Case studies give HIM knowledge a real-life test

Book offers quantitative cases, too

The call came one afternoon from the incomplete chart area. A physician was demanding to see the person who had coded one of his charts. "Dr. Mitchell is furious with these codes," the caller said. "He doesn’t want a complication code as a principal diagnosis. Get over here!"

The 20-year-old coder thought she had mastered much of the coding process, but nothing she had learned in school had prepared her for handling an irate physician.

Hard to prepare for all scenarios

"None of your didactic training in coding prepares you for these kinds of situations," says Susan Pritchard Bailey, MBA, RHIA, a consultant with Bailey & Associates in Lenox, MA. That’s why Bailey wrote a book about case studies in health information management (HIM), so students could apply their practical knowledge to real-life situations, she explains.

"The case method takes practice, but it develops an interesting bond between the instructor and students, and students and other students," she says. "It is a different teaching method that allows everyone to relax and talk and discuss how they feel about things and how they would approach problems. It also pulls in a little psychology."

This kind of discussion can spice up a teaching format that includes lectures and multiple-choice tests. "A lot of our HIM material is geared that way because the certifying exams are multiple choice."

The American Health Information Management Association (AHIMA) in Chicago advocates the use of case studies in the classroom, says Bob Garrie, MPA, RHIA, AHIMA’s director of education and accreditation. "They provide a way to do problem solving and critical thinking. They also provide students an avenue of taking all the pieces and formulating ways to solve health information problems."

Bailey used other books about case studies while on the faculty of Ithaca (NY) College. These books, however, were usually oriented toward for-profit corporations. "There wasn’t really anything relevant to HIM."

To fill a perceived void in HIM education, Bailey collected her own case studies in a book and added worksheets and an instructor’s guide. The book, Problems and Cases in Health Information Management, was published in 1997. (For a look at one of the cases in the book, see p. 46.)

The book includes 13 case studies, although the first case is broken down into four smaller cases. "This gets students used to the case method," she says. "Many instructors have never used or been exposed to the case method. I wanted to start with something small so instructors could begin to work with their students."

The cases involve practical application of the student’s knowledge of health information science, logical thinking, mathematical ability, and common sense. Most of the cases involve decision making at the frontline supervisor level or above.

Bailey chose the topics of her cases through her teaching experience. As one focus, she chose quantitative measurements. Exercises in quantitative measurement aren’t prevalent in HIM, she says. "Sometimes as a supervisor or manager you have to get out your calculator and do some math."

In the book, for example, the student has to evaluate quality management in the transcription unit. "It’s a fairly simple case for someone who has been a transcription supervisor, but not for a student," she says.