Anna Coote: public, private, corporate, and personal aspects of a Health Information Manager.
Knowledge workers (Beliefs, opinions and attitudes)
Knowledge workers (Practice)
|Publication:||Name: Health Information Management Journal Publisher: Health Information Management Association of Australia Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 Health Information Management Association of Australia Ltd. ISSN: 1833-3583|
|Issue:||Date: Feb, 2010 Source Volume: 39 Source Issue: 1|
|Topic:||Event Code: 200 Management dynamics Computer Subject: Information accessibility|
|Persons:||Named Person: Coote, Anna; Coote, Anna|
|Geographic:||Geographic Scope: Australia Geographic Code: 8AUST Australia|
Reading through previous professional profiles, I find that I fit
into the pattern of how most of us came to the health information
management profession: that is, through contact with a Health
Information Manager (HIM) who was enthusiastic about their job or their
studies, or with someone working closely with the profession (1).
After finishing my BA, majoring in French, at Macquarie University, I took a bus from Kathmandu to London, and thence to the grape harvest in the French Beaujolais district, where I worked as the bi-lingual telephonist for the International Centre for Research (IARC) in Lyons, France. This was my first contact with the health information management profession. Being a United Nations (UN) body, the IARC offered one of the few legal avenues for work for a young Aussie in the European Union (EU) back in the early 1970s, when work permits were only available to EU residents or their offspring. Employment in the IARC meant that I was working in an imaginary country called the UN where work permits were not required, and whence I could escape to French life outside work. One of the researchers there convinced me that I should study Medical Record Administration rather than Librarianship when I returned to Australia, which saw me doing an Associate Diploma in Medical Record Administration at Cumberland College, graduating in 1979.
My first job was in the historic stone cottage at the entrance to Gladesville Hospital, which housed the Medical Record Department. There I quickly learnt the joys of bed returns at a psychiatric hospital, which not only involved admissions and separations, but also all movements of patients by category, including transfer from voluntary to scheduled, between the different types of schedule, and so on. After 12 months at Gladesville, I moved up the road to the larger Rozelle Hospital, also a psychiatric hospital. I am proud to say that at that time I participated in the establishment of a group of people working in psychiatric hospitals who met quarterly to discuss problems in our specialised area. That group eventually became the Small and Private Hospitals Group, the only formal part of HIMAA (NSW branch) still functioning. At the same time I started some part-time teaching at Cumberland College, and occasionally I run into HIMs who remember sitting through my forms design and health statistics classes.
For the next 11 years I worked as a full-time lecturer at Cumberland College, which then became the School of Health Information Management at The University of Sydney. During that time I worked on the change of our qualification in NSW from Associate Diploma to Degree, and taught medical terminology, systems analysis and design, Health Information Systems and Australian Health Care Systems--this was in the days when we were expected to be able to teach whatever was required. At that time, the School of Medical Records was a collaborating body with the World Health Organization (WHO) and I had the time and energy (and no family constraints) to accept work as a consultant to WHO in the Western Pacific Region. In this capacity I worked in Brunei, The Federated States of Micronesia, Palau, Vanuatu, Malaysia, Papua New Guinea, and Nauru. Word seemed to have got out that I was competent, and later I worked in Samoa, Laos, Dubai, and Lebanon on World Bank and AusAID projects after I submitted my name to various databases of companies bidding for international projects.
Eleven years as a lecturer was probably too long, and I decided to become a part-time employee of the university, and undertake some consulting work in Australia. I had the good fortune to be approached by the Director of Nursing of a hospital that was preparing for accreditation--Could I help them in their preparations? I metaphorically crossed my fingers behind my back, and said--Yes, of course I could do that. Over the next few years I prepared 10 hospitals for successful accreditation status, and learnt an enormous amount about all departments of a hospital, from the Maintenance Department to the Operating Theatre.
