Career Profile – Minute with a Member

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Dee Erickson, RHIT

Meet Long-Time WSHIMA Member Dee Erickson, RHIT

Dee Erickson currently serves as the HIM Director and HIPAA Privacy Officer and the Compliance Officer for her organization.  She has also been a WSHIMA member for over 38 years.  We recently interviewed Dee to find out more about her HIM career and her perspective on industry changes over the years. Here is a summary of Dee’s responses to our interview questions.

Tell me about your professional background. How did you get started in HIM?  How did your HIM career evolve over time?

During my first year of college, I got a weekend job as a hospital Admitting Clerk in a small rural hospital.  I always knew I was interested in some type of career in healthcare, but I also knew that direct patient care was not for me.  I enjoyed working in Admitting and enjoyed interacting with patients and staff.   Within a few months, I was offered another part-time position in the Medical Record Department as a file clerk and immediately something clicked.  I like everything about the department, liked how their work fit into the success of the facility, liked the need to be organized and detail-oriented and I was especially fascinated with the coding system (they had just converted the year prior from ICD-8 to ICD-9-CMs to give you an idea of how old I am!).   The Director of the department was interesting to talk to and although she had no formal training in Medical Records, she was very supportive of my beginning idea to go to “medical record school.”  She was a member of the American Medical Record Association (our current AHIMA) and would provide me with stacks of AMRA journals which I would pour over, not really understanding it all but fascinated just the same.

I soon applied for the Medical Record program at Shoreline Community College and under the guidance of Lynn Regudon, RRA, thoroughly enjoyed every aspect of my education.  After graduation, I was hired for the Release of Information desk at Children’s Hospital and stayed there for a handful of years before receiving a call from the same small rural hospital that they needed a department director and would I be interested?  Thrilled at the opportunity to go back to the hospital that started my interest in medical records, I made the move.   I only thought I would stay a few years at Willapa Harbor Hospital and then move on.  Thirty-four years later, I’ve never left and never regretted it.  During my time here I’ve grown with our department and hospital, adding more employees and more technology.  I’ve had several opportunities to oversee other departments including Patient Registration, Risk Management, and Quality Improvement.  I currently serve not only as the HIM Director but also as the HIPAA Privacy Officer and the Compliance Officer.

How did your HIM education/training/credentials benefit you in your career?

My education at Shoreline, and subsequently receiving my credentials, opened doors that I might not have had otherwise.  AHIMA training and credentials are recognized and highly sought after by hospital administrators and just having those credentials has afforded me the opportunity to work in areas of the hospital outside of the Health Information Department.

What are three of the biggest changes to HIM that you saw during your career?

Technology!  We’ve gone from 100% paper records with huge rooms of shelving to store those records, to electronic health record systems where information is retrieved at the push of a button.

Our professional titles being changed from Accredited Records Technicians (ART) to Registered Health Information Technician (RHIT).  Similarly Registered Records Administrators (RRA) were changed to Registered Health Information Administrators (RHIA).  This may not seem like a huge change but for those of us who first earned our ART or RRA and had proudly used those title for several years, it was quite a change!  Our department was once known as the Medical Record Department are now known as Health Information Management.

Probably one of the biggest changes I’ve seen through the years is the recognition of the expertise of the Health Information Management field.  Our tasks historically were to index, file and maintain the paper records.  We were sometimes just seen as the “file room” or “the secretarial pool.” Through the years we have not only played a big part in building a robust electronic health record system and all that comes with that but also being recognized as the go-to experts in areas such as data analysis, data collection, HIPAA Privacy and Compliance.  And of course, in the last few years, the pandemic and COVID reporting responsibilities have added a new set of skills to our toolbox!

What prompted your interest in joining WSHIMA? What do you see as the value in participating in a professional organization?

As a student, I was excited to join AMRA because reading their journals was what really got me excited about the possibilities of the medical record field.  Shortly after college graduation, I joined WSHIMA where I was afforded the opportunity to network with others, share ideas and receive educational opportunities.

What advice do you have for people just starting out their careers in HIM?

Be open to the doors that your degree will open: coders, auditors, data analysts, cancer registrars, quality improvement specialists, insurance investigators, data collection and reporting specialist… the opportunities for RHITs and RHIAs are endless.

Anything else you would like to share? Future plans?

My future plans are to retire in a few years, with the satisfaction of looking back at a successful career in Health Information Management!

Brenda Guhlke, RHIT

Meet Long-Time WSHIMA Member Brenda Guhlke, RHIT

Brenda Guhlke has been a WSHIMA member for over 37 years.  We recently interviewed Brenda to find out more about her HIM career and her perspective on industry changes over the years. Here is a summary of Brenda’s responses to our interview questions.

How did you get started in HIM?  How did your HIM career evolve over time?

