Title: Training a Health Information Technology Workforce: Addressing Pending HIT Worker Shortages
1The Health Information Technology Workforce
Addressing Pending HIT Worker Shortages March
2008 Sally Buck, M.S. Rural Health Resource
Center
2Mission
- 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)
4Quality 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
5HIT 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.
6The 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.
7The 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.
8So.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
9But WAIT!
- Who is talking about
- HIT Workforce
-
- HIT Education?
- This is not explicitly identified and/or
supported in many current discussions and
debates.
10Workforce 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
11Unprecedented 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.
12HIT 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)
13HIT 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.
14Unprecedented 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
15Informatics 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
16AMIA 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.
17What 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
18Health 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
19Building 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
20Projected 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
21Unique 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
22Unique 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)
23Rural 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
24Workforce 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
25HIT 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
26HIT Training Models College of St. Scholastica,
Duluth, MN
- EHR readiness of faculty and students in Nursing
- The ATHENS Project
- The Academic EHR Subscription Service
27The 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
28The Academic EHR System for Critical Thinking
Clinical Preplanning
29The Academic EHR System for Charting Real
Practice
30HIT 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
31HIT 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
32Rural HIT Activities
- Rural HIT Support for CAHs
- National Rural HIT Coalition
- AHRQ Website Support
- National Critical Access Hospital Survey
33Rural 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)
35Sally 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