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PROFESSIONAL PROFILEIrene Kearsey: Acknowledgement of contribution to HIMAA’s Editorial BoardKay Bonello

It is with great regret that the Editorial Board has accepted the resignation of Irene Kearsey as Honorary Secretary to the HIMAA Editorial Board.

Irene’s sudden resignation at the annual face-to-face meeting on 5 February 2015 took everyone on the Editorial Board by surprise, including Irene herself, although she had been thinking for some time that she should hand over to someone else whose ‘currency’ in health information manage-ment was more up-to-date than her own.

After Irene’s retirement, her friends and colleagues on the Editorial Board ‘got together’ to pay tribute to her outstanding contribution to the Editorial Board, the journals, and to the health information management profession more generally, over the past 40 years.

Professional background – brief overviewIrene’s professional qualifications include a Bachelor of Applied Science (Medical Record Administration), Graduate Diploma (Health Administration), and Master of Arts (Archives and Records). She had a long and illustrious career as a HIM in the Department of Human Services Victoria (from 1977 to 2003), where she developed health information systems and data collections in various types of health services, including community health, hospital, emergency department, mental health, intellectual disability, Koorie health, public health and prison medical records.

Irene was instrumental, behind-the-scenes at the Department, in instigating the establishment of legislation in Victoria that was relevant to medical records, and in devel-oping the first record-disposal schedule, in conjunction with the Public Record Office Victoria. She also developed methods for improving data quality, represented Victoria on national working parties and committees regarding data collection and data definitions (Victoria was a leader in this area) and on the Victorian Records Management Network and Standards Australia committees. She established the Victorian ICD Coding Committee to provide expert advice to standardise clinical coding practice. This was the first formal source of

clinical coding advice in Australia and it became the model for other states. This quality of clinical coding facilitated Victoria’s easy transition to casemix funding in 1993.

Irene was also instrumental in supporting the development of the previous Graduate Certificate of Nosology course at Lincoln Institute of Health Sciences, and was an honorary secondment from the Department of Health to La Trobe University for two years, where she took the lead in devel-oping the first version of Performance Indicators for Coding Quality (PICQ). Since 2007, Irene has been an Adjunct Senior Lecturer at La Trobe University, a position that is still current.

Editorial BoardIrene’s contributions to the Editorial Board covered a wide range of areas:

Associate Editor:Irene first joined the Editorial Board in 2002 as an Associate Editor, a role she continued to hold until 2009. While Associate Editor, Irene took editorial responsibility for one complete issue of HIMJ each year.

Honorary Secretary to the Editorial Board:In addition to covering the role of Associate Editor for six years, Irene simultaneously undertook the role of Secretary to the Editorial Board, immediately offering to cover the role in an honorary capacity (it had previously been a paid position), starting in 2003 and continuing on for 14 years, until her retirement on 5 February 2015. In this 14-year tenure, Irene did not just take the Minutes; she also established a process for ‘important decisions’ and ‘new policies’, which made it

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easier to search the records of the Editorial Board meetings. Irene made my job as Chair of the Editorial Board, so much easier as she also prepared the meeting schedules, oversaw the annual review of the Terms of Reference, and completed the Quarterly Reports to HIMAA.

Reviewer of manuscripts:Prior to 2002, Irene had been a regular reviewer of manu-scripts (since 1996) and she continued to referee papers for HIMJ on a regular basis for many years afterwards. In fact, Irene’s contribution to the review process is still sought when manuscripts are submitted that fall within her area of expertise.

Edited issues of HIMJ:One of the most memorable issues of HIMJ that Irene edited was the health information management ‘history’ issue, where Irene wrote in her editorial (Kearsey, 2008: 6-7):

I am proposing that HIMAA attempts to collect historical data on the evolution of health information systems across Australia. … [collect and] collate the information and enter it into a database. … [or] a computerised and ongoing survey.

I put forward this under-developed idea because I feel one aspect of ‘a profession’ is research: we should know why we do things the way we do in order to assess whether that method is meeting the objective. It may be that individual hospitals have researched the effects of specific internal changes to assess the outcome. However, our profession has not been as active as we should be in the area of research and there are surely many projects in reviewing specific changes across the board and assessing their effects

I contend that ‘a profession’ also needs to be able to write a history of itself and of its practices. Phyllis Watson has been able to labour over the former, largely using the records of our professional organisation, but will we ever be able to work on the latter? My idea, as the database grows, would provide material for many types of studies.

The vision that Irene expressed in this editorial, her wish to capture and record the evolution of the work that HIMs do, the ‘operational history’ of the profession, demonstrates the depth of her commitment to record keeping, to research, and to building the knowledgebase of the health information management profession.