I started college after high school taking business classes at the local community college.  I decided that business wasn’t a career path I wanted to pursue and looked for something in the medical field since that was always an interest of mine.  My aunt had taken the medical record program at Spokane Community College and I thought that looked like something I would enjoy.  I completed the program in 1985 and passed the accreditation exam from AMRA (later AHIMA).  My first job was in a large nursing home in Spokane as the assistant director of medical records.  I also consulted at other nursing homes and helped them set up medical records departments and train employees.  I quit consulting when my first daughter was born in 1990 but continued working at the nursing home.  In 1991 the medical records supervisor position opened up at Lincoln Hospital in Davenport.  I was ecstatic as this was my local hospital and I was a local girl in the Reardan/Davenport area.  I have been at Lincoln Hospital for thirty years as the HIM supervisor and have seen the position evolve over the years as the medical profession has grown and expanded.  When I started in 1991, we had totally paper based records and transcription was done on tapes. We have expanded to an EMR over time and will be transitioning to Epic in June 2023.  If you work in a small rural hospital, you can be assured that you will have responsibilities that were not part of the HIM education or job duties.  I have been fortunate that over time I have been able to delete non-HIM duties from my department.  I consider this a great accomplishment as it allows myself and staff to be able to concentrate our time to what we are educated and trained to do.  The always-changing field of HIM has kept this job exciting and interesting over the years.

How did your HIM education/training/credentials benefit you in your career?

I learned the basics of the medical record field (later HIM) at Spokane Community College.  I completed the practicum at local hospitals which also helped give me an overview of what the day-to-day would look like in the medical record field.  None of my jobs would have been possible without the education or the credentials from AMRA (later AHIMA).  The addition of DRG’s in the 1980s helped the coding profession and the RHIT credential was needed to indicate that you had the needed knowledge to code in the hospital setting. Over the years, the RHIT credential has gained momentum and is now considered needed to succeed in the HIM profession.  My hospital career has been in a small rural hospital where being cross-trained in all areas of the department is needed.  Many changes in the HIM department have occurred over the last 30 years and keeping current with all the changes is imperative to a successful department and career.  WSHIMA has been very helpful in providing the opportunity for continuing education (CE) credits needed to maintain my credentials.  Attending the conferences sponsored by WSHIMA is a great way to increase your knowledge and to network with others in the HIM field.

What are three of the biggest changes to HIM that you saw during your career?

  1. The creation of the DRG reimbursement system in the 1980s was one of the first challenges for me in my early career. These changes also helped show administration the importance of the HIM department and how coding fits into the reimbursement track. Also, we were introduced to encoders and how they can assist coding staff and make sure our coding met the highest standards.  This also brought to our attention the importance of keeping current with the coding since reimbursement was now impacted.
  2. The transition to EHRs from paper records was a gradual and very important aspect of my career over the last 30 years. It changed how we operate on a day-to-day basis and improved patient care.
  3. The transition from ICD-9 to ICD-10 was very exciting and helped improve our ability to code more accurately.

What prompted your interest in joining WSHIMA?  What do you see as the value in participating in a professional association?

I was first introduced to WSHIMA at Spokane Community College by the HIM program director and have been a member since I received my RHIT credential.  The organization has provided continuing education opportunities as well as networking with other HIM professionals.  Belonging to professional organization makes it possible to stay informed and connected. My membership has been an invaluable resource.

What advice do you have for people just starting out their careers in HIM?

HIM is a great career choice.  There are many different avenues to choose from so pick an area that interests you and jump right in.  If there is an additional credential in your field of choice, then obtain it, if possible. If you like doing a variety of things, then working in a smaller critical access hospital may be a good fit for you.  Networking with peers can be very helpful when starting out in your career.  Join your local and national professional organizations to assure you stay current with all the changes and to take advantage of all the educational opportunities that they provide.  Never stop learning!

Anything else you would like to share?  Future plans?

I have thoroughly enjoyed my HIM career and all the challenges and fun that have occurred over the past 35 years.  My 30 years of hospital experience have all been in rural healthcare.  I am proud of our hospital and the high-quality patient care that we provide our community and surrounding areas. We will be transitioning to the Epic EHR next year and I am looking forward to the experience.   My HIM department has been an important part of our successes and I plan on continuing to move our department forward in the ever-challenging healthcare system until retirement.

Elizabeth Higgins, RHIA, CCS

Meet Long-Time WSHIMA Member Elizabeth Higgins, RHIA, CCS

Elizabeth Higgins has been a WSHIMA member for over 38 years.  We recently interviewed Elizabeth to find out more about her HIM career and her perspective on industry changes over the years. Here is a summary of Elizabeth’s responses to our interview questions.

Tell me about your professional background – how did you get started in HIM?   How did your HIM career evolve over time?

I first read about HIM in a college catalog from Carroll College in Helena, MT in the early 1980s.  They offered a BA degree in what was then called Medical Records Administration.  I was in high school and this sounded very appealing to me since I was interested in the health/medical field but didn’t want to do patient care.  I graduated from the Carroll program and passed the test to obtain an RRA (registered records administrator), which eventually transitioned to the RHIA credential.  My first job was Assistant Director of Medical Records.

How have your HIM education/training/credentials benefited you in your career? 

I started out with the RHIA credential, which helped me get my first job in HIM after graduating from college.  As I developed an interest in coding, I obtained a CCS from AHIMA as well as an additional Home Health coding credential from another organization.  These credentials demonstrated that I had the skills and knowledge required to work as a coding professional when opportunities arose.  My HIM credentials have also allowed me to earn a higher salary over the course of my career.

