My daughter received her first progress report from the International Bacceularate school she attends. She was disappointed in her grades this first quarter because she did not get straight A's, as she was accustomed to. I have to admit, I was probably as upset as my daughter about her grades.

As it turns out, the grades school-wide were not what the kids or parents expected. A letter went out to all parents from the principal that informed us he expected these grades and was not alarmed by them. The principal went on to say that grades alone are not a true measure of what your child has learned. 

He described a culture obsessed with grades. My daughter has grown up in an educational system centered on rote memorization. Teachers instruct students on what they need to know to pass standardized tests.  Now, she will have to be re-programmed to learn with a different approach to education. The focus is not on getting an A, but really understanding concepts and applying what she has learned. The expectation is that students find the answers for themselves by engaging in critical thinking. Thinking outside the box is encouraged, and students are expected to participate in class discussions. 

I am having a tough time explaining these expectations for success to my daughter. When I thought about this over the last few days, my daughter is being asked to think just like any student attending a university. The expectation is not just to memorize information; the student should demonstrate understanding by expressing views in discussion and providing credible sources to support their views. Course projects reflect further understanding of concepts presented by the instructor. 

Though my daughter did not receive the grades she expected, she is learning what will be expected of her when she attends college. I would rather she learn this lesson early than later.

November is not only the start of the holiday season, but also the time of year when HIM professionals celebrate Health Information and Technology (HI&T) Week. This is our week to pat ourselves on the back and celebrate the achievements made during the year. I am sure that HIM professionals across the country will showcase their departments and take the time to appreciate the hard work by HIM staff.

I remember all the HI&T celebrations over the years. Activities included HIM open houses to shine the spotlight on services provided by the HIM department. It is amazing that staff outside the HIM department are still a little fuzzy about exactly what goes on in the department. They know this is the place where patient records are maintained and we transcribe all those medical reports.

HIM professionals can use HI&T week to educate those who work outside the department about the vital services HIM professionals perform. We are more than just a warehouse for records.  The electronic health record (EHR) has transformed the HIM department to an important player in the collection and dissemination of patient health information. We must be knowledgeable about so many areas, including patient privacy, documentation standards, revenue cycles, reimbursement and the never-ending federal regulations. 

This week, I educated my HIT students about HI&T week and the activities that are planned around the country. I created a short video, which I shared with other students and instructors in the program. The students really enjoyed this and are looking forward to celebrating their first HI&T week as a HIM professional. Let me know how you celebrated HI&T week at your department.

I have been trying to get the flu shot for the last few weeks. As you know from watching the news, the flu shot is in short supply. After my third attempt, the nurse practitioner promised to call me as soon as a new shipment arrived. I thought with all the overly anxious people walking in to get the shot, the last thing she would want to do is call one of us. 

Well, much to my surprise, she called me late Monday night and said she had just received a shipment of the flu vaccine. I told her that I would be the first person in line the next morning--and on Tuesday, I was. I was so excited to finally get this ordeal behind me.

On Thursday morning, I started to get sick. I came down with sneezing, coughing and a bad nasal congestion. This can't be happening! I just got the flu shot 2 days ago. I have tons of work to complete. By 10 a.m., I could no longer concentrate on anything, so I thought I will just lie down for an hour. That hour turned into a couple of hours.

Because I had classes to teach that night, I did not want to take anything that would make me drowsy. I took some non-drowsy medication and went back to bed. I asked my 12 year old to wake me up for my first class at 8 p.m. I don't know how I made it through the class without my students thinking I had been up the night before tying one on. All I needed to do now was stay awake for my next class at 10 p.m. Somehow I managed to stay coherent during the hour.

It is now Sunday evening, and I am trying to catch up on the work I could not do over the last few days. I truly understand that old saying, "No rest for the weary."

The introductory course I teach in health information technology (HIT) gives students the basics on health information. This week I did a lecture on the diversity of career options available in HIT. Students coming into the program are usually familiar with coding and transcription, but they are not familiar with other positions within HIM. They were surprised to learn their options include compliance, consulting, privacy and electronic health records (EHRs) to name a few.

So far, most students are interested in coding and cancer registry. The Bureau of Labor Statistics 2008-2009 Occupational Outlook Handbook shows employment is expected to grow faster than average. Employment of EHR and health information technicians is expected to increase by 18 percent through 2016--faster than average of all occupations because of the rapid growth in the number of medical tests, treatments and procedures that will be increasingly scrutinized by health insurance companies, regulators, courts and consumers.

