Skilled Occupation List (SOL) 2015-16 Tracking Code: VW9RK6 Name Individual * Mr Richard Lawrance Organisation Health Information Management Association of Australia (HIMAA) What are the industry/industries and ANZSCO occupation/s that you or your organisation represents for the purposes of this submission? Industry Occupation The three dropdowns below accord with the ABS ANZSCO classification of occupations. Selections are required at the Occupation Group 2-digit level and at the Occupation Unit (4-digit) level, but can also be made down to the Occupation (6-digit) level depending on the occupation/s to which your submission relates. Additional occupations can be selected by way of the Add item button. For each occupation selected, please indicate whether your advice is to Include, Exclude, or is Neutral (other) with respect to the 2015-16 SOL. The rest of the form can be used to provide evidence/reasons to support your recommendations. Attachments can also be added after clicking the 'Submit' button. Item 1 Page 1 of 6
Occupation Group * Business, Human Resource and Marketing Professionals Occupation Unit * Archivists, Curators and Records Managers Occupation Health Information Manager 224213 Summary advice for 2015-16 SOL * Include Exclude Neutral Item 2 Occupation Group * Other Clerical and Administrative Workers Occupation Unit * Other Miscellaneous Clerical and Administrative Workers Occupation Clinical Coder 599915 Summary advice for 2015-16 SOL * Include Exclude Neutral Are there any occupations that you represent where there is evidence of imbalances in the demand for and supply of skills in the medium-to-long term? * Clinical Coder 599915 Health Information Manager 224213 Page 2 of 6
Is there evidence of imbalances in the demand for and supply of skills in the medium-to-long term in non-metropolitan areas? If so, can you indicate in what part of Australia and the number in the occupation in over or undersupply. Supply of both Health Information Managers (HIMs) and Clinical Coders mirrors the supply of general practitioners beyond the cities: increased diversity and comprehensiveness of practice, but decreasing supply with increasing rurality and remoteness. There is no specific evidence on undersupply of coders in rural and remote areas compared to metropolitan, but a likely estimate of general undersupply, based on AIHW 2010 analysis compared to 2011 Census figures, is a minimum of 688 (39% of required workforce) and maximum of 2032 (190% of required workforce). The undersupply in rural and remote will proportionately increase with rurality and remoteness. Are there any occupations which require formal licensing or registration arrangements in order to practice/perform in this occupation? For example: Midwives are required to register with the nurses board in their state or territory Panelbeaters are required to be registered or certified with the state Motor Vehicle Repair Industry Authority Both occupations are currently certified by their professional association, the Health Information Management Association of Australia (HIMAA). Is it expected that your employment sector will be impacted by any medium-to-long term trends which will impact upon demand and/or supply (excluding costs associated with training, labour hire, and international sponsorship)? Please provide evidence (e.g. data source, policy document) which substantiates these claims. Page 3 of 6
For example: New benchmarks for childcare centres mandate increased staff-to-child ratios and higher qualification standards for childcare workers. These two occupations are the main constituents of the health information management profession. The undersupply in this profession is well documented across Australia in a range of reports: - Health Workforce Australia [2013] Health Information Workforce Report - Australian Institute of Health and Welfare (2010) The Coding Workforce Shortfall Cat No. HWL 46, November. - Shepheard, J. (2010) Health information management and clinical coding issues Health Information Management Journal: 39 (3) 37-41. - Queensland Health Human Resources Branch: Health Information Managers Review 2009 - Queensland Health, Health Information Manager and Clinical Coder Workforce Project Final Report, February 2010 These studies reveal that, despite a period of growth in both professions in the early 2000s, demand outstripped supply. Since 2006, a dramatic downturn in supply has been experienced in both occupations making up the health information management profession: Clinical Coders and Health Information Managers (HIMs). This increase in demand is due to two major innovations in Australian health care delivery: ehealth and Activity Based or Casemix Funding. Research from around the world culminated, in the first decade of the 21st century, in an understanding by governments that primary care - particularly