What are three of the biggest changes to HIM that you have seen during your career?

A lot has happened since 1985!

  • The evolution of the EMR
  • The expansion of the prospective payment system
  • The many specialty credentials now available through AHIMA
  • The transition from ICD-9-CM to ICD-10-CM and ICD-10-PCS.

Sorry, I know that’s 4!

What most excites/interests you about the HIM field?

The importance and scope of our work.  Accurate, complete, secure health information that is available to those who need it is critical to patient care, accurate reimbursement, and research, to name a few uses.  I also really enjoy reading about the advancements in medicine such as new drugs, treatments, and technology through my work as a coder.

What prompted your interest in joining WSHIMA?  What do you see as the value in participating in a professional association?

My initial interest as a young professional was to get to know others in HIM since I was a new resident of the State of Washington.  WSHIMA has since provided resources and support regarding pertinent HIM issues such as legislation changes, updates in the industry, and continuing education opportunities.

What advice do you have for people just starting out their careers in HIM?

There are so many opportunities in HIM!  Find an area that interests you and consider obtaining an additional credential.  Attend HIM association meetings/conventions at the local and national level whenever possible to meet other HIM professionals, gain knowledge, expand your horizons, and have fun!  Also, be a lifelong learner and embrace continuing education.

Anything else you would like to share?  Future plans? 

HIM is an excellent field.  I have had many varied experiences and opportunities in my 36 years of working in HIM.  I now work in the field of Home Health coding and plan to continue working in this area, since new opportunities continue to become available.   I work with a great team and learn something new every day.

Rhona Moses, RHIA, CCS-P


Meet Long-Time WSHIMA Member Rhona Moses, RHIA, CCS-P

Rhona Moses has been a WSHIMA member for over 38 years.  We recently interviewed Rhona to find out more about her HIM career and her perspective on industry changes over the years. Here is a summary of Rhona’s responses to our interview questions.

Tell me about your professional background – how did you get started in HIM?   How did your HIM career evolve over time?

My first HIM job was as a medical transcriptionist in a large multispecialty clinic.  To qualify for that position, I completed a 9-month Medical Transcription course in a local business college.  I had always been interested in medicine, and this was a good first step for me after high school.  Later I took an on-call transcription position in the local hospital, which opened my eyes to many more HIM opportunities, including management.  This was when I made the decision to pursue a bachelor’s degree in HIM.

How have your HIM education/training/credentials benefited you in your career?

Education gave me the fundamental HIM knowledge, and credentials opened the door to a wide variety of work opportunities.  In addition to transcription, I’ve worked in a hospital medical records department doing everything from record filing and retrieval to release of information.  While working at this hospital, I was also going to school, and because I had just completed my Anatomy & Physiology course, I was offered an opportunity to learn hospital coding, which has served me well over the years.  After I completed college and got my RHIA (in those days it was called RRA), I was able to apply for my first supervisory position.  From there I’ve been fortunate to work in a variety of HIM management capacities.

What are three of the biggest changes to HIM that you have seen during your career?

The first was with DRGs and the change in reimbursement methodologies.  While this brought attention to the importance of coding, it also brought heightened responsibility to assure coding met the highest standards.

The second change was with electronic medical records – first with the very slow pace of adoption, then with managing patient records in systems that were not designed by HIM professionals.

And finally, compliance requirements have had a huge impact on coding, privacy and security, and have now expanded to health information exchange (HIE).

What most excites/interests you about the HIM field?

HIM offers so many different opportunities, and one can choose to specialize based on your own interests and aptitudes.  It is also gratifying to be part of a larger purpose, and to make a positive contribution to patient care.

What prompted your interest in joining WSHIMA?  What do you see as the value in participating in a professional association?

Staying connected to my professional community has been invaluable over the years, and WSHIMA made that possible.

What advice do you have for people just starting out their careers in HIM?

The biggest challenges are not in finding technical solutions to HIM problems but are in bringing people together for a common cause.  My advice is to learn how to collaborate and recognize that the best successes are usually achieved when working as a team.

Anything else you would like to share?  Future plans?

I am now retired, and the one regret I have is that I did not keep a work diary.  I would love to look back on some of my early experiences and colleagues with a clearer memory.   Thank you for the opportunity to share.

Katrina Ludington, RHIT, CCS

Meet Long-Time WSHIMA Member Katrina Ludington, RHIT, CCS

Katrina Ludington has been a WSHIMA member for over 40 years.  She currently works as a Team Lead inpatient/outpatient (IP/OP) auditor primarily working with overseas coders.  We recently interviewed Katrina to find out more about her HIM career and her perspective on industry changes over the years.

Here is a summary of Katrina’s responses to our interview questions.

Tell us about your professional background – how did you get started in HIM?   How did your HIM career evolve over time?

