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Training a Health Information Technology Workforce: Addressing Pending HIT Worker Shortages

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Title: Training a Health Information Technology Workforce: Addressing Pending HIT Worker Shortages


1
The Health Information Technology Workforce
Addressing Pending HIT Worker Shortages March
2008 Sally Buck, M.S. Rural Health Resource
Center
2
Mission
  • To provide technical assistance, information,
    tools and resources for the improvement of rural
    health care.
  • To serve as a national rural health knowledge
    center and strive to build state and local
    capacity.

3
  • Private non-profit organization 501(c)3
  • Created in response to the increasing challenges
    of providing health care in rural communities
  • Consolidated with the National Rural Health
    Resource Center in January 2003
  • Federal and state contracts and grants (Delta
    RHPI, Flex Program-TASC, SHIP, Workforce, Rural
    Networks, Community Development)

4
Quality Crisis
  • The stunning high rates of medical errors,
    resulting in deaths (44,000 to 98,000 annually),
    permanent disability and unnecessary suffering,
    are simply unacceptable in a medical system that
    promises first to do no harm.
  • -William Richardson
  • IOM Committee Chair

5
HIT Overview
  • Despite the evidence that health information
    technology (HIT) has the power to transform
    healthcare, studies have found widespread use
    remains low among consumers, physicians, rural
    hospitals, and other health care providers.
  • Rapid movement toward the digital management of
    data and information in multiple industries.
  • Staggering HIT workforce needs will be required
    to support this industry transformation.

6
The HIT Crisis
  • American health care has moved during the last
    decade to promote implementation of HIT.
  • The CDC Centers for Disease Control and
    Prevention reported that 20 more hospitals had
    EHRs last year than in the year before.
  • During this time, the nation came to recognize
    the power of HIT to address some of the biggest
    problems we face.

7
The HIT Workforce Crisis
  • Even with the advances, the health care industry
    lags all other major industries in IT adoption.
  • Need for HIT management is increasing
  • Parallels technological advances
  • Has been mandated by President Bush (Executive
    Orders April 2004, August 2006)
  • Transitioning from antiquated paper record
    systems to EHRs, PHRs, e-Prescribing, CPOE,
    Secure Messaging, Home Monitoring, Disease
    Registries, etc.
  • HIE/RHIO efforts are driving forces
  • Health care facilities are already struggling to
    staff HIT needs.

8
So.The Race is On!
  • Everyone is lining up to play
  • want a piece of the technology
  • want to deploy the technology
  • want to create infrastructure and build
  • complex systems and RHIOs to manage health
    information exchange (HIE)
  • want to deploy systems to take full advantage
    of what HIT has to offer

9
But WAIT!
  • Who is talking about
  • HIT Workforce
  • HIT Education?
  • This is not explicitly identified and/or
    supported in many current discussions and
    debates.

10
Workforce Crisis Overview
  • 1992 economist Robert McTeer, wrote that instead
    of asking if the US can create enough jobs, we
    should be asking if our educational system can
    produce enough workers
  • 15 years later we still asking the same question
  • Rural health has unique challenges and
    opportunities

11
Unprecedented Growth in IT Workforce
  • Bureau of Labor Statistics - Occupational Outlook
    Handbook 2006 projects
  • 18 of the top 20 fastest growing occupations will
    be in health care and computer science related
    professions
  • Employment of medical records and health
    information technicians is expected to grow 27
    through 2014
  • Employment of computer support specialists is
    expected to increase 18-26 for all occupations
    through 2014
  • A 49 growth in the number of health information
    management (HIM) workers by 2010, one of the
    fastest-growing health occupations.

12
HIT and Computer Science Workforce Shortages
After five years of declines, the number of new
CS majors in fall 2005 was half of what it was in
fall 2000 (7,952 compared to 15,958)
13
HIT and CS Workforce Shortages
  • The Society for Information Management (SIM) is
    examining the combined effects of radically
    dropping enrollment in IT programs at the
    undergraduate level and the first wave of baby
    boomer retirements.
  • According to SIMs report
  • "Between the retirements that are coming and the
    reduction in computer science students, we're in
    a very difficult position.
  • Health care will be competing with all other
    industries for fewer and fewer IT graduates.

14
Unprecedented Growth Meets Unexpected Decline IT
Workforce
  • Estimated that approximately 6,000 new HIM
    workers are needed each year to fill new
    positions and replace those who retire or leave
    the field.
  • 2,000 new graduates enter the HIM field each
    year.
  • USA produces only 200 new Informatics graduates
    per year (MD, RN, DDS Masters)
  • Need 10,000 by 2010

15
Informatics Training in U.S.
  • 37 Formal programs
  • 50-80 MDs in pipeline
  • 80 EHR ready
  • 30-60 RNs in Program
  • Schools of Nursing have separate programs
  • 100 EHR ready
  • Capacity to triple output

16
AMIA 10 X 1010,000 Trained by 2010
  • The American Medical Informatics Association
    (AMIA) believes that strengthening the breadth
    and depth of the health informatics workforce is
    a critical component in the transformation of the
    American health care system
  • AMIA is committed to the education and training
    of a new generation of clinical informaticians by
    the end of the decade to lead the transformation
    of the American health care system through the
    deployment and use of advanced clinical computing
    systems of care.

