Help Wanted: Professional Practicum Sites Prepare Our Future Colleagues

The professional practicum experience is an essential part of the health information curriculum. According to the Commission on the Accreditation of Health Informatics and Information Management (CAHIIM), professional practice experiences are utilized to reinforce didactic learning (classroom instruction) in a hands-on environment. Students must complete a minimum of 40 hours as part of the accreditation requirements.¹ Many health information programs may require at least 120 hours per semester for their students.

As of 2020, there are currently 288 health information programs in the United States, according to the CAHIIM dashboard. The average enrollment for each program is around 77 students.

The number of programs is classified by region:

• Midwest: 108
• Northeast: 38
• Southeast: 81
• Southwest: 32
• West: 29

The health information academic programs need our involvement in providing practicum sites for our students. Currently, practicums are offered in face-to-face, virtual, and hybrid environments. These formats are determined by the practicum site, health information programs, and in accordance with CAHIIM standards.

The Role of the Practicum Site Facility

Although requirements may be different for each facility, here are some general responsibilities that has a practicum site facility has when hosting a student:

• Assign a designee who is responsible for coordinating the practicum.
• Assign tasks and projects for the student (not solely watching tasks being completed).
• Provide feedback for the students.
• Provide orientation for the students.
• Complete documents that may be required as part of the curriculum (evaluations).
• Provide resources such as a computer and other equipment.
• Provide emergency medical treatment, if applicable.

It is important for the university and the facility to discuss the requirements with their legal counsels to make sure that state laws are being maintained.

The Role of the Health Information Program

The health information program has the following responsibilities when hosting a student:

• Determine the proper students for the facility.
• Identify the rules, regulations, and number of hours for the students.
• Serve as a liaison between the students and practicum site facility.
• Ensure that there is an affiliation agreement between the facility and the health information program.

Professional Practicum Experience Site Options

In the past, the health information department in a hospital was usually the most common area where students completed their internship. As health information professionals have moved into nontraditional roles, it has expanded the options for the students. Students can participate in more areas and learn about quality improvement, revenue cycle, compliance, data analytics, information technology, etc. Here are some additional options for professional practicum sites:

• Physician offices
• Pharmaceutical companies
• Insurance companies
• State departments of health
• Health information exchanges
• Community health centers
• Cancer registries
• Health consulting companies
• State hospital associations
• Nursing homes
• Vendors
• Correctional health centers
• Public health agencies

Benefits of Hosting Students

It is important for health information professionals to host students, as there are benefits for both the students and for practicum sites.

According to Jennifer Duckworth, RHIA CHPS, HIM quality assurance advisor at Community Health Network, “There are multiple benefits to hosting a student in the health information management department. Students want to learn as much as possible during their practicum experience, so hearing about their achievements and favorite shadows at the end of the practicum is a positive for the department. Another benefit is having students work on tasks that often get put on the backburner; having a student work on those tasks is a win-win for both sides.”

According to Cindy Spann, MIS, RHIA, CHPS, CCS, CCS-P, FAHIMA, executive health information management director at Community Health Network, “Being a PPE site allows the students and schools to get to know the organization and vice versa. It provides the organization the opportunity to showcase the HIM professionals in our organization. The students can teach us new things. They know how to use technology and advanced functions that they share with us. We can learn from one another. Students are the future of our profession.”

Kim Seitzinger, RHIT, HIM manager/transcription at Community Health Network, says, “Our managers often comment on the experience of mentoring the student and expression of gratitude when a project is completed. Usually, the projects are such that managers have a need but not the time. Spending the time with the student to kick off the project, and explain the needs and value of the project, creates the enthusiasm of obtaining a goal. Students help us in many ways. We encourage sites to be more active in this process. Often, we accept more than one student because facilities may not have the time or knowledge to onboard or lead in project completion. In the past five years, we have mentored 60 students. We tend to feel supporting the programs is not only an obligation but also a valuable experience.”