A career in Health Information Management (HIM) was not my first choice, but ultimately it has been the best fit for me.  My early focus was on becoming a Registered Nurse, and the preparation for this included Medical Assistant training in my senior year of high school, and working as a Medical Transcriptionist while attending my local community college nursing program.  My change of career path occurred when I married in 1976 and my husband was transferred by the Coast Guard to Kodiak, Alaska.  I had to withdraw from the nursing program after 1-1/2 quarters of being a nursing student, which included performing patient care in acute care hospitals.  These years of learning and experience provided a very strong clinical background which has been very beneficial to my career in HIM.

With my experience in Medical Transcription, I was hired in the Medical Records department at the only hospital in Kodiak, Alaska – at that time it was a 25-bed hospital with 12 bassinets.  The supervisor of the department was an A.R.T. and she told me about the AMRA Correspondence Course for Medical Record personnel.  This consisted of 25 modules and was later known as the Independent Study Program for HIM.  It was a requirement at the time that to be enrolled, a person had to be working in the Medical Records Department and be supervised by someone with AMRA credentials.  When I completed the course, I was able to take the ART credential exam before moving back to Seattle.

I was hired at Providence Medical Center in Seattle in June 1980 as an acute care inpatient coder.  I worked there until 1991 and then moved to Highline Medical Center which was closer to my home.  I worked at Highline until 2001 when I took a break for a few years due to health reasons.  When I left Highline, I was the Coding Supervisor for our small department.

I went back to work again part-time in 2007, again coding for Highline Medical Center until 2010.  This is when I started my current HIM auditing career and working remotely from home.  I was able to travel to work sites in Hawaii for several years until their systems became 100% electronic.

I currently work full time as a Team Lead inpatient/outpatient (IP/OP) auditor primarily working with overseas coders.  Assisting coders with Quality Appeals is my main focus, along with helping to provide education.  Working with overseas coders, from India and the Philippines primarily, has been a very interesting experience.  I first began to audit overseas coders through a former employer, prior to ICD-10-CM implementation and was really surprised at the DRG accuracy.  My current employer used a mix of domestic and overseas coders for several years and had just transitioned to 100% global just prior to the time I was hired in 2017.  The team I work with is dedicated to supporting these coders and facilitating between them and the HIM departments of the hospitals in our system.

The challenges, of course, are language and comprehension at times, I would say on both sides!  We have weekly meetings with each vendor team and it takes a while to get used to the accents and speed of talking.  The benefits have been having a chance to teach and educate coders who are very receptive and appreciative, as well as learning from their members in some instances.  Some of their coders come from a clinical background such as nursing, pharmacy, physicians, and other healthcare-related fields, so this is a nice contribution to the team.

How did your HIM education/training/credentials benefit you in your career?

The most beneficial HIM training and education was the work I was able to do in the Medical Records department in Kodiak, AK.  This was an A-Z experience in what it takes to admit a patient to the hospital, process all documents related to the medical records, and all steps involved until the record was filed.  This included helping to admit patients, transcribe physician dictation, analyze for deficiencies, code records and add diagnoses to index cards, as well as taking Medical Staff minutes and transcribing autopsies.  I also typed up official birth certificates and obtained newborn footprints for the hospital’s unofficial birth certificates.  When the hospital opened a 19-bed SNF facility, I was able to learn and work with long term care records.  The down side of this was that when I started coding in 1980, the work was so monotonous that I was starting to look around for other options.  My credentials led to the job at Providence and soon after DRGs came on the scene, and I was hooked by the challenges this presented!

What are three of the biggest changes to HIM that you saw during your career? 

  1. The creation of DRGs, including linking the diagnoses and procedures reported to payment.   This raised the importance of HIM to hospital administrations and opened the door for standalone groupers and then to the encoding software.  Optimization of DRGs became my specialty and a 6-week trial of auditing DRGs and tracking the potential increase in reimbursement led to approval for encoders for all coders within a month.
  2. Computerization of all HIM processes and data quality improvement measures.
  3. HIPAA and other regulation changes.

What prompted your interest in joining WSHIMA?  What do you see as the value in participating in a professional association?

I wanted to stay informed of the current issues, meet others working in the same field, and gain continuing education (CE) credits while having some fun!  Teamwork is needed to keep HIM departments running smoothly – and the professional associations are another form of teamwork to help improve HIM in our state and contribute to the nationwide quality of HIM as well.

What advice do you have for people just starting out their careers in HIM? 

Don’t be afraid to try the different opportunities available in the HIM field.  There are so many more now than when I started in 1978.  Find a comfortable place to start and be willing to branch out when something new in the field catches your interest.  Go to meetings and meet your peers – this can lead to open doors you might not have imagined!

What are your future plans?

I’m very content in my current position, and my goal is to continue contributing to my team and retire in the next 10 years.   Most likely I will continue working on a limited part-time basis after I retire from full-time work.

Suzanne Gunn, RHIT, CCDS, CCS

Meet Long-Time WSHIMA Member Suzanne Gunn, RHIT, CCDS, CCS

Suzanne Gunn has been a WSHIMA member for over 43 years.  She currently works as an inpatient coding auditor verifying MS-DRGs and APRDRGs.  We recently interviewed Suzanne to find out more about her HIM career and her perspective on industry changes over the years.

Here is a summary of Suzanne’s responses to our interview questions.

Tell us about your professional background – how did you get started in HIM?   How did your HIM career evolve over time?

