October marked the one year anniversary of our Coding Specialist Program (CSP). We are so proud of this program and the success it has already seen – in the form of tremendous interest and many enrolments and especially in the wonderful feedback we have received from so many of our learners. As the only CHIMA-recognized post-graduate coding program in Canada, we are proud to have already had 165 learners – and counting – enter the program and to be setting a new standard of advanced practice in coding.
We developed CSP in response to consistent, ongoing feedback that we were receiving from Health Information Management (HIM) graduates, CHIM professionals and employers (our members). With the expansion and broadening of the HIM curriculum standards (Learning Objectives for Health Information Management – the LOHIM standards), HIM programs across Canada must teach an enormous curriculum in two years. Many of our graduates wish to go into coding roles, however, HIM graduates are not yet proficient coders and require further training.
We surveyed our graduates and their practicum supervisors and confirmed there was a significant need for advanced training in coding – to allow recent graduates to be able to specialize, be more confident in their coding and to be more competitive in applying for coding jobs. We heard from employers that the cost of training new graduates to become highly competent coders was significant, sometimes requiring 6-12 months of on-the-job training. To make matters worse, this process of training was taking other coders away from their jobs and costing health organizations a significant amount of money.
High-quality coded data is such an important resource in our Canadian healthcare system – supporting safe and high-quality care provision, research, service planning and funding. Our coders are therefore a very important asset and consistent, high-quality training is imperative.
So, CHA Learning set out on the journey of developing the program with an evidence-based and experiential approach, focussing on complex and error-prone case types. We worked with two of the foremost coding experts in Canada to develop the program: Joy Fletcher (author of the ICD-10-CA/CCI Classification Primer) and Margaret Penchoff (a CIHI Classification Specialist for the last 12 years). We established an advisory committee of experts and employers from across Canada and sought their input into the curriculum and the instructional design. We worked with partners to acquire real cases and de-identified charts so that the program would simulate the real-life coding experience. We developed a program that is unlike anything else that exists and we are very proud of the rigour and the value it is providing – not only to new graduates but also to many coders who are looking to continue their professional development and to invest in their own knowledge and skills.
Since the launch of CSP, we also have been working with employers who are turning to this program as a valuable way to support and supplement their in-house training – using it as a tool in the onboarding and training process and even in recruiting people to become coders in areas of the country where there is a real shortage of qualified professionals.
The next step for some of our learners will be to successfully challenge the advanced certification examination currently under development by CHIMA to gain formal recognition with a new credential. All current and previous students of the Coding Specialist Program will be eligible to challenge this exam once it is available.
Margaret Penchoff, our lead subject matter expert and faculty in CSP, has been a tremendous asset to our program, our team and our students. The hours and time that went into developing and refining the program, and updating it again when the 2018 Coding Standards were released, was remarkable. Margaret is a very dedicated and supportive faculty member we are very fortunate to have on the team. I asked Margaret a few questions in reflecting on this special, one-year anniversary:
Why did you get involved in leading the development of this program and as faculty? Why do you continue to enjoy it?
I saw this as a great opportunity to continue to learn. A friend once said to me “the best way to learn is to teach.” This is so true, I learn so much from students who are eager to learn. When you teach you are constantly challenged to think things through clearly so you can explain the answer in logical and sequential terms.
Why do you feel this program is important to the field of HIM and HIM professionals?
While the role of the HIM professional is going to change with the introduction of technological advancements, the need for experienced coders will remain. Masterful coders can explain and justify why cases are classified the way they are, something a computer cannot do. Validation of automatic coding will be extremely important and the role of coders will evolve. Based on recent surveys the population of coders ready or near ready to retire is significant so we need HIM professionals prepared to step in to fill these positions.
For years, recent graduates and the healthcare industry have anecdotally identified the need for a program that would better prepare those who wish to begin or expand a career in coding. Recent graduates face two common roadblocks getting a job: many jobs require prior coding experience and healthcare employers say it takes too much time and human resource commitment to train an inexperienced coder. So graduates find themselves in the proverbial catch-22 of trying to get a coding job that requires experience …and no one willing to give them the experience to get a coding job.
What makes this program so unique?
The goal was to build proficiency, efficiency and confidence by giving “Certified Health Information Management” (CHIM) professionals the opportunity to develop their coding skills through hands-on learning. The learners have the opportunity to apply ICD-10-CA and CCI coding rules and conventions; and, the accompanying coding standards to real cases. Working with expert faculty, the students must articulate and justify their code assignment through a process called “journaling.” Rather than teach new theory, the purpose of the program is to teach learners through a systematic process to apply their coding knowledge and to solidify application of the theory so that they can accurately – and with confidence – code any case they encounter. The result is an advanced level of coding competency. This experience is invaluable to coders at any stage of their career – there is always something new to learn.
What is your favourite part of being a faculty member in the program?
The exchange with the students and what I learn from them. As a seasoned professional, I often think things through subconsciously and quickly to come up with an answer. When a student asks me to explain why it is mandatory to assign a code, it forces me to bring my rationale to the conscious level and to articulate the steps formally. I have to organize my thoughts and logically articulate them. Sometimes further research is required in order to figure out where a case is best classified. When this is the case, I also have to do the research to learn more about a disease or intervention, then share my findings with the student and help the student interpret and understand how the classification applies to the disease or intervention. Therefore, I am also learning.
Do you have any lessons learned as a faculty member (for yourself or the program) you would like to share?
There are always going to be challenges. Rather than focus on the negative, strive to focus on the positive and the ultimate goal. Look for solutions and make it happen rather than identify reasons for giving up.