A clinical nurse abstractor reviews patient records for information and metrics that suggest trends, identify healthcare gaps, and pinpoint potential quality issues. The goal of data abstraction is to translate patient information into a format that helps healthcare professionals identify trends and make decisions.
This is a tech-heavy role that requires attention to detail and excellent organizational skills.
Data abstraction nurses can have flexible schedules and many work from home. A related role involves seasonal, contract work as a Healthcare Effectiveness Data and Information Set (HEDIS) abstractor.
What does a data abstraction nurse do?
Data abstraction involves reviewing patient records for specific clinical information to answer questions about quality, health trends, or service usage. Other names for this career include clinical data specialist or nurse reviewer.
This work helps healthcare providers improve quality and identify changes in health trends to make healthcare more accessible, less expensive, and more effective for patients.
According to a paper published in Perspectives in Health Information Management, key pieces of information abstracted from medical records include data for:
- Centers for Medicare & Medicaid Services (CMS) quality reporting measures
- National Quality Forum (NQF) quality measures
- The Joint Commission quality measures
- Patient registry functions (trauma, stroke, cancer, thoracic surgery, general surgery, cardiac etc.)
- Clinical research studies
- Any providers involved in the patient’s care
- Date, time of procedure, surgical suite, time of anesthesia, results
- Clinical documentation integrity (CDI) recommendations
- Date of Present On Admission (POA) indicator
- Admission/Discharge Dates
- Discharge Disposition
This role is ideal for nurses who are familiar with clinical terminology, medical coding, or healthcare data. Nurses who don’t have this background can still enter the field as most employers provide thorough training.
Data abstraction offers a wide range of possible careers for nurses with diverse clinical backgrounds. In fact, there are abstractors for every type of specialty from cardiology, pediatrics, orthopedics, sepsis, oncology, and trauma.
Not all positions require a bachelor’s degree, so this career path could be an option for Registered Nurses with an Associate degree or Licensed Practical Nurses (LPNs).
My hours are generally 8-5 – it is not monitored super intently. We provide information on the resources our Medicaid members need to keep themselves well and safe at home. This is determined through yearly or every 6 month assessments.-Experienced Abstraction Nurse
Who hires data abstraction nurses?
Data abstraction nurses may be hired by health insurance companies or health technology companies. Here are some of the companies that look for data abstraction specialists:
Check out the Nurse Fern job board for the latest jobs in data abstraction.
I do data abstraction for joint surgeries, extracting conservative treatment, symptoms, exam findings, imaging and compare it to the guidelines established by AIM or CMS (depending on the health plan). My work day is defined by 8 hours. My case metrics are 28 per day. I do take incoming calls and work on queue cases simultaneously.-Experienced Nurse Abstractor
A day in the life as a data abstraction nurse
Data abstraction nurses are typically assigned a queue of data questions. After reviewing their assignment, they delve into patient records to find and extract the relevant information.
A data abstraction nurse might look at immunization records, blood pressure and other vital signs, or usage of diagnostic services. Then, the nurse must enter the data into software so the raw information can be translated into actionable health information.
There are both full-time and part-time roles in this field. Some abstractors work part-time on their days off from bedside nursing or during the busy HEDIS season (typically January-May). Many companies allow their abstractors to complete their work at any hour of the day or night, from anywhere in the US with an internet connection, as long as deadlines are met in a timely manner.
Some data abstractors focus on reviewing records and entering relevant information into specific registries. Others are involved in analyzing and interpreting data and some even help develop programs or software that improve data access and interpretation.