I began my career in 1978 as a coder working with ICD-8 and handwritten paper abstracts to collect health data.  Over time, my career evolved from an in-house coder to a contract coder, inpatient coding auditor, and eventually a CDI liaison; and I made the transition from ICD-9-CM to ICD-10-CM/PCS. I presently hold a position in auditing, emphasizing ICD10CM education with recognition from AHIMA as an ICD-10-CM/PCS Trainer.  Based on my work, the greatest need for ICD-10-CM education is in understanding disease processes and PCS rules for approach and body part characters.

How did your HIM education/training/credentials benefit you in your career?

I learned coding by taking the coding course offered by AHIMA or American Medical Records Association (AMRA) back in the day.  Then, I followed up with Leah Davidson’s classes at East Los Angeles College. My practicum was at Stanford University Medical Center, UCLA Health, and Long Beach Memorial Hospital.

In the 1970s, the HIM credentials did not hold clout.  It wasn’t until 1984 when DRGs were introduced, that HIM coding became a focus of interest in the hospital.  It wasn’t until the early 90s coding compliance auditing became fashionable.  Mostly, DRG compliance audits were the order of the day. The demand for coding credentials took hold, and eventually, I acquired the Certified Coding Specialist (CCS) and Certified Clinical Documentation Specialist (CCDS) to augment my knowledge and skill set for auditing and education.

What are three of the biggest changes to HIM that you saw during your career?

The three most significant HIM changes in the past 43 years of my experience are the emphasis on data collection, the protection of the health record, automation of health data, and computer-assisted coding.   Along with this, the security of electronic health data took hold.  There was a time medical records were open for all to see.  Medical records would end up in the trunks of cars of physicians who would hoard the documents for their needs.  Records would disappear for weeks.  Medical record departments would be open, unattended…can you imagine that happening today?

What prompted your interest in joining WSHIMA?  What do you see as the value in participating in a professional association?

I joined WSHIMA when I moved to Washington in 2013.  I bought my home in Shelton.  WSHIMA offers many opportunities for education at reasonable fees.

What advice do you have for people just starting out their careers in HIM?

Health Information Management is a dynamic profession with so many specialties.  Choose carefully. Research your options.  There is something for everyone—coding in particular demands clinical training.  If a person wishes to pursue disease classification, do not obtain training in medical billing vocational programs.  These sell you short.  You will end up a biller and not an HIM data abstractor/coder of health information.  Creating patient data sets extends far beyond sending the codes to billing.  The data sets land in local reporting agencies, state agencies, CMS, CDC…the WHO. The best training for coders is offered through AHIMA or the local community colleges with an HIM program.

What are your future plans?

I plan to continue to work for a few more years. I try to maintain balance in my life. I enjoy my dogs, playing my clarinet, flute, and oboe.  I did perform in an orchestra until the pandemic broke out.  I don’t know what the future holds for music performance.

Laura Grubb, RHIA

Meet Long-Time WSHIMA Member Laura Grubb, RHIA, Compliance Officer, Privacy Officer and Risk Manager.

We recently interviewed long-time WSHIMA member, Laura Grubb, to find out more about her career and perspective on HIM.  Here is a summary of Laura’s responses to our interview questions.

Tell us about your professional background – how did you get started in HIM?   How did your HIM career evolve over time?

I graduated from Tacoma Community College (TCC) and obtained RHIT certification in 1980. I also graduated from the College of St. Scholastica with a Bachelor of Science degree in Health Information Administration in 1987. And I am a graduate of the 24-week risk management course put on by the Risk Management & Patient Safety Institute.    I am an active member of the American Health Information Management Association, Washington State Health Information Management Association, Healthcare Compliance Association, and Washington Health Services.   I am and have been serving for several years on the Tacoma Community College (TCC) Health Information Management BAS Program Board and I lead the Rural Collaborative Compliance Committee.

I was hired for my first job while I was still attending TCC.  It was at Good Samaritan Hospital, Puyallup, WA.  I was there from 1980 – 1990.  I started as a chart abstractor – then a coder – then the assistant director.  Around 1984, I determined it was time to further my career by returning to college to earn a BS in Health Administration.  St. Scholastica had a program for working RHITs, a progression program. In this program you attended local colleges for general subjects and went to the St. Scholastica campus each June for focused Medical Record/Health Information Management learning. Therefore, I continued to work full time at Good Samaritan Hospital, and they were gracious by allowing me to attend college and university classes (mostly in the evening).      This program was the first of its kind in 1984 as remote or distant learning was a new concept.  After graduating from St. Scholastica and successfully receiving my RRA (now called RHIA), I began looking for a job opening as a Department Director.    In May 1990, I began my career at Mason Health. Mason Health is a Public Hospital District Critical Access Hospital with associated provider clinics.  Mason Health has grown over the years and now supports 7 specialties and 50+ providers. I have directed the HIM department at Mason Health for many years; the organization had a 24/7 operation for the first 20 years of my employment.   I continued to serve as the Director of Health Information Management & Privacy Officer until 2017.  I was then offered a new position as a Senior Leader and took my current position in 2018 as the Compliance Officer. Over the years in addition to the traditional role of HIM, I have directed Utilization Review, Regulatory Compliance, Privacy, Medical Staff Quality, CMS/DOH and TJC Surveys and District Risk Management.  I am currently responsible for the Compliance Program which includes corporate compliance, privacy, medical staff quality and risk management.

