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Let's get together: benefit by facilitating self-forming groups.

IN 1999, THE AMERICAN HEALTH INFORMATION MANAGEMENT Association, Chicago, began an expedition into the then-little-known world of communities of practice. Five years later, AHIMA's thriving online communities have helped its 48,000 members network and learn from each other and have taught the 76-year-old association valuable new lessons about community management.

AHIMA's members manage personal health information throughout the health care industry. Since information management practices started migrating from paper to electronic systems, the professional practices in the field have undergone profound changes. Recent workforce research, for example, shows that today's health information management professionals work in 40 different settings, from hospitals to pharmaceutical companies, and have 200 different job titles, from privacy officer to data quality manager.

The rapidly changing practice environment and the expanding roles of its members led AHIMA to explore communities of practice, or online forums that allow members with common interests to network. As the communities-of-practice project has become a part of the association's day-to-day operations. AHIMA has enhanced its benefits to members, learned how to support member-driven communities, and learned how to define success. This article describes why AHIMA created online communities and the challenges, benefits, and lessons we learned that may be relevant for your association as you undertake similar activities.

Members' changing needs

When AHIMA's leadership decided to launch communities of practice, the association was at a turning point. The health information field had been evolving and changing, but it was clear that the pace of change was about to accelerate dramatically. The technological barriers to electronic health records were largely solved, and consensus was growing that bringing health care into the information age was an important national agenda item for reasons ranging from the cost and safety of health care to the aging population.

Health information management professionals needed to help drive change and that meant that they couldn't wait for best practices to bubble up to the national level, be packaged, and trickle back down. The association needed new ways of disseminating information and supporting members in solving day-to-day work challenges. To that end, in 1998, AHIMA's board of directors charged a special task force to create a new organizational model designed to allow the association to be more membercentered and facilitate interactions between and among members across geographic barriers.

Early in the process, AHIMA conducted a member values assessment as part of its annual member survey. The assessment provided some interesting insights into what members were thinking:

* They were convinced of the need to adapt to an accelerating economy and workplace and were willing to change.

* Many wanted to become more involved in the association but were not particularly interested in governance-type roles.

* They needed ways to better leverage information to work more efficiently and effectively.

* They needed to keep up with increasing pressures on the workforce and the increased diversity of workplace roles.

For its part, the association wanted to develop an organizational structure that would accommodate this increased diversity in workplace roles as well. Our existing model, with its six specialty groups, was no longer adequate or cost-effective given the number of job niches members now occupied. With members holding 200 job titles, AHIMA could not afford to support the corresponding number of specialty groups and needed a more flexible way to connect members.

Clearly, the time was right for change. AHIMA needed to develop ways for its members to more effectively tap into their collective body of professional knowledge. And by providing the right tools, AHIMA aimed to remain the primary source of professional information for its members.

Selecting the model

In 1999, we found the solutions to our needs in a relatively new concept called practice communities. At that time, the phrase "communities of practice" was just beginning to appear in business literature and referred to a new organizational form that complements existing structures and facilitates knowledge sharing, learning, and change. (One particularly influential article, "Communities of Practice: The Organizational Frontier," by Etienne Wenger and William Snyder, appeared in the January-February 2000 Harvard Business Review.) It was reassuring to learn that leading companies were using this organizational form, although association experience at the time was almost nonexistent. Here are the steps we took to move the project forward:

Agree to create a new organizational model. The task force recommended a new functional model for the association with members at its center. A key component was communities of practice. AHIMA's intention in creating these communities was to build more than a Web site. We planned to create a one-stop professional practice resource where members could learn to do their jobs better--from each other. The site would include tools such as threaded discussion forums, chat rooms, access to industry news, and, importantly, access to an online body of knowledge for the field. The board approved the model in January 2000.

Make members drive the new model. AHIMA board and staff understood that it was not sufficient to say, "build it and they will come" with regard to our new model. Instead, the initiative would be centered on and driven by members. The real value would be added when members could virtually put their heads together to solve problems, share resources, and generate new ideas about their workplace problems. As members of the communities, individuals would provide support to each other by sharing experiences and answering other members' questions. Staff would provide resources and support, but member involvement would make communities come alive, making them a compelling member benefit.