When I chose HIM as a career years ago, I had no idea what it really was or what the job prospects were after graduation. In these tough economic times, students want to go into a profession that will offer them a career that will continue to be in demand.

There has been so much attention on the H1N1 flu in my kid's school district. My daughter's middle school has reported two confirmed cases of the H1N1 flu, and there have been a tremendous number of kids out with flu-like symptoms. My daughter missed 2.5 days of school with flu-like symptoms. Schools are asking that children and teachers stay home if they are running a fever or have flu-like symptoms. Hand sanitizers are placed front-and-center in all stores. I have stocked up on hand sanitizers at home and given my best "mom speech" to the kids to wash their hands.

College campuses around the country are bracing for a potential outbreak of the H1N1 flu. The sudden rise in flu cases has some local colleges preparing for the rise in student absences. Currently the number of students and faculty out sick with the flu at the University at Buffalo and Hilbert College are low, but according to one article, both schools expect those numbers to rise. 

The close confinement of students in college dorms increases the likelihood of spreading the virus. With college campuses spread out all over the place, it is difficult to control the spread of the virus. University officials have to take precautions. We have hand sanitizers all over the buildings," said Peter Burns, Hilbert College dean of students. "We have an isolation room if somebody comes down with severe symptoms or fever. We've actually had one student so far we've put in isolation--come to find out he's fine."

The online university is not affected in the same way. You will not be able to see a substantial drop in attendance due to H1N1 flu. If online students are affected by the H1N1 flu, university officials don't have to worry about students coming to campus sick and spreading the virus. With the new term just starting online, I'm not sure how the H1N1 flu well affect my courses this term, but I will definitely have more flexibility with students submitting assignments.

Source: College Campuses Tweak Attendance Policies for H1N1

My daughter transferred to a new school this year. She had no interest in transferring to this school, but like all parents I overruled her objections so she can be prepared to compete in the highly competitive world we live in. 

The curriculum at the new school is extremely challenging. My daughter has homework every day, including weekends. She is often up late during the week completing assignments. She has several teachers during each term, and they all have their own Web sites, which students are responsible to visit to get their assignments. 

My daughter is well into 8 weeks in this term and is having a difficult time managing the stress. My daughter doesn't have the same responsibilities as my adult students, but there are similarities in the level of stress associated with completing assignments. I often discuss with students how to develop a plan for them to stay on track with assignments while juggling school, family and work. I approached this with my daughter in the same manner. 

The first step is to get a planner or calendar and record assignments and deadlines. Tackle assignments by completing pieces of them daily, so you can show some daily progress and feel like you have accomplished something. Prioritize the assignments according to the deadlines. Take some time away from studying and assignments to relax.

To my surprise over the past weekend, my daughter informed me that she had formed a study group with two other students. They spent part of their weekend going over assignments and homework. The support of others can be a big factor in getting through those difficult patches.

I have been learning how to use the American Health Information Management Association virtual lab applications for the HIT program. The virtual lab simulates various HIM functions, such as release of information, master patient index  (MPI), chart deficiencies and the encoder, which gives students exposure to the electronic health record (EHR) and computerized HIM functions. 

When I started out in the HIM program years ago, everything we learned was demonstrated as a manual function. These manual functions were so tedious and often caused bottlenecks to occur. I worked my way through college by working in a hospital on the evening and weekend shift in the HIM department. One of my primary responsibilities was maintaining the manual MPI. I remember typing up the MPI cards and filing them in the huge cardex. The cardex was cumbersome and had a foot pedal that allowed you to access the other part of the alphabet. I remember cards falling behind the cardex and the foot pedal getting stuck so I could not access the other side of the cardex. When I filled in during the week for the MPI clerk, only one person could access the MPI because it was not built for multiple access. We often had traffic jams around the MPI during the busiest time of the day. 

When I landed my first job, the hospital had a motorized MPI that moved all the trays containing the MPI cards. This motorized cardex had the some of the same drawbacks as the previous cardex I worked with in college, but it also had some new tricks. Once you pushed the button to retrieve a particular MPI card, for example, the trays would move so fast that it would dump some of the trays holding the MPI cards. My biggest headache occurred when the motor malfunctioned; the company had to be called in to fix the motor so we could be operational again.