As leader of The Rural Collaborative Compliance Committee, I have the opportunity to connect with other facilities.  The Rural Collaborative is a group of 21 Hospital Systems – rural critical access hospitals and a few small hospitals.  We collaborate on many aspects of healthcare from contracting, policy writing, advocating, and dealing with the day-to-day activities.  The Committee meets formally every month.  However, we connect whenever there is a need.  The team addresses current compliance challenges like conflict of interest, new regulations, managing investigations, etc.  As leader, I set the agenda, lead the meeting, and assure the follow-up commitments are completed.  I also find guest speakers when the group is interested in learning more about a topic.  The most recent guest we hosted were the OIG, Fraud and Abuse Unit, HIPAA and How to manage contracts more effectively.  There are 25 members on The Rural Collaborative Compliance Committee as often the legal counsel will join us to participate on this team’s work.

How did your HIM education/training/credentials benefit you in your career?

With the BS in Health Information Administration, I was confident in my profession and able to understand and perform competently in my daily work.   This includes all of the ongoing education, training, collaboration that keeps my professional skills fine-tuned.  It was so invigorating when I was invited to help build a Bachelor of Science program at Tacoma Community College.  The teachers and students are amazing!  One more reason to be proud of our organization and profession!!

What are three of the biggest changes to HIM that you saw during your career?

I have seen a lot over the years.

  1. Shift to computerization. In the beginning, using computers and automation was very rare. In 1983, I was very pleased to be the first at Good Samaritan Hospital in the department to have a computer at my desk.  It was because DRGs were here and I was tasked with teaching this new system to the providers and staff, along with running the program that was on a special computer disk.  This was with the intent that a DRG could be entered on the bill.  Wow – how times have changed.  From paper charts and reading doctors’ handwriting in court, to patient portals, data mining, care coordination and filling the needs of a multitude of requestors, there has been lots of change.
  2. Change in the way we operate on a daily basis. In the beginning of my career there was a top-down model for management and this was very person-focused.  The provision of care was also top-down – the provider (MD, DO, etc.) was the driver and everyone followed their lead.  Today’s daily work is very focused on the team, process, or system. Everything is analyzed with these areas being the primary source of opportunity for improvement and collaboration.  The person is often influenced by the process.  This doesn’t mean that there is no personal accountability, but we start the work in a different way.  New tools – Lean, Baldrige, TJC and DNV, the list goes on and on.
  3. Transition to telehealth. I never dreamed early in my career that I would lead the implementation of a Telehealth Program. Telehealth in the 1980s would be only imagined in a science fiction action-adventure movie. At Mason Health, prior to COVID, we had a contract with a group of telehealth providers for the provision of care in the hospital.  They were focused on specialized services, like Acute Stroke Care and nocturnists (medical and pharmacists).  Telehealth in our clinic and outpatient areas was never approved for reimbursement; therefore, not even explored in our rural community.  With COVID, the need was there and fortunately, there was agreement that it should be a reimbursed service.  I formed a team, created my action plan, and we were off and running.  In the beginning, the team was meeting 2-3 times a week.  In less than two months, our team had the first version of clinic-based telehealth up and running for our patients.  Since then, we have continued to improve the program for our patients and providers. This work has allowed the telehealth program to remain sustainable and financially viable which should continue into the future.

What prompted your interest in joining WSHIMA?  What do you see as the value in participating in a professional association?

I have always been a member of AHIMA and the membership of the state association where I was working since graduating.  I find the annual meetings to be so informative with choices of topics.  I have always learned most from interaction with other professionals and value the resources and suggestions that come when visiting during our WSHIMA meetings.  One example was listening to a webinar recently on HIPAA that brought home some areas that need to be addressed in my local setting.  By making the educational component a priority, I was able to reflect on my clinic and do a self-assessment of changes that need to be made.

What advice do you have for people just starting out their careers in HIM?

HIM is well worth the effort!  There are so many opportunities this one career can offer to you.  Once you have the education, you can remain a generalist or specialize in an aspect of the career that really calls to you.  You can focus on different aspects of HIM over the years as your interests change.  There are so many opportunities and such great people to partner with!    Change should be expected, so do not be afraid of it…. Persevere!  Stay connected!  Stay engaged! And never stop learning.

What are your future plans?

I am looking forward to sitting for the Certified Healthcare Compliance (CHC) certification.  Although my career is nearing its sunset, I am still excited to be a part of the HIM profession and still believe I can add value for many years into the future!

Nancy Manolides, RHIT, CCA

Meet Long-Time WSHIMA Member Nancy Manolides, RHIT, CCA

Nancy Manolides has been a WSHIMA member for over 40 years.  She is currently a Coding/Clinical Documentation Specialist at Virginia Mason Medical Center.  We recently interviewed Nancy to find out more about her HIM career and her perspective on industry changes over the years. Here is a summary of Nancy’s responses to our interview questions.