The launch of HIM-I (HIMAA’s professional practice journal) in 2011, with its focus on publishing articles of interest and immediate use to practitioners, has gone some way towards fulfilling Irene’s vision. These articles are a record

of health information management practice over time and will provide a rich resource for future historians and researchers of health information management.1

Informal contributions.Irene’s unceasing support for the health information manage-ment profession took many forms and she tirelessly gave of herself when it came to supporting other HIMs, especially those who were new to the profession and those who were reluctant to publish their work. She was a regular attender at journal planning meetings, including informal meetings with state representatives where Editorial Board members’ attend-ance was not a requirement. Through these she inspired many HIMs to write by suggesting practical ideas for articles that were relevant to their own personal work experience and providing ongoing mentoring and gentle encouragement that assisted them to write. For Irene, no idea was too small or too ‘underdone’ to be discarded. She viewed ideas as ‘seeds’ to be nurtured and encouraged. She was committed to the view that ‘half-baked ideas’ (her expression) are simply earlier stages in the development of ‘good ideas’.

In fact, Irene’s involvement with the journal began long before she joined the Editorial Board. In the early years, she wrote for the Journal (Australian Medical Record Journal) under the nom de plume of Purges. She was also advertising officer for AMRJ for some time, retiring in 1992.

Professional career highlights …

Victorian ICD Coding Committee.Irene founded the Victorian ICD Coding Committee in 1978. For those who may be interested to read more about her adventures in this area, edited excerpts from ‘The last gasp member profile – Irene Kearsey’, published by the Victorian ICD Coding Committee on the eve of Irene’s retirement from the Committee and the Victorian Department of Health in 2002, are included at the end of this article (see Box 1). This was the first source of shared coding advice in Australia. The Victorian Department of Health was introducing a data collec-tion and Irene realised that standardised coding practices were

1 Irene’s 2008 comment about the profession not applying the knowledge and skills (that set them apart from others in the workplace) when it comes to recording the history of their own profession was supported when the author of this article attempted to retrieve information about Irene’s contri-bution to the profession from the HIMAA office, the assumption being that there would be a record of all Life Members’ contributions in the HIMAA archives. This is not the case. Perhaps it is not too late to revisit Irene’s ‘words of wisdom’ and to actively pursue publishing important historical records in HIM-I, such as profiles of Life Members, so this information is not lost forever.

Irene’s unceasing support for the health information management profession took many forms and she tirelessly

gave of herself when it came to supporting other HIMs, especially those who were new to the profession and those

who were reluctant to publish their work

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PROFESSIONAL PROFILE

needed. While Victorian graduates were taught to a standard, they could easily drift into hospital-based methods. When AIDS first appeared and the book had no code for it, Irene realised the need for a national source of coding authority and she lobbied for its formation.

PICQ.While on secondment to La Trobe University’s partner-ship with the National Centre for Classification in Health, Irene led the development of the Performance Indicators for Coding Quality (PICQ), an automated clinical coding check for admitted patient databases. She requested this secondment because she wanted to work on a system for checking clinical coding quality in a data collection that was standardised and simple to use; this was to be used alongside recoding audits. PICQ is now owned by a commercial company, routinely updated and refined. It is something Irene is particularly proud of.

Irene tendering the ‘expected’ carrot tribute to Gulf Station’s Clydesdales, Dinah, Gil and Shadow, who become visibly ‘cross’ if visitors arrive without carrots or fruit (stamping is involved but also very expressive glaring!).

Contributions to HIMAA - professional association

Victorian Branch of HIMAA.Irene worked tirelessly for the Victorian Association for many years, as a committee member (1977-1988), treasurer (1977-1980), and served on various VMRA subcommittees, including Continuing Education, Constitution Review, and Submission to Law Record Commission Privacy Review. She was the MRAA Continuing Education Representative for Victoria.

HIMAA – National Association.Irene was a member of the MRAA council for several years and was involved with the setting up of the first national office in Victoria in 1985. Her involvement on a national level has included giving advice on a number of issues particularly related to our Archives. Her work on the MRAA Archives and files over the years was invaluable. In the 1980s and 1990s Irene was the MRAA representative on the Australian Council of Allied Health Professionals, and in 1998 she received a Certificate of Appreciation from HIMAA for representing the Association for so many years.

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Conferences and presentations.Irene has chaired and presented papers at many MRAA/HIMAA conferences and seminars and was Convenor of the very successful Eighth Australian Medical Records Conference. She was also on the Conference Committee and Publicity Officer for the Twelfth Australian Conference on Medical Records.

Life Membership of HIMAA.In 2005 Irene was made a Life Member of HIMAA. Upon being told she would no longer be required to pay an annual subscription she made a donation to the Association that would produce annual interest roughly to match an annual subscription. Irene’s initial thinking was that the money could be used for ‘student prizes’ but this proved difficult to admin-ister.

Over the years, the money has been used to subsidise travel costs for students on professional placements, occa-sional conference attendances and the like. In this way, Irene’s generosity has touched many HIMs, who may not even know her name!