17
What Do We Need? (AMIA)
  • Support for training existing workforce
  • 10 X 10 distance education
  • CME short courses
  • Support for community level training
  • Community Colleges
  • Other community based training and support
  • Educational support K-12
  • Support of existing training programs
  • Support for training new faculty

18
Health Professions Workforce HIT Educational
Needs
  • Health care informatics academic programs
  • BA/BS degrees
  • MA/MS degrees
  • Graduate Certificate Programs
  • Health care informatics
  • Nursing informatics
  • Electronic health record strategies
  • Revenue management
  • Project management
  • EHR readiness of faculty and students in all
    health professional programs

19
Building the Workforce for Health Information
Transformation (2006)
  • A workforce capable of innovating, implementing
    and using health communications and information
    technologies will be critical to health cares
    success.
  • A crucial success factor
  • educational curricula and learning environments
    that fully reflect the electronic environment in
    which health professionals will practice.

A Report published jointly by AHIMA and
AMIA www.ahima.org/emerging_issues/workforce_web.
pdf
20
Projected Shortages Meet Educational Bottleneck
Health Professions Workforce
  • Primary care physicians
  • Registered nurses
  • Mental health providers
  • Dentists
  • Pharmacists
  • EMS
  • We need more than we can educate! And that
    doesnt address the HIT readiness factor

21
Unique HIT Challenges Faced by Rural Health Care
  • Limited staffing / funding
  • Limited access to expertise in tertiary health
    care centers
  • Higher numbers of solo practices and small group
    practices
  • Inability to address / stay abreast of
    opportunities presented through HIT Adoption
  • Inability to assess needs for HIT adoption

22
Unique HIT Challenges Faced by Rural Health Care
  • Limited IT infrastructure and support
  • Distance to support services / consultants
  • Limited access to existing rural networks or
    cooperatives
  • Recruitment and retention in rural settings
  • Education of existing staff (rural tends to be
    older)

23
Rural HIT Workforce Issues and Getting the Data
  • Critical to assessing the current and future
    demand for rural HIT workforce is the ability to
    collect, analyze, interpret data and share
    findings
  • Presently there is no central data repository for
    rural HIT workforce needs
  • Consequently, there is no evidence based
    workforce data

24
Workforce Data Needed
  • Valid and reliable data on supply and demand
  • Educational preparation(s) existing, needed, and
    available for multiple professions
  • Distribution and use of personnel in rural
    settings

25
HIT Workforce Study
  • A National HIT Workforce Study could
  • Identify the HIT Workforce needs of urban and
    rural health care
  • Identify appropriate levels of HIT training
    required (professional development, certificate,
    associate, bachelors, masters, PhD)
  • Identify existing educational standards for HIT
    programs and recommend new standards as
    appropriate
  • Inventory existing academic and training programs
  • Quantify projected demand with existing and
    projected supply of qualified workers

26
HIT Training Models College of St. Scholastica,
Duluth, MN
  • EHR readiness of faculty and students in Nursing
  • The ATHENS Project
  • The Academic EHR Subscription Service

27
The Academic EHR System
  • Live electronic health record with secured
    Internet access 24 x 7
  • Comprehensive point-of-care reference resources
  • Up-to-date evidence-based practice, clinical
    decision protocols,
  • Medical terminology, drug, lab/ diagnostic, and
    cultural guides
  • Pristine Clinical Cases
  • 40 diverse and robust admission to discharge
    actual medical cases

28
The Academic EHR System for Critical Thinking
Clinical Preplanning
29
The Academic EHR System for Charting Real
Practice
30
HIT Network SISU Medical Systems, Northeast, MN
  • A consortium of 14 medical centers in Northern
    Minnesota working together to share information
    technology resources
  • Information systems staff
  • Hardware
  • Software
  • Fully-equipped and secure data center
  • PACS, Telepharmacy

31
HIT Network SISU Medical Systems
  • Shared IT Staff
  • Staff coverage 24 X 7 X 365
  • Support Meditech software support (EHR)
  • Network administrators
  • Security coordinators
  • Clinical analysts

32
Rural HIT Activities
  • Rural HIT Support for CAHs
  • National Rural HIT Coalition
  • AHRQ Website Support
  • National Critical Access Hospital Survey

33
Rural HIT Activities (cont)
  • State HIT Grant Technical Assistance
  • National Rural HIT Knowledge Center and Website
    www.ruralhit.org
  • Developing a HIT roadmap tool for rural
    hospitals with Stratis Health

34
(No Transcript)
35
Sally T. Buck, M.S. Program Director Rural
Health Resource Center 600 E. Superior St., Suite
404 Duluth, MN 55802 218-727-9390, ext.
225 sbuck_at_ruralcenter.org
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