Research technology needs and prepare a request for proposal. The decision to create online communities was a significant one, especially given that off-the-shelf solutions were limited and did not reflect the vision and specifications for which members were asking. Therefore, the only viable option at the time was a custom-built solution. A cross-functional staff team created a request for proposal to find a vendor to create the communities. The document covered the features that eventually would be a part of the communities of practice: discussion forums, chat rooms, and document-sharing capabilities; the ability for members to join communities at will; and the capability to integrate with AHIMA's member database. The cost: $300,000; months to implement; and staff time spent on designing, testing, and redesigning. Of course, today, off-the-shelf options incorporate many of the features AHIMA had to custom build only four years ago.

Beta test the system. By early 2001, the association was ready to launch beta-test communities. Three communities were included in our beta launch: a geography-based community for the state of Illinois, a position-based community for directors of integrated health care delivery systems, and a community for one of the former specialty groups. Volunteers tested the communities, road-testing the functions, noting system bugs, and providing feedback to staff via weekly conference calls. Initial feedback helped AHIMA understand the kinds of issues that first-time users might encounter--most of which related to making the site user-friendly and intuitive--and fine-tune things.

Launching the communities of practice. Finally, the project moved to an operational stage. The communities of practice were unveiled at AHIMA's national convention in October 2001. Volunteers showed the audience how the communities would work; and, later, members attended hands-on training sessions, which AHIMA continues to offer each year. Almost immediately, AHIMA began to monitor and collect user feedback, and we continue to make modifications to improve usability, based on the profile of members and their unique requests and needs.

Fast forward

Today, AHIMA's communities of practice comprise an interactivity-rich. Web-based portal that members use to access the association's full range of knowledge resources, maintain dynamic member-to-member networking groups, share professional practice solutions, and conduct a variety of association business. For instance, while AHIMA's house of delegates still meets face-to-face once a year at the convention, it discusses and votes on issues year-round through its community. Members also have the ability to vote in national elections for the board of directors via communities.

To participate in these communities, members use common Web-based tools, including threaded discussion forums, chat rooms, polls, and news feeds. Also the communities facilitate member-to-member networking through a variety of options, including

* links to the FORE Library: HIM Body of Knowledge, an online repository of articles and items related to health information management practices (the body of knowledge site was developed at the same time as the communities of practice and is an integral part of the strategy to make the association indispensable to members):

* the ability to share previously created documents (forms, policies, and procedures) that demonstrate best practices:

* the ability for members to easily propose, lead, and disband communitics as needed (all that's required is a topic related to the industry and a facilitator); and

* access to a detailed member profile function to search for others with similar interests, job titles, and geographic locations.

Staff support

AHIMA's staff participation in this project has evolved across time. While we did not add staff to support the communities, the initiative has touched every part of the organization and, in some cases, resulted in a shifting of priorities and projects within departments. Support for the communities of practice comes from the following departments:

* Volunteer services. Volunteer services staff originally administered the six specialty groups and their related activities, including board communication, budgets, newsletters, educational conferences, and so forth. They now support the communities of practice, doing everything from training and mentoring facilitators, monitoring community activity, and attempting to increase member usage of the communities to writing facilitator and member help guides and providing group training at the AHIMA annual convention.

* Information technology. One Web services staff member provided technology support for the initiative during the vendor selection process and throughout the first year following implementation. This required about 50 percent of his time. During the past couple of years, however, that time has been reduced to 5-10 percent. The initial time commitment was directly related to the custom-built solution (probably less time would have been required if we had chosen an off-the-shelf solution). Information technology staff members continue to monitor the community-of-practice technology infrastructure and enhancements.

* Membership. Our membership department monitors integration of the communities with the association's membership database. When professionals join AHIMA, staff provides access to the communities within 24 hours. In addition, membership staff ensure that members provide demographic and job-related data for the database, which enables community users to search for fellow members with specific jobs, skills, and interests.

* Marketing. This department creates collateral materials that orient members to the benefits of communities and encourage participation. Marketing also has conducted several campaigns to get the word out about the project.

* Communication. Major efforts of this department focus on informing members of the benefits of the communities through vehicles such as the magazine, print newsletters, and an e-mail newsletter.

* Senior staff. Because AHIMA's board and senior staff viewed this initiative as an opportunity to increase the value of association services, it was important that senior staff take an active role. AHIMA's senior vice president served as the project's liaison to the board and led the cross-functional team from 2000 to 2002.

