In the medical field, numbers are everything.
In March, researchers at the Boston University School of Medicine estimated that one in six American women and one in 10 American men would develop Alzheimer’s disease later in life. Earlier that same month, the Centers for Disease Control in Atlanta estimated that one of four teenaged girls in the United States suffers from a sexually transmitted disease. It was also reported that 1.3 million people annually in Africa would be affected by heart disease during the next 20 years.
These are sobering statistics, certainly. But how, exactly, are such estimates and predictions generated? How can anybody know how many people worldwide died from cancer last year, or how many people in Asia succumbed to avian flu, or how many Americans are expected to contract West Nile virus in the coming mosquito season? Just who keeps track of all this stuff?
Many such statistics come from the World Health Organization, the CDC and other national and international health groups whose business it is to keep tabs on humanity’s war on disease. But these organizations are situated at one end of a large and complex health information system that makes it possible for countries like the United States to gather, maintain and interpret the data that backs up the kind of headline-grabbing statistics quoted above.
“We do have an international diagnosis system,” explained Margaret Skurka, program director for health information management (HIM) at Indiana University Northwest. “That is a universal system, the International Classification of Diseases. It’s like the Dewey Decimal System. The number for diabetes in the United States is the same number in Canada, Kenya and Switzerland.”
While the international codes for disease are the same, Skurka said, the methods, standards and efficacy of the information-gathering process varies substantially, especially in Third World countries. That’s why Skurka, who is president-elect of the International Federation of Health Records Organizations (IFHRO), is co-chair of a joint initiative with the WHO and the National Center for Health Statistics (NCHS) to improve and standardize training for medical coders across the globe.
“A significant focus of outreach of this project is … how are we reaching out and getting better data from underdeveloped countries?” Skurka said. “If you die in the United States, we do autopsies all the time to get a good cause of death. If you die in a Third World country, say in Africa, and you die in a village, there is a person from the Ministry of Health who literally goes and talks to a surviving family member … to gather data to take verbal autopsies, because that’s better than nothing.
“If people within the Ministry of Health know about coding and have the right books that have the right numbers in them, then, at least from those countries, we can have accurate data reported. Because anything is an improvement over no training and no accurate coded data,” she said.
Skurka is a Frankfort, Ill. resident who has taught at IU Northwest since 1977. In addition to her bachelor’s degree from the University of Illinois and her M.S. from Purdue Calumet, she is also certified as a Registered Health Information Administrator and as a Certified Coding Specialist. In 2000, Skurka served as president of the 54,000-member American Health Information Management Association.
In 2004, she was selected to represent the United States at IFHRO, and her term as president-elect of the international group will extend until 2010, when Skurka will begin a three-year stint as president. Her IFHRO duties have taken her to Tunisia, Korea, Japan, and Italy, among other locales, but for Skurka the exciting aspect of this work isn’t the travel but the chance to help make a difference in world health issues.
“We are on the data side of it,” she said. “If there is accurate data, then we can make better predictions and better recommendations. Is what we’re doing working? Are we improving life? Are we reducing incidents of disease? It’s really kind of an altruistic, big-picture goal. I’ve really been excited about this project, because I think that it will make a difference.”
Even in the United States, Skurka said, the health information field is worth getting excited about. The IU Northwest College of Health and Human Services’ popular HIM program, which offers students a coding certificate and an associate’s degree in health information technology, regularly fills its available slots.
IU Northwest students can complete a B.S. degree in Health Information Administration through a combination of traditional classes at IU Northwest and online classes offered through IUPUI in Indianapolis. The Northwest program recently received a $40,000 workforce-development grant to help fund upgrades to its educational software and online offerings. IU has one of only two HIM programs in the state of Indiana.
Because coders and registered health information technicians (RHITs) are in high demand at medical centers across the country, Skurka said, graduates who pass the national credentialing exam find good jobs.
“We’re interested in the person who thinks healthcare is interesting, and who wants to take those exact same courses in anatomy, physiology, pathology, and medical terminology … but then wants to combine that clinical side with the data side and come at it from a data-driven, informatics perspective, rather than from a patient-care, hands-on perspective,” she said. “This field is really the business side of healthcare.”