Medical Records and Health Information Technicians
Employment is expected to grow much faster than average.
Job prospects should be very good; technicians with a strong
background in medical coding will be in particularly high demand.
Entrants usually have an associate degree; courses include
anatomy, physiology, medical terminology, statistics, and computer
This is one of the few health occupations in which there is
little or no direct contact with patients.
Nature of the Work
Every time a patient receives health care, a record is maintained
of the observations, medical or surgical interventions, and treatment
outcomes. This record includes information that the patient provides
concerning his or her symptoms and medical history, the results
of examinations, reports of x rays and laboratory tests, diagnoses,
and treatment plans. Medical records and health information technicians
organize and evaluate these records for completeness and accuracy.
Technicians assemble patients’ health information. They make
sure that patients’ initial medical charts are complete, that
all forms are completed and properly identified and signed, and
that all necessary information is in the computer. They regularly
communicate with physicians and other health care professionals
to clarify diagnoses or to obtain additional information.
Some medical records and health information technicians specialize
in coding patients’ medical information for insurance purposes.
Technicians who specialize in coding are called health information
coders, medical record coders, coder/abstractors,
or coding specialists. These technicians assign a code
to each diagnosis and procedure. They consult classification manuals
and also rely on their knowledge of disease processes. Technicians
then use computer software to assign the patient to one of several
hundred “diagnosis-related groups,” or DRGs. The DRG determines
the amount for which the hospital will be reimbursed if the patient
is covered by Medicare or other insurance programs using the DRG
system. In addition to the DRG system, coders use other coding
systems, such as those geared toward ambulatory settings or long-term
Some technicians also use computer programs to tabulate and analyze
data to improve patient care, control costs, provide documentation
for use in legal actions, respond to surveys, or use in research
studies. For example, cancer (or tumor) registrars maintain
facility, regional, and national databases of cancer patients.
Registrars review patient records and pathology reports, assign
codes for the diagnosis and treatment of different cancers and
selected benign tumors. Registrars conduct annual followups on
all patients in the registry to track their treatment, survival,
and recovery. Physicians and public health organizations then
use this information to calculate survivor rates and success rates
of various types of treatment, locate geographic areas with high
incidences of certain cancers, and identify potential participants
for clinical drug trials. Cancer registry data also is used by
public health officials to target areas for the allocation of
resources to provide intervention and screening.
Medical records and health information technicians’ duties vary
with the size of the facility where they work. In large to medium-sized
facilities, technicians might specialize in one aspect of health
information or might supervise health information clerks and transcriptionists
while amedical records and health information administratormanages the department. In small facilities, a credentialed
medical records and health information technician sometimes manages
Medical records and health information technicians usually work
a 40-hour week. Some overtime may be required. In hospitals—where
health information departments often are open 24 hours a day,
7 days a week—technicians may work day, evening, and night shifts.
Medical records and health information technicians work in pleasant
and comfortable offices. This is one of the few health occupations
in which there is little or no direct contact with patients. Because
accuracy is essential in their jobs, technicians must pay close
attention to detail. Technicians who work at computer monitors
for prolonged periods must guard against eyestrain and muscle
Training, Other Qualifications, and Advancement
Medical records and health information technicians entering the
field usually have an associate degree from a community or junior
college. In addition to general education, coursework includes
medical terminology, anatomy and physiology, legal aspects of
health information, coding and abstraction of data, statistics,
database management, quality improvement methods, and computer
science. Applicants can improve their chances of admission into
a program by taking biology, chemistry, health, and computer science
courses in high school.
Hospitals sometimes advance promising health information clerks
to jobs as medical records and health information technicians,
although this practice may be less common in the future. Advancement
usually requires 2 to 4 years of job experience and completion
of a hospital’s in-house training program.
Most employers prefer to hire Registered Health Information Technicians
(RHIT), who must pass a written examination offered by the American
Health Information Management Association (AHIMA). To take the
examination, a person must graduate from a 2-year associate degree
program accredited by the Commission on Accreditation for Health
Informatics and Information Management Education (CAHIIM). Technicians
trained in non-CAHIIM-accredited programs or trained on the job
are not eligible to take the examination. In 2005, CAHIIM accredited
184 programs for health information technicians.
