The process of creating a health information management (HIM) credential like the Certified Health Data Analyst (CHDA) or the Registered Health Information Administrator (RHIA) is not unlike building a new home. Some of the most important work is done before construction even begins and the whole process requires permits and inspections. A house needs a blueprint, an architect, contractors, and inspectors. Likewise, a new credential comes under the review of subject matter experts, instructors, and—often—more than one certification or accreditation body. Both are built to last and stand the test of time, which requires renovations, updates, maintenance, and due diligence. And when done right the resulting product only grows in value over time.

The process of creating a new credential can take three to five years, with the goal of launching a valid, reliable, and legally defensible measurement of professional competence. AHIMA’s certification process is considered the “gold standard” based on several factors—one of which is the fact that AHIMA credentials are created using a scientific process that is scrutinized by the Commission on Certification for Health Informatics and Information Management (CCHIIM) before they are released to the public. Here’s a step by step look at the credential creation process.

Step #1

When building a home from the ground up, a lot of work must be done before construction begins: creating a blueprint, bulldozing the property, leveling the ground, pouring a foundation, installing footings, and erecting wooden forms. The same level of preparation unfolds when AHIMA and CCHIIM decide to create a credential. First, a job task analysis is launched to develop a legally defensible exam blueprint, which involves a diverse—in terms of gender, race, and geographic location—sample of stakeholders. They assess the criticality and frequency of current workplace practices, skills, tasks, and responsibilities. The results of the job analysis influence to what extent the competencies are revised for each respective certification examination.

Step #2

Building a new home also requires the receipt of inspections, bids, and approvals from multiple parties and contractors. This makes sure everything is done by the book, prevents design flaws, and determines if the home meets basic standards. The certification development process must meet a number of different standards (detailed in the final slide). The second phase of the exam blueprint development process involves distributing a survey to professionals, or incumbents, in the area that is being studied (for example, CDI specialists for the CDIP credential). The survey takers are asked to provide feedback on the domains and tasks provided during the initial phase.

Step #3

Now it’s time to start building—the flooring, roofing, and walls form a skeleton, and suddenly a structure resembling a home is revealed. The same goes for a certification exam. The original group of subject matter experts meet to review the survey results and make recommendation regarding test plan weights. This recommendation is then taken under consideration by CCHIIM and voted on to create the new exam blueprint. All reports outlining the job task analysis for each AHIMA credential can be found on AHIMA’s website. These studies are a critical piece of evidence that point to the need, purpose, and legal defensibility of a certification exam. Once the blueprint is accepted it becomes the foundation for all exam item development.

Step #4

By now, builders are on to the nitty gritty of construction—HVAC and plumbing systems go in, as well as ductwork, electric wiring, and sewer lines. There’s also another round of inspections of the framing, mechanical and electrical systems. A certification exam blueprint plays a similar role. Exam item writers and reviewers recruited from the industry provide feedback and exam questions. To assure the exam is measuring topics that it is designed to measure, the blueprint is used in all aspects of exam development. All items used to determine competence are aligned to the exam blueprint and pre-tested before being used as exam questions.

Step #5

One of the final steps of home building is installing flooring, drywall, design finishings, and insulation, which plays a major role in providing climate control—protecting the home from poor weather. AHIMA’s credentials are similarly insulated—against legal challenges and against accusations that the credentials don’t accurately measure industry jobs and tasks. Terrence Wright, AHIMA’s director of certification, says that he has confidence that if anyone ever challenges AHIMA’s credentials (for example, someone who fails an exam and appeals the outcome) he has standing to defend it. This helps AHIMA’s credentials stand apart from competitors.  “If corners are cut [in exam development] it could cost you in the long run. AHIMA is good at having enough evidence for me to take anyone’s stand as a witness and defend it,” Wright says.

Step #6

A new home’s success is gauged by those who live in it—just like finding a new job is the ultimate test of a new credential. AHIMA prides itself as offering the “gold standard” in credentials for several reasons. The flowchart in this slide, with the steps spread out over three to five years, offers a comprehensive look at AHIMA’s intricate “gold standard” certification development process that helps make AHIMA credentials the best in the industry, Wright says. AHIMA considers its credentials better than competitors’ for the following reasons:

  • All of AHIMA’s testing development materials are posted online, including the initial job task analyses and the exam blueprints: Many of AHIMA’s competitors do not do this, which makes it hard for candidates to understand a certification’s place in the job market and why the certification is worth their time and money.
  • AHIMA’s certifications comply with the Standards for Educational and Psychological Testing which was developed by the American Psychological Association (APA), the American Educational Research Association (AERA), and the National Council on Measurement in Education (NCME). The guidelines presented in the standards by professional consensus have come to define the necessary components of quality testing. Some competitors don’t take this step with their certifications.

Four of AHIMA’s credentials (the CCS, CCS-P, RHIA, and RHIT) are accredited by the National Commission of Certifying Agencies (NCCA), which occurs on a five-year cycle. During this process AHIMA provides information regarding development processes, psychometric properties of exams, and exam items and program governance policies and procedures.  NCCA accreditation happens outside of the development and delivery process and serves as a “gold seal” in telling the industry that all appropriate exam development activities took place.


  1. Is the flow chart image used in Slide #6 available in a larger, higher resolution format somewhere? I would like to use this image in educating my employer on the significance of AHIMA certifications.

    1. Hello Hugh — I found the same flow chart image on the AHIMA website at the certification tab, About CCHIIM, and then Exam Development – go all the way to the end of the page. It seems to be a little clearer there.

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