general practice - was far more effective than the hospital and secondary care systems in delivering general health outcomes in terms of both quality and cost. Primary care delivers better quality care which is more cost effective. And this constitutes 80% of the care delivered here in Australia. To improve the effectiveness of care in the hospital system, greater continuity of care is needed between hospital and primary care sectors as well as cost efficiencies and quality of care improvements in the hospital sector itself. The ditigisation of health information provides the key to both initiatives: - Effective capture, coding, transmission and storage of quality care delivery is essential for successful continuity of care across the hospital~primary care divide and for the flow of funding to points of quality care (ABF). - Clinical Coders are responsible for the coding of clinical care information for electronic readability and management. - Health Information Managers HIMs are responsible for the interflow between data and information through the health system such that it is useful to each function in the quality of care~cost cycle - care delivery - procurement - facilities - administration - finance - HR. Yet at a time when these two professions are in increasing demand, the supply since 2007 have been decreasing. A combination of Census data and the 2010 AIHW report reveal the complex trends. - ABS Census data shows a decrease of a staggering 41% in Clinical Coders between 2006 and 2011 - from 1806 to 1069. Page 4 of 6
- This is supported by the AIHW's report from industry research (R=85%) which revealed 1186 FTE Clinical Coders in the workforce in 2009. - A combination of 2006 Census and 2010 AIHW report reveals a similar drop in HIMs - from 865 to 630 (27%). The loss of half of Australia's complement of HIM degree courses (QUT and Sydney University) in 2007 had a drastic impact on HIM workforce supply. The AIHW report predicted a need for between 3,101 and 1,757 Clinical Coders in 2015. That is next year. Yet the trend, as demonstrated by the 2011 census, had been downwards rather than upwards. There is a dramatic short-to-medium term need in Australia for the extension of opportunities to skilled migrants with Australia-equivalent qualifications and experience in the occupations of HIM and Clinical Coder until government and industry can, with the profession's association (HIMAA), develop the necessary Australia-wide education and training solutions to sustain this niche professional market at home. The numbers needed are modest, but they are essential over the next 5-10 years in order to enable the success of cost effectiveness improvements in the national health budget through better quality care over the next 50 years. Please provide any other information you consider relevant evidence to support your submission For example, you may know of some independent studies about your occupation that supports your advice to us. - Health Workforce Australia [2013] Health Information Workforce Report - Australian Institute of Health and Welfare (2010) The Coding Workforce Shortfall Cat No. HWL 46, November. - Shepheard, J. (2010) Health information management and clinical coding issues Health Information Management Journal: 39 (3) 37-41. - Queensland Health Human Resources Branch: Health Information Managers Review 2009 - Queensland Health, Health Information Manager and Clinical Coder Workforce Project Final Report, February 2010 Would you like to make any additional comments on the SOL? HIMAA would welcome the opportunity to make a presentation or engage in further discussions with the Department of Industry to assist understanding of the importance of this niche profession, health information management, as a small but vital key AT THIS TIME in securing Page 5 of 6
future much-needed successes in continuity of care, quality of care and cost-effectiveness savings. Please provide the name, position and contact details of a person within your organisation who is willing to be contacted if any further information or follow-up is required. Name * Richard Lawrance Position * Chief Executive Officer Contact details * ceo@himaa.org.au ph. 02 9887 5903 mb. 0408 507 211 All information, including name and address details, contained in submissions will be made available to the public on the Department of Industry website unless you indicate that you would like all or part of your submission to remain in confidence. Automatically generated confidentiality statements in emails do not suffice for this purpose. Respondents who would like all or part of their submission to remain in confidence should provide this information in an email to SOL@industry. gov.au. Legal requirements, such as those imposed by the Freedom of Information Act 1982, may affect the confidentiality of your submission. Page 6 of 6