Experienced medical records and health information technicians
usually advance in one of two ways—by specializing or managing.
Many senior technicians specialize in coding, particularly Medicare
coding, or in cancer registry. Most coding and registry skills
are learned on the job. Some schools offer certificates in coding
as part of the associate degree program for health information
technicians, although there are no formal degree programs in coding.
For cancer registry, there were 11 formal 2-year certificate programs
in 2005 approved by the National Cancer Registrars Association
(NCRA). Some schools and employers offer intensive 1- to 2-week
training programs in either coding or cancer registry. Once coders
and registrars gain some on-the-job experience, many choose to
become certified. Certifications in coding are available either
from AHIMA or from the American Academy of Professional Coders.
Certification in cancer registry is available from the NCRA.
In large medical records and health information departments,
experienced technicians may advance to section supervisor, overseeing
the work of the coding, correspondence, or discharge sections,
for example. Senior technicians with RHIT credentials may become
director or assistant director of a medical records and health
information department in a small facility. However, in larger
institutions, the director usually is an administrator with a
bachelor’s degree in medical records and health information administration.
Medical records and health information technicians held about
159,000 jobs in 2004. About 2 out of 5 jobs were in hospitals.
The rest were mostly in offices of physicians, nursing care facilities,
outpatient care centers, and home health care services. Insurance
firms that deal in health matters employ a small number of health
information technicians to tabulate and analyze health information.
Public health departments also hire technicians to supervise data
collection from health care institutions and to assist in research.
Job prospects should be very good. Employment of medical records
and health information technicians is expected to grow much faster
than average for all occupations through 2014 because of rapid
growth in the number of medical tests, treatments, and procedures
that will be increasingly scrutinized by health insurance companies,
regulators, courts, and consumers. Also, technicians will be needed
to enter patient information into computer databases to comply
with Federal legislation mandating the use of electronic patient
Although employment growth in hospitals will not keep pace with
growth in other health care industries, many new jobs will, nevertheless,
be created. The majority of new jobs is expected in offices of
physicians as a result of increasing demand for detailed records,
especially in large group practices. Rapid growth also is expected
in home health care services, outpatient care centers, and nursing
and residential care facilities. Additional job openings will
result from the need to replace technicians who retire or leave
the occupation permanently.
Technicians with a strong background in medical coding will be
in particularly high demand. Changing government regulations and
the growth of managed care have increased the amount of paperwork
involved in filing insurance claims. Additionally, health care
facilities are having difficulty attracting qualified workers,
primarily because of the lack of both formal training programs
and sufficient resources to provide on-the-job training for coders.
Job opportunities may be especially good for coders employed through
temporary help agencies or by professional services firms.
Some cancer registrars may have difficulty finding open positions
in their geographic area because of a limited number of registrars
employed by health care facilities and low job turnover. However,
when a position does become vacant, qualified cancer registrars
have excellent prospects because of the limited number of trained
registrars available for employment.
Median annual earnings of medical records and health information
technicians were $25,590 in 2004. The middle 50 percent earned
between $20,650 and $32,990. The lowest 10 percent earned less
than $17,720, and the highest 10 percent earned more than $41,760.
Median annual earnings in the industries employing the largest
numbers of medical records and health information technicians
in 2004 were as follows:
General medical and surgical hospitals
Nursing care facilities
Outpatient care centers
Offices of physicians
Medical records and health information technicians need a strong
clinical background to analyze the contents of medical records.
Other workers who need knowledge of medical terminology, anatomy,
and physiology but have little or no direct contact with patients
include medical secretaries and medical transcriptionists.
Sources of Additional Information
Information on careers in medical records and health information
technology, including a list of programs accredited by CAHIIM,
is available from:
American Health Information Management Association, 233 N.
Michigan Ave., Suite 2150, Chicago, IL 60601-5800. Internet:
Information on training and certification for medical coders
is available from:
American Academy of Professional Coders, P.O. Box 45855, Salt
Lake City, UT 84145-0855.
Information on a career as a cancer registrar is available from:
National Cancer Registrars Association, 1340 Braddock Pl.,
#203, Alexandria, VA 22314. Internet: http://www.ncra-usa.org/
Bureau of Labor Statistics, U.S. Department of Labor, Occupational
Outlook Handbook, 2006-07 Edition