I work part time for oncology abstraction and I am expected to do at least 10 hours weekly but no more than 19 hours. I log in to the system and start abstracting the tasks assigned to me. Once I finish, the system will notify me that there’s no more tasks to abstract and to check back later.-Experienced Abstraction Nurse
Background and experience for data abstraction nurses
Many nurses do not have experience in data abstraction when they enter this field. However, there are certain skills and experiences that can help you succeed, including:
- High level of comfort with technology and different healthcare programs, like Cobius or patient records software like EPIC and Meditech
- The ability to work independently and stay on task without direct oversight
- Strong organizational abilities and attention to detail
- Experience working in research or patient records (like clinical documentation integrity or case management)
- Proficiency in medical terminology and treatment protocols through bedside nursing work
If you are interested in data abstraction, you can start to build experience in this area by:
- Volunteering for chart auditing projects on your unit
- Getting involved in research or other data-specific work
- Learning more about coding basics, particularly the measures related to the abstraction work that you’re interested in
- Consider certification in a specialty area like the Oncology Certified Nurse certification
I work 10-19 hours a week when I want to. I typically work more middle of the week (t-w-th). Not usually more than 4 hours at a time because it gets monotonous.-Experienced Abstraction Nurse
Certification options for data abstraction nurses
Most nurses who are just getting their start in the field do not have any certifications and pursue these as they gain experience.
The Certified Tumor Registrar (CTR®) is an option for nurses who work in oncology abstraction. To be eligible for this exam, candidates must have an Associate’s degree and recent relevant work experience.
Another option is the Certified Health Data Analyst (CHDA) program offered by the American Health Information Management Association (AHIMA).
AHIMA also recommends a minimum of 3 years of healthcare data experience and experience in data acquisition, data analysis, data management, data interpretation and reporting, and data governance before taking the exam.
The CHDA is a difficult exam. According to data published by the AHIMA, there was a 14% pass rate for first-time test takers in 2021, up from 10% in 2020 and 2019.
The main benefit of this work is that it’s flexible. It’s a due-date kind of job so as long as your cases are done by the due date, it’s all good.-Experienced Nurse Abstractor
Interview tips for data abstraction nurses
It’s important to tailor your resume to the potential employer, including any clinical experience you may have in a particular specialty. For example, if the position involves reviewing oncology charts, make sure you highlight your experience in this area.
If you have experience reviewing charts in any capacity, be sure to mention this experience as well. Also mention your ability to stay on task without direct oversight as well as ways you demonstrated attention to detail and strong organizational skills during previous work.
Check out the Nurse Fern resume template to help you tailor your resume in preparation for your job search. Be sure to also update your LinkedIn profile to ensure that potential employers can learn more about your education and work history.
How much do data abstraction nurses earn?
The salary for data abstraction nurses can vary based on prior experience, type of position (contract or full-time), and job title. According to ZipRecruiter, the average salary for nurse abstractors is $68,231 per year or around $33 per hour. HEDIS abstractors who work on a contract basis may make slightly less at $58,628 per year or $28 per hour. It is common to see salary, hourly, or per chart compensation.
There is the potential to earn higher salaries for nurses with a Bachelors degree or higher, with prior experience in a particular specialty like oncology, or who take on analytical, supervisory, or managerial roles.
Pros and cons of working as a data abstraction nurse
Data abstraction is a flexible job that can include both full-time and part-time positions. Many employers don’t require set shifts and instead allow employees to complete their work whenever they prefer.
Benefits of data abstraction include:
- Flexible hours
- Part-time and seasonal opportunities that may be combined with bedside employment
- Ability to work from home
- Independent work environment without the need to directly interact with other staff or patients
- Minimal phone or meeting times
- Ability to work from anywhere in the United States
Data abstraction isn’t the right job for everyone, though. Here are common complaints about working in this field:
- Work can be monotonous at times
- Pay may be dependent on efficiency or cases completed, newer or less experienced abstractors may not earn as much
- Part-time or seasonal work may not be sufficient for individuals who need a full-time income
- Remote work may be lonely due to limited opportunities for interpersonal interaction
Are you interested in working as a data abstraction nurse?
Data abstraction is a flexible career that can be performed in both a full-time or part-time capacity. There are many ways to get started in data abstraction, including entry-level HEDIS work. The potential for growth in this field is high, given the ever-increasing emphasis on healthcare analytics.