Individuals who coordinate professional practicum sites can earn five CEUs for supervising a student with a maximum of 10 CEUs for each recertification cycle.²

Challenges

Our health information students need practicum sites. Many practicum sites cannot take students because of workload, reduced staff, and the occurrence of large hospital systems acquiring other hospitals, etc. In addition, many practicum sites may be unwilling to take a student because of a remote workforce. Sometimes, there is a challenge because the student cannot get VPN access or permission to work in the electronic health record. COVID-19 has also affected students being able to be placed in a professional practice experience site.

“It’s inevitable that technology issues will arise with a virtual practicum, but that is true of all professions,” Duckworth says. “The key is not giving up because one thing fails. It’s important to work with your organization’s information technology department and try different methods of using technology to find a way that will work. Showing students’ challenges with technology is a valuable learning opportunity.”

Projects and Tasks

The professional practicum experience should involve tasks where the students get hands-on experience. Many health information programs have tasks that need to be accomplished during the specified time frame. In addition, the AHIMA Health Information Curriculum Competencies© can provide guidance. The AHIMA Exam Content Outlines for the Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or the Certified Coding Associate (CCA) list potential tasks as well.

“The health information leadership team brainstorms projects together, and we keep a running list of possible ideas,” Spann says. “We use regulatory items, documentation challenges, EHR needs, audits, etc., to identify projects that will be meaningful to the student as well as the organization.”

Here are some potential ideas for student projects:

• Evaluate E&M claims
• Evaluate forms
• Review work queues to help resolve missing diagnosis claims
• Review the hospital abbreviations list
• Facility and professional coding
• Revenue cycle analytics
• Document imaging
• Chart completion/analysis
• Release of information
• Review policies and procedure
• Develop an HIM department orientation toolkit
• Develop a quality assurance process

Providing a Virtual Practicum Experience

COVID-19 forced many health information professionals to work from home. This change affected students as well. Some facilities decided that they could no longer take a student. Other facilities began the process of transitioning the PPE to a remote environment. One facility in the Indianapolis, Indiana, area has hosted over 39 students using a virtual environment. They utilize Microsoft Teams to provide information about the different positions in the health information department. Students meet with managers to receive instruction about their projects. One advantage of hosting students in a virtual environment is that you can host more than one student at a time.

“First and foremost, how you design a virtual practicum experience is ever-changing, so it is important to remain open to new ideas and adjust as necessary to provide students with the best experience possible,” Duckworth says. “Sometimes new ideas come from students’ feedback. Don’t shy away because the world of HIM has moved to a mostly remote environment in the acute care setting. It’s still our obligation as a HIM professional to mentor and provide a real-world experience for students, regardless of how we provide it to students.”

Seitzinger says, “We are committed to support professional development and recognize the ongoing needs. Our management staff of seven actively participates in this process. Depending on the needs, it is not uncommon for two to three managers to offer to take a student. There is always a need for student placement and, through the years, we have streamlined onboarding of the students by having one person coordinate the process. We tried a variety of methods, but it came down to one person doing this onboarding to be more efficient.”

Pay it Forward

It is important for you to host a student. According to the AHIMA Code of Ethics, Principle 7.1: “Provide directed practice opportunities for students.”³ Benjamin Franklin stated, “Tell me and I forget. Teach me and I remember. Involve me and I learn."

How Can You Get Involved?

• Contact your local health information program director and let them know you are interested in becoming a site.
• Volunteer to be a clinical site coordinator or allow students to shadow for the day.
• Provide case studies to the health information program director.
• Provide deidentified medical records for coding and auditing purposes.
• Utilize test environments to enable students to get exposure to health information and revenue cycle applications.

Notes

1. Commission on the Accreditation of Health Informatics and Information Management. 2021. 2018 Baccalaureate Degree Health Information Management Accreditation Standards. https://www.cahiim.org/docs/default-source/accreditation/health-information-management/him-standards/standards-him-baccalaureate.pdf

2. Commission on Certification for Health Informatics and Information Management. 2021. Recertification Guide. https://www.ahima.org/media/gq5jeclv/recertification_guide_2021.pdf

3. American Health Information Management Association. 2019. AHIMA Code of Ethics. AHIMA Code of Ethics

Nicole Van Andel is a lecturer in the health information management program at Indiana University