RN and HIM can get along, after all: Meet Rebecca McDade and Andrea Smith

HIM professionals and nurses can get along, after all. There has long been a divide in the clinical documentation integrity (CDI) profession over who can/should serve in the CDI role. Though it has lessened with the passing of years, that divide still exists today. Recent ACDIS survey data shows that 72% of CDI professionals are nurses. Nothing wrong with that; nurses make wonderful CDI professionals. But I know of many fine CDI professionals with HIM/coding backgrounds who have also succeeded in the role. As well as MDs, even the occasional respiratory tech or CPHQ. With this episode of Off the Record I wanted to prove that an RN and an RHIA can not only exist side-by-side, but get along, quite amicably. As friends, even. Turns out I did not have to look far or dig too deeply. At a reception at the ACDIS national conference earlier this year I ran into Andrea Smith and Rebecca McDade. I made my way over to their table, and a half hour of conversation (and a bit of wine) later, invited them on to a podcast that did not yet exist, except in my mind. What struck me was that they were friends, despite their very different backgrounds. Five months later I had them on Off the Record. And can now bring you this show, and revive a part of the conversation we had that evening at ACDIS. Andrea is the CDI Director at Washington Regional Medical Center in Fayetteville, Arkansas, a nurse who moved into CDI eight years ago. Rebecca meanwhile is Director of Revenue Cycle Integrity for the same organization, and an RHIA. Despite their differences they work very well together, complimenting each other’s unique strengths and skills in adjacent roles (note: Rebecca is not directly in CDI but works closely with that department). We cover the lay of the land at Washington Regional Medical Center, including the staffing of its CDI and coding programs, metrics for success, and assistive software. Then a day in a life of each, their roles and responsibilities, and respective origin stories. Things get interesting when we talk about the historical RN/HIM divide, how they’ve bridged that gap, and the unique strengths each profession brings to the table (this starts at about the 37-minute mark of the show). Hosting this conversion reinforced that we can get along, at least some and perhaps most of the time, if we’re willing to acknowledge differences and be generous. Andrea and Rebecca are proof.