Tell us about your professional background – how did you get started in HIM?   How did your HIM career evolve over time?

I got started in HIM in 1980 after completing the Medical Record Technician Program at Shoreline Community College.  I remember being interested in the medical or dental field but didn’t want to pursue nursing or dental hygiene (was worried about math and other requirements).  After looking through a catalog, I chose the Medical Record program, thinking it would be a good fit with my clerical and organizational skills.  At that time, you could finish with “Medical Secretary”, “Transcriptionist”, or the full two-year Technician program.  The Program Director really made the coursework fun and interesting! I started in 1977, finished spring of 1980, then obtained my Accredited Record Technician (ART) credential with AHIMA and began my first full time job at Overlake Hospital doing analysis and emergency department coding.  A year later I married, moved to the Bay Area in California, and worked in a small community hospital Medical Records department where my main duty was release of information, but I was also expected to help with coding backlog and other duties.  Then, after returning to Seattle in 1984, I worked as a part-time coder for Virginia Mason until 1986 when I had my second child.  I took a very long break from the field to raise my children and worked as a paraeducator for the Shoreline School District, but did maintain my credential knowing that I would eventually return to the field.  In 2004 I took ICD-9 and CPT coding courses offered on Saturdays at Bellevue Community College to refresh my skills, and then obtained the Certified Coding Associate (CCA) credential.  I returned to a coding job at Group Health in Redmond for two years, and then went back to Virginia Mason as a Coding/Clinical Documentation Specialist doing mostly inpatient coding.  I have now been here for 14 busy and challenging years.  I’ve also been able to transition to working from home, first for part of my time and now for all of it given COVID-19.  I do not miss commuting but did enjoy being in the hospital setting in Seattle for many years.

How did your HIM education/training/credentials benefit you in your career?

All of my education, credentials, and training have enabled me to continue learning and working in the HIM world of today.  My focus has been coding for the last few years, but I also enjoy reading and learning about other issues.  There have been so many opportunities through AHIMA, WSHIMA, and SHIMA to keep current and maintain my credential.  Most of this is done during work time, but I do enjoy going to an outside conference or workshop occasionally (especially the WSHIMA annual conferences which I have attended in both the Seattle area and Spokane).  They are a great opportunity to network, especially if new to the field.

What are three of the biggest changes to HIM that you saw during your career?

I would say that the three biggest changes are automation (computers were just coming about in our field when I started my career), the shift to DRG reimbursement instead of coding for classification/statistic purposes only, and the more specialized job duties in a hospital setting.  Also, being able to work remotely and the change from ICD-9-CM to ICD-10 coding (especially procedure coding).

What prompted your interest in joining WSHIMA?  What do you see as the value in participating in a professional association?

WSHIMA has always been the professional organization for me, offering many opportunities for continuing education, networking, and new career opportunities.

What advice do you have for people just starting out their careers in HIM?

My advice for people just starting out in HIM would be to stay connected with your peers, join the professional associations and continue learning!  Also, attend workshops, conferences, local meetings and be open to trying different jobs until you find the one that works for you!  Be willing to accept change, as things don’t stay the same in healthcare.

What are your future plans?

I’m approaching the end of my career, and can only say that HIM has been a great field of work for me.  When I retire next year, I hope to do more traveling, spend time with family (especially my grandchildren), and volunteer in my community.  However, I think I will always be interested in and connected to the medical field, especially with my son being an Anesthesiologist and other family members/friends working in healthcare.

Terri McDaniel, RHIT

Meet Long-Time WSHIMA Member Terri McDaniel, RHIT

Terri McDaniel is a long-time WSHIMA member having joined AHIMA in 1978.  She is currently the HIM Director at the Deaconess and Valley Hospitals in Spokane, part of the MultiCare Health System.  We recently interviewed Terri to find out more about her HIM career and her perspective on industry changes over the years. Here is a summary of Terri’s responses to our interview questions.

Tell us about your professional background – how did you get started in HIM?   How did your HIM career evolve over time?

I have three decades of HIM experience and AHIMA/WSHIMA membership. The Health Information Technology (HIT) program was introduced to me from a hometown family friend. I accepted a track scholarship with Spokane Community College and graduated from the HIT program there. With each new position/opportunity, I continually strive to say “yes” for more scope and responsibilities which serves me well.

My first RHIT position was with Division of Disabilities at Interlake School, Medical Lake, WA.  It was a facility for the severely/profoundly handicapped. This facility has since closed. I transcribed medical record dictation; completed release of information chart assembly/analysis and coding. I also supported the clinical teams by producing their individual plans of care for the residents.

Next, I accepted a coding position in an acute care hospital and then worked in the Deaconess Hospital Quality Department was as a Quality Coordinator where I supported various clinical departments by performing audits, statistical analysis of audit results, and performance improvement presentations.

Then, I moved into HIM management positions starting with Eastern State Hospital, a psychiatric facility, where I worked for a number of years as Manager of HIM helping with the design of their electronic medical record on a statewide task force.  I then moved back to acute care/hospital-based positions in HIM from 1991 to present, and currently work as HIM Director for Deaconess and Valley Hospitals, Spokane, WA.

