally, in associate degree level HIM/HIT programs, 69% of the courses are taught by adjunct faculty. This trend is partially due to college funding limitations for full-time, master s qualified faculty (even with master s in related disciplines such as informatics), partially to a limited number of HIM professionals with master s degrees and partially due to the fact that a master s qualified professional earns significantly more money, nationally, in industry than in the academic setting. The program manager teaches a substantial number of overload credits which contributes to the lower percentage of adjunct-taught credits when compared to the national trend. If the program manager only taught her contracted amount then the picture drastically changes as shown below. Academic Year Total Credits Contracted* Full-Time Credits Overload Credits Adjunct Credits Percent Full-Time Percent Overload** Percent Adjunct 2005/ / / / / Total *50% release time for program manager + 2 credits taught by full-time nutrition faculty = 17 contracted credit hours for each school year. **Overload and summer. There is a need for one full-time HIM instructor. This is consistent with a proposal pending in 2011 through CAHIM to require one full-time instructor in addition to the full-time program manager with teaching responsibilities to increase academic and career advising by an HIM professional as well as to create a stronger foundation for continuous quality improvement. Comments so far have indicated that if adopted, this proposal may cause many smaller programs to close. The comments will be accepted through March 2011 and then the resolution will go for either approval, modified approval (perhaps programs with fewer than 50 students would be exempt) or rejection. From summer of 2010 through the academic year, grant funding enabled the program to hire part-time people for both assistance with curriculum development especially application exercises for increased hand-on experience on a number of HIT-related software programs and for assisting students with classroom demonstrations and homework assignments involving any of the several types of software used in the program and assisting with professional practice experience coordination. Performance-earned funding will enable the program to have 60 hours per semester of help for ongoing support of application activities and PPE coordination as well as assisting with job placement (curriculum development for new courses is complete). Given AHIMA/CAHIIM s proposal discussed in the previous section, to require programs have, at a minimum, a full-time program manager plus a full-time faculty position, and given the program growth which is projected Health Information Management Program Review Page 17

19 to continue, the program would greatly benefit from a half-time professional practice coordinator with responsibilities for assisting students with hands-on technology application activities that prepare students for their PPEs and supplement site time in PPEs. This support would substantially increase the program manager s ability to more effectively advise students with an emphasis on the transition from college to the workforce and to meet the rising demand for teaching more sections of medical coding (including the transition to a new diagnostic coding system that will require courses for existing coders (CE) and the responsibility of teaching both coding systems during the transition period (ending with an implementation date of Oct 13, 2013). E. Faculty Development All adjunct faculty maintain their credentials through continuing education activities plus some of the adjunct faculty take advantage of LSCC s Professional Development Center. The program manager routinely exceeds CE maintenance. During this period, this included both HIM-specific and general professional development activities such as: Completing an 18-credit hour graduate certificate in medical informatics teaching and integration through the University of West Florida Several online industry-specific webinars Conferences for: AHIMA national, Assembly on Education Summer Symposium, FHIMA state conference, and PAHCOM (Professional Association of Healthcare Office Management) Guest lectures on Electronic Health Records and on Medical Office Revenue Cycle Issues Co-authored a book with two colleagues that requires annual editing; in progress of authoring a text on Medical Office Management and Technology (both for LWW Wolters Kluwer) that has received excellent feedback from reviewers for the first draft of each chapter and should be published by the end of 2011; and contributed a chapter to a medical informatics text Actively participating on a statewide task force to develop a toolkit for health information exchange that can be used by health information professionals as a guide Serve on a statewide frameworks committee for HIM, Coding Certificate and Medical Transcription Facilitated two online mini-courses in electronic health records and patient safety for a pilot group of local physicians and practice managers plus a second group of Lake and Sumter County high school allied health instructors F. Faculty Evaluation An annual analysis of student feedback of all HIM adjunct faculty along with the program manager has resulted in mostly positive feedback for those instructors the program still uses as active instructors. One of the current instructors is frequently criticized because her online exams are structured so the student only receives a score, not any feedback of which questions the student missed or what the correct answer should have been. The program manager has discussed the instructor s philosophy Health Information Management Program Review Page 18

20 with her at length and fully supports her methods. The instructor feels that test integrity for fully online, non-proctored assessments would be compromised if students have a chance to review the details of their test results. On the other hand, she posts discussion topics for all students once she analyzes the results of an exam. These discussions address any topic that she feels students need to go back and review and why. Additionally, she invites each student who is concerned about their results to ask her specifically where they were weak on that exam and she ll reply or even call each student to discuss areas on the assessment where the student may have missed or misunderstood the concept related to something they missed on the test. There are no other consistent areas where students express disagreement or criticism of the instructors. Each year, the program manager must review student feedback of instruction for each adjunct instructor and provide results on the annual CAHIIM program review along with a plan for correcting any areas where the instructor received a low overall rating. Health Information Management Program Review Page 19

