Early-career pathways in health information management: A comparison of graduates’ position titles and knowledge-skill domains using two classificatory methodologies

Background: This study extended prior research on employment outcomes of the 2012–2016 and 2017–2021 health information manager (HIM) graduate cohorts from La Trobe University, Australia. Objectives: (1) To classify graduates’ early-career pathways, applying two classificatory methodologies, employing (a) position title (methodology 1), (b) self-reported knowledge and skills-based duties (methodology 2); (2) To compare outcomes of the methodologies; (3) To examine graduates’ duties within the profession’s established knowledge-skills domains and inform understanding of HIMs’ roles. Method: Residual data from prior cross-sectional studies were applied to early-career graduate HIM positions, using the two classificatory methodologies. Results: Methodology 1 showed a greater proportion of roles under the “Health Information Management” domain. Methodology 2 revealed more roles aligned with the “Health Information Systems” and “Data Management and Analytics” domains. A longitudinal increase in health systems implementation, system documentation development, database management, and IT system support and maintenance characterised increasing “technologisation” of HIM roles (“Health Information Systems” domain). Clinical coding of admitted episodes (“Health Classification” domain) was the most frequently reported skill utilised in HIMs’ first post-graduation position, offset by a slight, longitudinal decrease in clinical coding engagement. The 2017–2021 cohorts progressively reduced involvement in clinical coding roles, instead utilising more skills in the “Health Information Systems” and “Data Management and Analytics” domains. Methodology 1 showed a cohort 1 to cohort 2 increase in graduates assigned to the “Data Management and Analytics” domain (10.2–16.6%); Methodology 2 showed a simultaneous decrease (22.0–15.1%), arguably influenced by artefactual differences. The apparent decline in the “Data Management and Analytics” domain should be viewed cautiously owing to HIMs’ increasingly data-driven work. Conclusion: Reliance on job title may oversimplify or misrepresent the scope of HIMs’ duties. Choice of classificatory methodology significantly impacts upon the domain to which HIMs’ roles are categorised. The findings support a skill- and duty-based methodology for accurate capture of evolving HIM roles. Implications for health information management practice: This research provides valuable insights into HIM workforce trends, and foundations for (a) longitudinal career pathway and skills mapping and (b) a visual tool (career map) to support the profession’s visibility, promotion, and development of illustrative career trajectories.