New opportunities for volunteer leaders

As staff responsibilities changed, volunteer responsibilities changed, too. AHIMA's previous governance structure allowed national leaders to emerge through the ranks of its 52 geographic chapters. Communities of practice created a new channel--the role of community facilitator--to identify emerging volunteer leaders. Up-and-coming practice and technology experts can now be recognized and perhaps encouraged to move into committee or board positions.

In fact, the key to a rich community is its facilitators, who volunteer to support and champion the success of a particular community. Their participation allows the communities to be truly member-driven. Facilitators monitor activity within the community, encourage member participation, and organize community events (virtual or face-to-face). If a facilitator stays engaged with his or her community of practice, the community thrives; if content grows stagnant, members eventually stop returning, and the community withers.

The duties of a facilitator include

* starting discussions;

* polling community members;

* ensuring content is up-to-date;

* ensuring members' questions are answered;

* coordinating communication to members;

* identifying and using experts;

* scheduling and hosting chat sessions;

* managing and organizing community resources; and

* planning face-to-face community events, as well as virtual.

Staff support facilitators with initial one-on-one training, followed by ongoing training via biweekly chats and updates. In-person facilitator training takes place annually at the national convention.

In addition, staff recruit new facilitators for inactive communities of practice. They often do this via e-mail messages that ask for volunteers to serve and outline the benefits of volunteering. If a facilitator cannot be found, the community is closed. But if a facilitator emerges, the same community of practice can start again. We have found that a team of two or three facilitators is best, especially for an active community.

Creating member-driven communities in which members interact with each other, share documents, and initiate events, all without staff assistance, remains AHIMA's biggest challenge.

Keys to a rich community of practice

By February 2004, AHIMA's communities of practice included 200 communities and 300 facilitators. The most vibrant communities are those that relate to an aspect of a particular practice or to a hot professional challenge. Five types of communities support participating members: issuebased (e.g., implementing regulations): role based (e.g., health care privacy officers); setting based (e.g., health information management as applied to physician clinics); geography based (e.g., state or local groups, often in conjunction with the component state associations); and governance related (e.g., facilitating the work of volunteer groups). To date, 25,000 of our 48,000 members have visited the communities.

Members are using the communities in the following ways:

* Choosing the communities that reflect their professional interests, and joining as many as they'd like, at no additional charge. Our six specialty groups used to cost $35 per group.

* Keeping current via a single point of access to association news, industry news, and the professional body of knowledge.

* Interacting with colleagues by posting questions; sharing observations; sharing documents, data, or images; or attending chat sessions on topics of interest.

* Initiating new communities of practice related to specific job functions, practice settings, or special interests and steering the content according to their collective needs.

* Contacting colleagues who share common interests, job titles, and geographic locations.

Measuring success

In many ways, the communities are already fulfilling the original dream of a new way for members to communicate and share information. As we had hoped, the communities of practice are attracting new AHIMA members who are drawn by the communities' promise. For example, AHIMA membership has increased by an average of 8 percent for the past two years. It's impossible to determine how much of the new growth is directly attributable to communities, but we believe that communities contribute to the overall excellence of AHIMA's member benefits. And we are encouraged by reports of employers that believe the communities are relevant to employees' work (and that, in some cases, have resumed paying dues for their employees). Surveys of communities-of-practice users have yielded the following positive comments:

* It "gives me an automatic network of peers for sharing similar practice issues."

* "It is beneficial to see what questions are out there and how others are coping with their problems."

* It provides "instant information when most needed."

* "Questions and situations that I hadn't considered are brought to my attention and add to my knowledge" when I use the communities of practice.

Staff and volunteers are working to incrementally increase member participation. Although we may never see 100 percent participation, every member who uses the communities makes them stronger. At the same time, the communities are just one of many resources AHIMA provides to ensure that members will find the association relevant now and in the future.

In fewer than three years, AHIMA has seen the benefits of communities of practice in advancing health information management practice, providing a complement to face-to-face member networking, and increasing the perceived value of AHIMA to its members.

By Rebecca Garris Perry, CAE, and Anne Zender

Rebecca Garris Perry, CAE, is senior vice president and chief financial officer and Anne Zender is director of communications at the American Health Information Management Association, Chicago. E-mails: and
COPYRIGHT 2004 American Society of Association Executives
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Article Details
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Title Annotation:Self-Forming Groups; creation of a new organization model
Author:Zender, Anne
Publication:Association Management
Geographic Code:1USA
Date:Jul 1, 2004
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