21 IV. STUDENT DATA Originally, in when we received capitalization incentive grant money to start the HIM degree and Coding Certificate Program, the economy was decent but with the growth of the healthcare industry in Lake and Sumter Counties, a needs assessment confirmed that more health information professionals were needed in the region. However, since HIM is not a common choice for traditional students coming right out of high school and a lot of good candidates already either had lesser day jobs in local health facilities or worked in an unskilled but full-time position and who didn't think nursing was a viable choice for them, expressed an interest in a career change to a nonnursing allied health career. Therefore, the original program was designed with the classes all being available at night so a person with a full-time day job could attend classes part-time at night over a few years and obtain the degree. With the shifts in economy, there is more interest in a full-time program but not enough to justify offering both a day and a night time program. Also, we are moving toward making 50% of the program or more available online so that may meet everyone's needs - full and part-time students. A. Enrollment The following graph and table show trends in program enrollment for both the AAS degree and the certificate program. 70 H. I. M. Programs Enrollment Fall Summer 2010 Number of Students Enrolled Fall 2005 Spring 06 Summer 06 Fall 2006 Spring 07 Summer 07 Fall 2007 Spring 08 Summer 08 Fall 2008 Spring 09 Summer 09 Fall 2009 Spring 10 Summer 10 A.A.S. Medical Coder/Biller Certificate Source: LSCC Banner Data, November 2010 Health Information Management Program Review Page 20

22 Program Headcount Enrollment* FTE Enrollment** 05/06 06/07 07/08 08/09 09/10 05/06 06/07 07/08 08/09 09/10 AAS Health Info Tech Cert Coder/Biller Total * Headcount Enrollment unduplicated headcount within a school year. ** FTE Enrollment total LSCC credits taken by all students in program divided by 30. The increase in enrollment in HIM programs is the result of several factors. First, national awareness of the HIM/HIT profession skyrocketed early in 2009 due to the HITECH part of the American Reinvestment and Recovery Act which funded a variety of programs incentivizing physicians to convert from paper to interoperable electronic health records, training programs and programs that hire grads of HIT programs to assist providers in obtaining the available incentives and make progress toward national health information exchange. Secondly, a weak economy has resulted in record numbers of people seeking re-training in a growth career due to a decline in jobs in certain other fields such as construction, real estate and other hardhit industries. Healthcare is a huge growth market and Lake County has a greater than average number of aging citizens creating a higher than average demand for healthcare workers. The third factor was a grant that paid tuition and fees for approximately 23 students (of which 14 have been successful) unemployed workers to train in an informatics certificate program all credit hours apply to the degree in HIM. This program did not have its own code when the cohort group started in Spring 2009 so everyone was registered under the HIM AAS degree which inflated the numbers. Percent of Students enrolled in Health Information Management Programs by Demographic Characteristic During Fall Terms Health Information Programs All LSCC Students Enrolled Student Characteristic Fall 2005 Fall 2006 Fall 2007 Fall 2008 Fall 2009 Students Fall 2009 in CTE Programs, Fall 2009 Female 94.1% 97.2% 89.7% 89.2% 89.8% 63.0% 64.4% Black 17.6% 16.7% 10.2% 13.5% 22.0% 11.3% 13.1% Hispanic White Other Ethnicities Unknown Under 18 Years Old 0.0% 0.0% 2.6% 0.0% 0.0% 13.5%* 1.4% and older Number of Students Enrolled , * Includes dual-enrolled students Health Information Management Program Review Page 21

23 LSCC HIM student characteristics are very similar to the national figures. A national survey of students in HIM programs (all levels from associate through masters) reflects the national average in 2009 of: 89% female; 13% black, 6.6% Hispanic, 71.7% white, and approximately 10% other ethnicities. Age groups revealed: (19% - probably higher if the associate level was reported separately from the baccalaureate level students based on discussions with colleagues at both levels), (26%), (25%), and (24%). The average age of HIM professionals is 46 years. Progression of Students through program: Experience has shown that many students enroll in the degree instead of the coding certificate because the coding certificate did not qualify for financial aid (except through Workforce Investment Act programs) until recently. Of those students, some of them finish the coding certificate, look for work and then come back to complete the rest of the degree (certificate is 34 of the 67 hours required for the associate degree). Other self-pay students enroll for the certificate but decide they would like the full degree. Regardless of whether or not a student starts out with the intent of earning the degree, they are advised to complete the medical sciences (anatomy and physiology, medical terminology, concepts of disease) first or as co-requisites as they progress from beginning, to intermediate and then advanced courses as outlined in the college catalog. Degree students are also advised to work on all general education courses from the start. B. Retention True retention is hard to measure because students don t always use the most appropriate program code when registering. Sometimes they register for an AA when they are actually pursing the AAS and sometimes they register for HIM for financial aid purposes but are actually in a pre-allied health program planning to transfer to a college that offers that degree such as dental hygiene or physical therapy assisting. Until recently, this problem was complicated by the fact that the medical information coder biller certificate was not eligible for federal financial aid so many students registered for the full degree even if their intent was just to complete the certificate program. For the purposes of the annual CAHIIM program review, the program manager only counts those students for retention and attrition who have sought advising from the program manager or who have responded to an instructor survey in an introductory class such as Foundations of HIM that they are pursuing the HIM degree regardless of what they are actually registered under. The results reported to CAHIIM for the degree only, using standard reports with manual adjustments based on program manager s advising records are as follows (any variance from the student tables located earlier in this section are due to the issues mentioned above): Health Information Management Program Review Page 22