Donna Barnard has been working in the HIM field for 37 years and contributes her multi-faceted HIM career path to “being in the right place at the right time and finding the right thing I enjoy doing.” Currently, she is the Director of Health Information Management/Utilization Management at University of Rochester Medical Center (URMC) where she will be celebrating her 25th anniversary next May. During her tenure at URMC she has witnessed the transformation of the HIM Department from paper to electronic processes.
Donna knew she liked healthcare, but she knew she did not want to be a nurse, or go to medical school, or be a radiologist, or even a pharmacist. She decided to register for the Medical Assistant program at SUNY Alfred. Luckily, at the time, the coursework in her freshman year paralleled the Medical Records Technology program. When she took the “Medical Records Science I” course, she identified quickly “this is what I was looking for.” So, without missing a beat, she switched to the Medical Records Technology program and graduated 2 years later. Still hungry for more, Donna wanted to continue her education. Following a tip from her advisor, she visited The Ohio State University where a former Alfred professor taught in the HIM program. She loved the school and transferred out to Ohio State where she completed her 4 year HIM degree in 1985. In addition to her RHIT and RHIA certifications, Donna added more credentials to her name. She earned her MBA degree from St. John Fisher College in 1991 and her Certified Healthcare Financial Professional (CHFP) certificate from the Healthcare Financial Management Association (HFMA) in 2017.
Donna landed her first job after graduation at the Healthcare Association of New York State (HANYS) in Albany. She worked with a group of people developing and implementing software for submitting data to SPARCS and DRG Encoder Grouper Software for HIM Departments throughout the state. During that timeframe she also did some backlog coding for hospitals, including Rochester General Hospital (RGH). She traveled back and forth for several months when she saw a posting at Rochester General for an HIM Assistant Director position. She applied and got the position. About a year later the director of HIM left and she had the opportunity to become director. Being under 25 at the time, Donna challenged her senior leaders and said to them, “Look, what harm will it do? You put me in this position and if I do well, great, if I don’t do well, you can move me back to assistant director and hire a director.” Well, she did do well and was the Director of HIM at RGH from 1987 to 1998. She also took on the additional responsibility of creating a financial counseling team to manage the prior authorizations that were required in the late 1990s.
When an opening for Director of HIM at another Rochester hospital became available in 1998, Donna went back and forth whether to apply for the position. Ultimately, she decided to apply and became the Director of HIM at Strong Memorial Hospital, a position she holds today. “It’s been good. I’ve had great opportunity to grow since I’ve been here.” Yes, indeed, originally hired as HIM Director for Strong Memorial Hospital, Donna’s role expanded as URMC acquired more hospitals and other healthcare facilities. “So, today we are the centralized UR Medicine HIM Department for all six affiliate acute care hospitals.” The six hospitals include Strong Memorial and Highland in Rochester, Thompson Health in Canandaigua, Noyes in Dansville, St. James in Hornell, and Jones Memorial in Wellsville. “This is about a year’s old data, but just to give you an idea, we are 1391 licensed beds, 68,410 discharges a year for the 6 hospitals, 222,000 ED visits, 144,000 urgent care visits, and about 45,000 ambulatory surgeries. So, we’re pretty busy.” Under Donna’s umbrella there are about 170 HIM employees who include coders, data integrity, Release of Information (ROI), Scanning, and SER and EMP teams. The SER and EMP teams set up and manage all EPIC users. Most of the HIM employees work remotely, with the exception of some members of the ROI team and most of the scanning team because they still touch paper.
Healthcare, in general, is always growing and moving forward. “When I first started, patients coming in for tonsillectomies and appendectomies were inpatient and they haven’t been inpatient for years and even bypass surgery used to be 10 days, now they’re out in 2 to 3 days.” The cumbersome process of managing paper medical records is now behind us. “We had 2 to 3 staff members that all they did was deliver charts throughout the organization all day long. We asked them to wear pedometers for a day to track their steps and they got 8 to 10 miles a day just taking records from the medical record room to various clinics and areas in the hospital.”
Donna wants to ensure her team stays current with technology. “I want to stay progressive and current and not become that old, back on the shelf leader that’s not staying progressive and current with what we are doing. To be progressive keeps you always thinking to assure we are staying current and relevant with information we are providing to those who use the electronic medical record and being ready to make that information available and accessible in a way that’s relevant to the healthcare provider.”
One of the greatest professional challenges for Donna has been the significant transition of the HIM department from what used to be a paper dominant, non-technical process, to a 100% electronic system and be able to operationalize all that work. “It’s been a good challenge and it’s been an exciting one. We’ve been able to transition staff from a historical HIM department into a more modern electronic medical record department and we’ve done it successfully six times.” Donna is most proud of the fact her team made the transition from paper to electronic without having to lay anyone off and to make sure everyone had a place to land. “We’ve done it successfully with bringing the team and the staff with us. There was training. There was education. There was ‘but I’ve always done it this way. Yep, but now we’re going to do it this way’ and working with teams to get them to that point.”
HIM is a rewarding career full of a variety of career options. Donna wants to spread the word about this high in-demand field to anyone who is interested in working in healthcare but not in direct patient care. “The more we can talk to people and explain what we do, the better chance of us recruiting more into our field. There are a lot of people out there who are interested in healthcare but they don’t want to touch the patient. So, we can say, “Here’s a great opportunity, you can work in a profession that has you working with clinical information and having the knowledge of it but you’re not in direct contact with patients.” She encourages students and HIM professionals to continue to grow and learn once you are working in the field. “See what else is out there. Add more to what you got. There are so many opportunities to grow in this field and it’s really just communicating to your manager by asking what is next and how do I keep growing and how do I expand my knowledge and keep it fresh and exciting?”
Donna moved back to the Rochester area in 1987. “It’s nice to be able to come home and raise a family and have job opportunities to grow without having to move myself and my family to do that.” She originally grew up in a small town between Buffalo and Rochester. “My husband likes to tell people I did 18 in Attica.” In her spare time Donna loves being outdoors. “Anything outside I’m happy with whether it’s hiking, snowshoeing , walking with friends, gardening, kayaking, paddle boarding; if it’s outside, I’m good.”
From the beginning of her college education and throughout her HIM career, Donna felt she was in the right place at the right time. She was in the right place at the right time to help her teams navigate through changes in HIM rules and regulations and ultimately through the conversion from paper to electronic processes. Donna did find the thing she enjoys doing. “I like figuring out with teams how to get the work done most efficiently, most accurately, most timely, and to make sure we are taking care of our patients and love doing it without ever having to put my hands on a patient.” She also loves the sense of security that comes with working in healthcare. “There will always be job opportunities.” But, the one thing Donna has come to really appreciate about working in HIM is the people. “It has been so much fun. Some of my best friends are HIMers. I’ve met a number of people locally and nationally by being involved in our HIM volunteer organizations. It’s the friendships and the camaraderie that comes with it that is most rewarding.” HIM truly has been a fulfilling career for her.
Carol Manfreda, RHIT