I can look back at these days and just laugh about all the wacky things that occurred. I am reminded of the slogan from a television commercial back in the day: "You've come a long way, baby."

I remember being in elementary school and how everyone was extremely excited about going to the library to check out books. My friends and I looked forward to this day all week; we could not wait to check out our favorite books. We would check out the same books over and over again, no matter how many times we had read them. There is something about that old musty smell you only get from the pages of a library book. As I progressed through the educational system, I still looked forward to going through the books, even though I did not care for the subjects.

Today, things have changed tremendously. E-books are the hot new thing replacing textbooks. School districts and universities across the country are ditching textbooks and replacing them with e-books. I worked with e-books before and did not like them at all. For one thing, you cannot tell the student to turn to page 75 in their textbook. When I am lecturing students, they always ask for the page number, so this was a real source of frustration. I love to highlight pertinent information in the textbook so I can refer back to it later. You cannot do this with the e-book. Some e-books don't do a good job of laying out the material so you can easily locate the information. Instead of receiving my instructor manual for one of my classes, I got a CD; the publisher was no longer printing the instructor text but putting everything on a CD.

How will I get that feeling of joy flipping through my instructor's textbook? How will I inhale the aroma of the pages? Where will I put all of my bookmarks? How do I substitute the magical moments of highlighting information with my favorite highlighter? I know the textbook will be completely phased out someday, just like the typewriter, land line phones and other great inventions of the past. Technology keeps changing the world we live in and we must embrace these changes or be left behind. But there will always be a place in my heart for those old musty pages of my books.

I try to attend coding updates annually, and I always learn something new. I attended a workshop this week on the 2010 ICD-9 changes. The amount of information is just mind-boggling. It is a good thing I don't have to perform coding for a living. The rationale behind using the new codes can be more confusing than the codes themselves.

There was also information on what we should be doing as coders, directors, documentation specialists, etc. to prepare for the implementation of ICD-10. An unofficial poll was taken and the majority of audience was not convinced ICD-10 would be implemented in October 2013. Most of the group felt that CMS had delayed the implementation so many times that chances are they will not be ready in 2013.

The speaker recommended that we put a team together to prepare for ICD 10 implementation. The amount of work that needs to be done to prepare for this is overwhelming.  Of course the coders need to be trained on this new system and I am sure that they will be ready to go. The software vendors, IT department, billing, insurance companies and other parties all must get on the bandwagon. As an educator, I need to be prepared to teach this new system to students. Both the American Health Information Management Association and American Academy of Professional Coders provide information on how to prepare for this change. There are Webinars and other training materials available through both associations. 

I recall being a student and learning how to code with ICD-9-CM. I thought it was the most confusing area of the HIM curriculum, and I knew it was one task I would not want to perform on a regular basis. I feel like a student again, and I'm sure I will have the same anxiety learning ICD-10. 

One of the perks of working from home is that you get to set your own office hours. There are no employees, boss or co-workers that you must make time for during an 8-hour day at the office. When I want to start my day, I simply go upstairs to my home office and start working. My schedule is not written down, it's all in my head.  No need to post office hours again.

Well, so I thought. My kids always come into my office when I in the middle of finishing up something that needs to go to my students or boss. I always tell them I am working, but they barge into the office without knocking. They want me to stop what I am doing and take care of whatever crisis they are facing. The hubby also has this habit. If I had a dime for every time I am asked, "What are you doing?" I would be a millionaire. 

So, I am going to try an experiment this week. I am going to post my office hours on the outside of my office door. I will indicate the day and time when my classes are in session and the times when I am catching up on e-mails, paperwork, etc. I plan to clearly label my idle time so they know when I am not at work. I am not sure if this will work. If not, I will have to purchase a lock for my office door to keep them out!

I was thrilled to pass the American Academy of Professional Coders (AAPC) certified professional coder (CPC) test on the first try this past spring. The experience was nerve wracking, and I didn't think I would survive it.

Well, you are reading this blog, so I obviously lived through the experience. I anticipated keeping up with all the changes and keeping my skills up. I was planning on the CPC being my last certification exam. However, the AAPC had other ideas. All credentialed AAPC members will have to take an ICD-10 proficiency test. I have lifted the information below from the AAPC Web site:

To ensure that employers continue to value the CPC and other AAPC credentials once ICD-10-CM is implemented (thus protecting all 60,000 credential holders), and that those credentials truly represent one's ability to code under the current code set, AAPC members holding a credential will have 2 years to pass an open-book, online ICD-10 proficiency test.

