“Right now, we’re coding mock charts for practice,” says HIT major James Cassamajor. He calls up a program on his computer, and enters data from a fictional patient chart.
“Let’s say the person is admitted for a headache,” says Cassamajor. “We have to determine the type of headache—severe headache, migraine, tension headache, atypical facial pain—we have to be familiar with medical terminology. It’s a whole different language.”
It’s not just coding—but coding is key
According to HIT Program Director Linda Carlson, anatomy and physiology courses “are the cornerstone of understanding coding.” Students have to know the difference between a disease and its symptoms.
She gives an example: appendicitis. “For coding purposes, you would not code abdominal pain.”
Billing is another consideration.
“Coding is the where the money is,” says Professor Rawle Chichester, who teaches Introduction to Electronic Medical Records, or EMRs.
“Whatever procedure the doctor performs, it’s assigned a code by the Internal Classification of Diseases. There is no other way to get reimbursed.”
BMCC—the only accredited program for HIT professionals
Students who earn an associate’s degree in BMCC’s HIT program are prepared to enter a field backed by the Obama administration—which set aside $46 billion to help doctors and hospitals go electronic, by 2014.
Not only that, graduates of the BMCC program are eligible to sit for the Registered Health Information Technician (RHIT) exam, a necessary step if they want to take full advantage of the medical industry’s shift to electronic records.
“There are certificate coding schools out there,” says Chichester, “but this is the only program in New York City accredited by the Commission on Accreditation for Health Informatics and Informational Management Education (CAHIIM), that awards an associate’s degree—making you eligible to take the RHIT exam. The only one.”
Courses for careers—not just jobs
“We start with Microsoft Office software,” says Chichester. “Word, PowerPoint, Excel—then go into health information applications. We have practice software we get directly from AHIMA--the American Health Information Management Association-- which students can access from home or in class.”
Technical skills are vital, but as the liaison between healthcare facilities, insurance providers, these EMR professionals also need good communication skills.
And entering a field that’s breaking new ground in information sharing, they need awareness of ethical issues unique to the HIT and EMR workplace.
“We teach the legal aspects,” says Chichester. “Confidentiality issues. We teach management. We teach quality assurance.”
The practicum: Real experience
Eventually, students apply their knowledge and procedures in a real job setting.
“We have about 25 hospitals and facilities available for the practicum,” says Chichester.
A preceptor – a hospital director or supervisor – mentors students and ensures they are exposed to an array of work areas utilizing EMRs.
“Cancer registry is one department where students spend time,” says Chichester. “Then they move on to billing and coding. They spend six weeks there, altogether.”
Hospitals transition to electronic records -- and so do their employees
J. Carrasco works in a hospital, and is upgrading her skills in the HIT program at BMCC.
“I love my job,” she says. “Every day you learn something new, diseases I didn’t know existed. But I came back to school because I want to apply for management positions, and it’s important to have the HIT degree.”
According to Chichester, about half of the 24 students in his class already work in the medical field.
“It’s full-time school, full-time job, full-time mother and wife for me,” says Carrasco. “We’re a ‘hybrid’ at my hospital—we have both electronic and paper files, but we’re trying to go electronic completely. It’s good for the patient. Cardio cases, you need information right away, and electronically, it’s much faster.”
Better access, better care
“Access is the big difference with EMRs,” Chichester says. “Before, if a doctor needed information, you had to search and search manually – now with EMRs, you just press a few computer keys.”
“Or let’s say the doctor tells you, ‘I need information on all the Cesarean sections I’ve done over the last five years.’ That would take weeks to find, but now, it takes a few seconds."
"Another example – the doctor ordered tests for a patient, but the results can’t be found. Now, the results are immediately entered into the system—they’re right there on the computer.”