How did your HIM education/training/credentials benefit you in your career?

The RHIT credential allowed me to apply for all my positions. I chose to keep a focus on family; coaching sports at club levels for many years while learning our profession. I relied on increasing knowledge on the job and self-study to prepare me for future positions. Although I didn’t pursue further higher education in the field, I was fortunate to be chosen for numerous leadership positions based on experience and reputation. I’ve held management level positions for over 20 years to include HIM Director, Privacy Officer and interim Compliance Officer.

What are three of the biggest changes to HIM that you saw during your career?

The encoder for coding and the increasing functionality of computerized assisted coding (CAC); Health Insurance Portability and Accountability Act (HIPAA); and a fully integrated electronic health record (EHR) as well as the pursuit of interoperability

What prompted your interest in joining WSHIMA?  What do you see as the value in participating in a professional association?

My first professional mentor Gwen Hughes, RHIA, CHPS, introduced me to the value of being part of our professional community. I served in numerous positions on the WSHIMA board over the years. AHIMA/WSHIMA membership supports my educational needs, is a tremendous professional resource, and furthers our patient’s need for advocacy at the state and national levels in all things health information-related. We are all “the patient” at some time in our lives.

What advice do you have for people just starting out their careers in HIM?

Explore what excites you personally and professionally. In my experience, a healthy life balance becomes more and more important over time. I love this quote to share and remember:

“We have these reservoirs of untapped potential inside of us to achieve extraordinary things” – Colin O’ Brady

Go find your extraordinary!

Stacey Stagg, RHIT, CCS

Meet Long-Time WSHIMA Member Stacey Stagg, RHIT, CCS

Stacey Stagg is a long-time WSHIMA member having joined AHIMA in 1978.  We recently interviewed Stacey to find out more about her HIM career and her perspective on industry changes over the years. Here is a summary of Stacey’s responses to our interview questions.

Tell me about your professional background – How did you get started in HIM?  How did your HIM career evolve over time?

I got started in HIM thanks to my Mom who was a nurse in Seattle.  She noticed a job opening in HIM and thought it sounded like something I would like.   I was always interested in the sciences and admired the nursing profession, but knew that hands-on patient care was not for me.   I started the HIM program at Shoreline in the mid 70s and started my first job at Stevens Hospital in Edmonds (now Swedish Edmonds) in 1978.  I had completed my directed practice at Stevens and they offered me a job upon graduation, which I gladly accepted.  I spent over 20 years at Stevens and specialized in coding, which is also my current area of expertise.  I started my own coding consulting company, Opticode, in 1998 and have worked with clients in the local area since then.

What prompted your interest in starting your own coding consultant company?

We used consultants to help with both coding backlogs and auditing while I was employed at Stevens. I realized this was something that I was interested in doing myself.  I started out with just one client but quickly expanded to several clients in the area within a couple of years.  This was before remote coding was an option. I enjoyed the variety of work and meeting and working with many coders in the greater Seattle area and eventually the state and beyond.  My work includes coding, auditing and training.  Working with the coding staff and providing educational opportunities is definitely the favorite part of my job.

How did your HIM education/training/credentials benefit you in your career?

My HIM education, continued training, and maintaining my credentials has been very beneficial to my career.   I have maintained my CCS in addition to my RHIT and believe that continuing education is the cornerstone to maintaining my ability to pursue my career as a coding consultant.

What are three of the biggest changes to HIM that you saw during your career?

The biggest changes to HIM during my career were as follows:

  1. DRG’s!  I started my coding career before DRGs.  Coding was primarily for collecting and maintaining data for research.   We were often behind by several weeks but there was no pressure since the billing was not impacted by our backlog.
  2. Encoders and the electronic medical record.   We used to record our codes on the paper record face sheet using our coding books to look up the codes.  The advantage was knowing how to use the index, but the rules and codes were much simpler in those days.   We also didn’t have Coding Clinic until the mid-80s.   I do feel fortunate to have experienced all these changes and to gradually build upon my knowledge and the complexity of coding as it has evolved over the years.
  3. ICD-10-CM and ICD-10-PCS.   A challenge to learn but definitely an improvement in the classification system.   I enjoy the level of detail and need for knowledge of anatomy and physiology and the disease process.  This keeps me interested in HIM and the coding profession.  So much to learn.

What prompted your interest in joining WSHIMA? What do you see as the value in participating in a professional association? 

I enjoy the contact with others in the profession through WSHIMA.  The continuing education opportunities are invaluable in maintaining a level of expertise required to stay current in our profession.

What advice to you have for people just starting out their careers in HIM?

I believe you must have a passion for your chosen career path.  Choose the area of HIM that appeals to you the most and make it your priority to continue to grow and learn.   This may include continuing education opportunities as well as learning from others in the profession with more experience.  The key is to keep challenging yourself.

Anything else you would like to share? Future plans?

I am at “retirement age” but plan on working at least several more years.   I feel very fortunate to have the flexibility to work remotely and part-time. I love my profession and continue to learn and feel challenged.

A BIG thank you to Stacey for sharing more about her background and experience!