International involvement.Irene has also participated in the work of the International Federation of Health Information Management Associations (IFHIMA), (previously known as the International Federation of Health Record Organizations [IFHRO]), representing MRAA/HIMAA and on working parties. From 1983-1997 Irene was MRAA’s Alternate Director on IFHRO.

Community serviceSince retiring from the workforce Irene has continued her pattern of contributing to society, including, for example: developing LibGuides for health information management students at La Trobe University; acting as Examiner for a number of Honours and Masters theses on health informa-tion management topics, and transcribing, indexing and IT processing for the Public Record Office (Victoria).

National Trust – Gulf Station (Yarra Glen)Irene’s involvement with the National Trust of Australia (Victoria) has a long history, which has included, for example, preparing reports for the Trust that recommend specific pieces of public art work for registration. However, Irene’s major current interest is as a volunteer at Gulf Station, an historic farm at Yarra Glen, where she acts as a tour guide, and also as secretary, newsletter producer, and membership officer for Gulf Station’s Friends group.

Long-time friend and colleague, Professor Phyllis Watson AM, added these words:

‘Irene’s quiet efficient manner made her a delight to work with. She always met deadlines and undertook a great deal of work on her own time with a profound commitment to our profession. I have valued her friendship for over 30 years.’

In conclusion, present HIMs are indebted to Irene for our high professional reputation due to her unceasing work in promoting the profession, contributing to the profession in a senior role and her voluntary workload for the profession.

HIMs truly stand on the shoulders of giants when we recognise Irene’s far-reaching contribution to health informa-tion management.

ReferencesKearsey, I. (2008). When did we start doing that? Documenting the

evolution of health information management in Australia. Health Information Management Journal 37(2): 5-8.

Kay BonelloChair, HIMAA Editorial Board

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Box 1

Victorian ICD Coding Committee

The last gasp member profile – Irene Kearsey: edited excerpts

On the eve of Irene’s retirement from the Department of Health, Victoria, in December 2002, she agreed to answer a few questions posed by the Victorian ICD Coding Committee. Her responses to some of these questions are copied below.

Brief Work HistoryI’ve lived in Australia since I was 21. After 16 years as a secretary in England, Australia and South Africa, I decided I wanted to do more than bash a typewriter keyboard so I found the diploma MRA course at Lincoln, which I undertook during 1975-76 (and once we all had PCs, I went back to bashing a keyboard…). After graduation, I did four months’ relief coding and a two-month project for Lincoln then, mid-1977, started with the Hospital & Charities Commission (Community Health Directorate) helping new community health centres set up record systems. Although it may appear I’ve been in the same job for 25 years, work content has changed so much over time, it has really been many jobs but without the hassle of writing applications. With successive Departmental reorganisations, the MRA group became involved with patient record issues in, and data collections from, hospitals, mental health. Currently, we are involved with admitted patients, emergency episodes and waiting lists. Along the way, I’ve worked on general disposal schedules and countless manuals; presented educational and conference sessions; contributed to legislation, Australian Standards and the National Health Data Dictionary; seen the beginnings of casemix (long before it was used for funding); and participated in the introduction of Freedom of Information and Privacy legislation. Then recently I was granted a secondment to work with NCCH on developing what turned out to be Performance Indicators for Coding Quality (PICQ). In earlier years, I have held various Association positions (State and National treasurer, education officer, conference convenor) and worked on numerous committees. I’ve worked with some wonderful (and one or two not so wonderful) colleagues and I’ve certainly never been bored…

Why did you join the Coding Committee?For me, it’s why did I establish the Coding Committee? In 1978, we were planning for the Department to start a central data collection from Victorian hospitals (see the three-part history published in February, May and August 1999 Coding Newsletters). If we were to collect data from hospitals, I thought we needed some standardisation: at that time, there was no NCCH, no Australian Coding Standards, no Australian coding publications, no official source of coding advice. In conjunction with the Victorian branch of the MRA organisation, we established the committee, which could act as an official source of coding advice to individuals and also published a newsletter. Later, I was able to lobby for the establishment of a national coding body that has given us our own classification system, Coding Matters, education programs and much more. It’s easy to take for granted the wealth of resources now available!

What do you see as the challenges for the Coding Committee in the future?For HDSS members, we need to continue the development of a database of queries and answers that will help better manage the query process and that we can put on the web for easy reference by coders. For the Committee, the challenge is to find new ways of responding to queries: these days, queries tend not to be immediately answerable– instead they highlight areas that need revision of codes or development of a Standard. We are currently exploring ways we can work even more closely with NCCH.

From your experience, what hints can you provide to coders on achieving and maintaining a high level of clinical coding competence?How can I, who spent four months as a relief coder in 1977 and who hasn’t coded since, offer advice to anyone? That’s why we have a Coding Committee! As a DHS person, I can say it is even more important that coders achieve a high level of competence.