HIM and Patient Advocacy

HIM Frontlines covers HIM professionals working in emerging roles and tackling difficult HIM problems.


If you talk to a group of health information management (HIM) professionals for very long, you will learn they all have one thing in common: among their own extended families, HIM professionals are the ones other family members go to for all healthcare-related questions.

Of course, doctors and nurses fulfill this role in their families, too, when it comes to clinical questions. But doctors and nurses are less helpful when it comes to things like explaining all the services and codes listed in medical bills, the process for obtaining medical records, interpreting the medical lingo in lab reports and diagnostic test results, or getting their patient portal set up. It’s being able to help people in this capacity that makes HIM professionals highly qualified for jobs as patient advocates.

“Patient advocates are often called on to review and understand medical records to ensure they are correct and complete and thereby assist patients by helping to explain the content in layman’s terms,” said Lesley Kadlec, MHA, RHIA, CHDA, a director of HIM practice excellence at AHIMA. “They also often have experience with a variety of registration processes or scheduling systems, customer service, claims processing, and referral management. All of these skills are transferrable to the patient advocate role.”

Despite this, it’s hard to find many HIM professionals with “patient advocate” in their job title. Likewise, job listings for patient advocates rarely require HIM backgrounds or credentials like the RHIA.

Rakeeda Wellman, MS, RHIA, however, is an exception. Wellman is a patient advocate at Mercy Medical Center in Baltimore, MD. And while her position is in the patient relations department, her HIM background and education do inform her work.

Wellman is one of only two patient advocates serving the main hospital in downtown Baltimore, as well as five additional care sites scattered through the city, which means a busy workload for Wellman and her associate. Before being hired as a patient advocate at Mercy, Wellman completed an HIM internship at the medical center before pursuing her master’s in health services administration. When she completed that degree she went back to Mercy and was hired to her current role.

What Patient Advocates Do

The duties assigned to patient advocates range from hospital to hospital and from system to system. For example, in a patient advocate job listing for an oncology clinic in Nashville, TN, the advocate provides “financial counseling services regarding payment arrangements and financial assistance for uninsured and underinsured patients presenting a financial need. Records and maintains comprehensive documentation of patient enrollment activities.” Other patient advocates help uninsured patients—or those with limited ability to pay—navigate state and federal assistance, like this position for MedData.

But other patient advocate jobs, like Wellman’s, are more customer service-oriented. Wellman fields all of the patient complaints that get called into the hospital, whether it’s people who are unhappy about the outcome of a procedure, dissatisfied with a service, upset about something in their inpatient room, or patients who feel like their doctor or nurse aren’t listening to them.

Most of the time Wellman directs the complaints to the proper person in the proper department, whether it’s to a physician, a nurse, someone in billing, or an HIM manager. Wellman has to follow up on each complaint with a written letter. When time allows she goes up to the patient floors to address patient and family concerns in person.

She says her HIM background comes in handy when patients call with questions about obtaining their medical records.

“When they call me and say ‘Hey, I don’t have my medical records,’ and they’re angry about that, I’m more able to easily direct them to where they should be,” Wellman said. “It’s given me more insight as to how I can answer their questions than if I were just to come into the department without that background.”

It’s skills like these that Kadlec says makes HIM folks appropriate for patient advocacy. But for those who want to spread their HIM wings into advocacy jobs that might require different skills, the leap can be hard. Yet there are ways around it.

“There are a variety of opportunities available for HIM professionals who want to become involved in consumer advocacy. They might want to start by looking for opportunities to volunteer for an advocacy role, either in their community, in their own healthcare organization, or by assisting a family member or friend who needs assistance in navigating a healthcare issue or process,” Kadlec said. “There are also a variety of specific patient advocacy jobs available for which HIM professionals often possess the necessary skills and training to perform well in the role, and HIM professionals may want to consider a career move into one of these types of positions if they offer an opportunity for advancement.”

Mary Butler is the associate editor at The Journal of AHIMA.

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