• You will be given 2 years to take and pass, beginning Oct. 1, 2012 (one year before implementation of ICD-10) and ending Sept. 30, 2014 (one year after implementation)
• There will be 75 questions
• It will be open-book, online and un-proctored
• Coders will have two attempts at passing for the $60 administration

I am not looking forward to the countless hours of studying, sleepless nights and anxiety attacks I experienced with the CPC exam. I guess this is all part of the never ending cycle of lifelong learning.

I appreciate any suggestions you have on preparing for the exam.

When I moved to North Carolina several years ago, I volunteered my time at a local shelter. I was hesitant at first because I didn't think I could really be of any help to these people in need. Once I was convinced by the shelter director, I signed up to volunteer a few hours on the weekend.

Looking back at this experience, I learned a lot about myself and the difference you can make in a small way. I have been thinking about getting involved with the regional and state health information associations. My children are older, so they do not require so much of my attention; they have friends of their own and are expressing their independence. This got me thinking about volunteering my time and getting more involved with health information associations.

I decided the best way to get involved is to volunteer my time to any area that can use my knowledge and experience. I took the first step this week and contacted the state association. I wrote a letter introducing myself and my educational and professional background. I expressed my desire to make a contribution to the association. Other than paying my membership dues and attending continuing education workshops, I have not been involved at the local or state level. Volunteering my time is one way of giving back to these associations that provide us with so much during the course of our careers.

I discovered a new technology toy this weekend. It's called Voki and it allows you to create an audio message with cool characters. You can select a character and change their hair color, eyes, skin tone and even apply makeup. I found a character I liked and created a perfect image.

The Voki can be used for social networking to talk with your friends. It can be used to send e-mails and post on your blogs. The problem with some technical applications is that they can be so difficult to use. Because so many of these sites are free, they don't come with any tech support in case you get stuck. I am not a tech savvy individual, so I like to keep things simple. It should take only a few steps and be easy to send as an e-mail or embed in one of my courses.

I tested Voki in my course and was amazed by how well it worked. The clarity of the voice was great, and I will be able to use it to post important announcements for students. This avoids typing text into the announcement board, which students don't read. The Voki is entertaining and fun. If you would like to try Voki, go to http://voki.com/. You will be hooked!

Next week marks the beginning of the fall semester at the community college where I teach in the medical assisting program. I am looking forward to meeting new students and getting back in front of the class. It's such a good feeling to see these excited faces in the classroom. The only difference this time is I will be teaching full-time at an online university.

In the past, I worked on a contract basis, which meant I took teaching assignments that fit my schedule. My courseload will be pretty full this fall, and I will have to rely on my skills as a master of organization skills. In addition to my duties as a full-time instructor, I have other responsibilities as a full-time faculty member. The good news is that some of classes are taught on different days of the week, which gives me some downtime to prepare for the courses. The two schools are also on different schedules, which provides downtown for me to catch my breath. My years of working as a RHIA extraordinaire has taught me how to juggle multiple tasks, prioritize and work smarter to get the job done.   

We are nearing the end of summer, and it is time for kids across the country to go back to school. The retailers have started the full-scale assault on parents to get to the mall and buy their kids clothes, shoes, computers and other items that your kids cannot live without. Oh, how could I forget those back to school supplies. My school district provides an online list of school supplies by grade level. These lists are just ridiculous. Why does an elementary kid need so many supplies?

My kids are obsessed with getting to Staples or some other store to purchase these supplies. They insist that if we don't shop early the store will be sold out of these supplies. I have two kids, so the costs of these supplies can send my budget over the top. My daughter will be a seventh grader this year. I had to purchase a calculator for $125, and I have to pay lab fees this year. It will cost about $300 just for her school supplies.

I remember my back-to-school days. My mother bought basic supplies and had enough money to purchase clothes for the new year. She was never stressed over school supply lists that would amount to the weekly grocery bill. We did not have a list of school supplies. Every kid showed up on the first day with a pencil, eraser, notebook paper and a shiny new notebook. The teachers provided you with everything else. If you couldn't afford these basic supplies, they were provided by the school. I was reminiscing about the good old days and my daughter quickly pointed out that this was how things were done in the age of the dinosaurs. Well, I long for the days of the dinosaur. Life was so simple!