I resigned from The University of Sydney and started the first health information management and coding company in Australia (you will have noted that the only subject that I didn't teach was coding!). The impetus for this was the decision by the then Commonwealth Minister for Health to move to casemix funding, and the decision that private hospitals be required to provide coded data to NSW Health. (At that time, private hospitals were not providing data to health funds or hospitals). It seemed to me that there would be a need for a company providing coders to private hospitals for as much, or as little, time as was required to code all of their discharges. In 1995, I changed the name of my company to Prime Care, and asked Peter Donnelly from Unistat to be my business mentor. Peter helped me to understand cash flow, held my hand as I made my first 'cold calls' to potential customers, and was an invaluable resource to a HIM dipping her toe into the waters of business.
I concluded that a coding company would need to be large enough to cover at least the eastern states of Australia to be financially successful, and so I invited Heather Grain to join me as a director of the company. Peter then became the third director, starting a business in records management that eventually broke away from the original company as it became very successful. Over the years, Prime Care employed 10 HIM/coding staff, with contracts in all states of Australia except South Australia, and in New Zealand. We also won a WHO contract in Fiji to teach ICD-10. I would like to acknowledge the role of people who worked for Prime Care, and who had the courage to take a full-time position with a fledgling company run by a Medical Records Administrator: Filippa, Joanne, Joan, Sandra, Suzanne, Vicki, Jill, Susan, Annemarie, Peter, Merril, Catherine and our long-suffering office manager, Robin. Without them my profile would be greatly reduced.
A couple of years into our partnership I noted that few if any hospitals in rural and regional Australia had the 3M Encoder (as it was called then), and I proposed to Heather and Peter that we develop an encoder. They endorsed my suggestion, and over the next year we developed the PrimeCoder. Our first step was to take our staff to dinner, and before dessert we asked them to brainstorm what they would like in an encoder--those were heady days! I think we managed to incorporate most of their 'wish list' into the PrimeCoder. We worked very hard on the PrimeCoder, and included our staff in its development, but unfortunately no one was interested in buying it, and we were unable to financially support further development and sales, so we regretfully shelved it. Recently, as a result of the introduction of SNOMED-CT, and the movement to the electronic collection of clinical (not administrative) data, Heather recognised an opportunity and resurrected and rebuilt the software to take advantage of its natural language processing capability, to develop a new generation product called the Smart Termer, which translates direct clinical text into ICD codes or SNOMED-CT and returns the result to the field appropriate to the data. I'm very proud that finally we are able to successfully take our software to the market so long after my initial suggestion.
This year, to my total amazement, I was approached with a request to sell the coding business of Prime Care. It did not take me long to see that this would create a much more interesting and broader-based company, and Heather and I agreed to sell the coding business to PH Prime Care, and to become directors of the new company PH Prime Care with Paul and Doug. At the time of writing, we have won the bid to undertake the NSW Health Clinical Coding 2009, for which I could never have considered bidding on my own. It is a marvelous feeling after 20 years to have support from others with financial and business expertise. The old Prime Care company has now been renamed Health EWords to reflect our concentration on the Smart Termer and other software.
These days when asked what I do, my first answer is Company Director--not something I ever envisaged as my future--and my second answer is Health Information Manager. My partner and I own a diesel pump and injector company, Gemini Diesel, of which I am a Director, I am a Director of PH Prime Care, a Director of Health EWords, and a Director on the HIMAA Board. All of these positions come with hefty responsibilities and challenges, which I really enjoy.
This request for my profile has been very timely, as so much is changing in my business and professional world. As I look back, I can see a lot of doors shutting behind me--no longer is the route from Kathmandu to London open, the Health Information Management Bachelors degree in NSW is gone (probably to be replaced by a Masters degree), and Commonwealth Scholarships and fee-free university degrees are no longer available. I was very lucky to have had these opportunities, and to have been in a situation where I was able to take them up. Hopefully, there will be more such opportunities before I finally become a grey nomad.
I cannot end a profile about myself, without also mentioning that I am a keen kayaker, I love body surfing, and that life is not worth living if I cannot 'go bush' every so often!
(1) Perhaps this should become one of the formal strategies for recruiting more students for health information management qualifications.
Anna Coote, BA, AssocDip MRA, DipEd, MHP
Managing Director and Health Information Manager
PH Prime Care Pty Ltd
92 Alpha Road
Willoughby NSW 2068
Member, HIMAA Board of Directors
Director, Gemini Diesel Pty Ltd
Director, Health EWords Pty Ltd
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