What was it like when you started as a HIM?
I started in Medical Records at Woden Valley Hospital (WVH) in Canberra on 7th June 1982 as the ‘Assistant Medical Record Administrator’ (temporary for 12 months). I was 20 years old and had only graduated as a Medical Record Administrator (MRA) six months before. I moved to Canberra from Sydney and into the staff residences in Building 6, the day before I started and I didn’t know a single soul in Canberra. On my first day, my new boss, Elaine Harris (who was lovely) introduced me to the staff saying ‘Jenny is our new Medical Record Administrator who will be replacing Julie while she is on maternity leave’. I was very young and timid and only looked about 15 so one staff member said, ‘but Julie was your 2IC! Is this little girl going to be the new second in charge? She doesn’t look old enough to have finished school yet!’. They all mothered me and took me under their wing but they were a wonderful team to work with and I learnt a lot (including TDF with middle digit colour coding). My main duties at that time were:
- ROI – actioning subpoenas for records
- clinical coding
Since then I’ve worn many hats within Medical Records at Woden Valley Hospital, Royal Canberra Hospital and Canberra Hospital, including Clinical Coder, Coding Manager, Deputy MRA, Forms Designer, Forms Manager, Research and Quality Manager, Project officer, CRIS Implementation Manager, Scanning Manager, Director and Senior Director.
Medical Record management at WVH was very different to Health Information Services at Canberra Health Service today. There were NO computers at all! There were no mobile phones, no email, no computerized PAS, no digital records, no scanned records, no barcoded forms and no barcoded patient labels!
The PMI cards and Workbox cards (for tracking incomplete records) were our bibles. We would work off the OP appointment and elective surgery booking lists to retrieve all the paper medical records in advance, manually track them out and send them to outpatients or the wards, ready for when the patients presented. We were pulling and refiling hundreds of records each week. On discharge we would add a new divider to the record for the latest admission and collate and assemble the new notes into the patient’s medical record folder and then file it in the doctors’ pigeon-holes for completion. The Doctors would then have to physically visit the Medical Record Department to sign the front sheet or complete their discharge summaries. We would then look up the diagnoses and procedures for each patient in the coding books, hand write the codes onto the coding data sheets and then send those to ACT Health for data entry. Scanning of medical records wasn’t introduced for another 12 years. The extent of our high-tech equipment in 1982 when I started was:
- An Electric typewriter (which we thought was pretty fancy at the time) to manually type the Patient Master Index (PMI) cards with details of each new patient and their Medical Record Number, which we allocated manually from a number register (which was just a large ledger/book with hand stamped consecutive numbers).
- An electric Card Veyor which was a massive machine with revolving shelves which held the 170,000 typed PMI cards. Royal Canberra hospital Medical Records had around 200,000 cards in their PMI. When a new patient presented anywhere in the hospital, that area would phone Medical Records and we would look up the patient in the PMI and read out the MRN, or if we couldn’t find them amongst our PMI cards, we would allocate a new number from the book and type up a new PMI card.
- An embossing machine that was used to produce red or blue plastic PINS card (like a credit card) with the patient details embossed on the cards that were then used to imprint the patient’s details onto their medical record forms and pathology request forms.
- A “mobile phone” was just a rotary dial desk phone with a really long curly cord!
What are some of your memories of your university years?
I moved to Strathfield in Sydney from Shoal Bay (which was a very small coastal town in 1980) when I was 17 to attended Cumberland College of Health Sciences at Lidcombe. The whole “catching trains” thing was completely new to me. So of course (and I think it might have been on my first day) I got on the WRONG train at Strathfield which took me on a different line. I was absolutely panic stricken, when I realised I was LOST in a big city!
I was still feeling pretty lost when I eventually made it to Cumberland College and Cherie Whitechurch saw me sitting on my own and invited me over to join her group with Jenny Cheeseman, Jenny Phillips, Wendy Drummond and a couple of others …and that was the start of some lifelong friendships.
That long walk from Lidcombe train station to Cumberland was a killer in summer when you had a bag full of text books as well as your Coding Books…and even worse in the rain.
I have fond memories of my Cumberland College days with those huge yellow outdoor chairs and the long rabbit warren corridors. Navigating your way around a new campus was challenging for us back them. I remember once when we opened a door that said “Exit” (trying desperately to find our way out of the building to get to the next class!) and accidently set off the security alarm! (oops…wrong door!…we didn’t ever do that again!). We were also blessed to have had some legends in the HIM field as our lecturers including the lovely Phyllis Watson for “Medical Record Management”…how could we possibly fail?
What made you choose HIM as a lifelong career? What has made HIM such a good profession for you?
When I did the aptitude tests in high school the careers guidance officer suggested either Medical Record Administration or Air Traffic Controller. I don’t think I would have lasted 5 minutes as an ATC! I was tossing up between Accountancy (as I was good at Maths) and Medical Record Administration. MRA was only 2 years at the time and Accountancy was 3, so I opted for MRA. Thanks goodness I did as it’s been a wonderful career for me.
When I first graduated, I was still very timid and shy and did not want to ever be the “boss” of Medical Records, but thought I would enjoy being a Clinical Coder or ROI clerk, or maybe even the Deputy. When I moved to Canberra to work at Woden Valley Hospital, the Canberra HIMs were a tight knit group that got on well and the ACT HIMAA meetings were more social get togethers than meetings. I was in awe of the experienced HIMs that I got to work with and learn from in those early years like Elaine Harris, Sue Chicchio, Jonette McDonnell and Gloria Spyropoulos to name a few. Then at some point, I’m not sure how it happened, but it seemed like all the other HIMs in Canberra took a step back and left me standing at the front… so I’ve been in the senior managing HIM role at Canberra Hospital for over 20 years. It’s been incredibly challenging at times, but also incredibly rewarding and I’m proud to have been part of some fantastic changes in health record management in the ACT and to have worked with so many wonderful colleagues.