# Presentation: 370584

## Building the Workforce forHealth Information TransformationLinda L. Kloss, CEOAmerican Health Information Management Association

**AHIC EHR Work Group September 25, 2007**

- Framing the scope of the Workforce Issues
- What we know today about  workforce needs
- AHIMA’s initiatives
- How can the government help?

## The Scope of the Workforce Challenge

**Informatics, IM, IT, medical librarian workforces**
** ****and others **_**whose job is IT/information**_

**Health information literacy of people served by the health system**

**Clinicians  and non clinicians who must use IT and information to do their jobs**

## Computer Science Trends in US Enrollment/Degrees

- Growth of PC
- drove this increase

- Growth of Internet
- drove this increase

- Reasons for low enrollments
- End of Y2K
- dot-com bust
- Press magnified impact of offshoring
- Post 9/11 less foreign student visas
- Chart data only CS- no data on other IT-related majors
- Spring ‘06 enrollment up

- Source: Microsoft

**Computer Science Trends in US Enrollment/Degrees**

## Shifting IT Workforce

- Source - BLS
- Quoted in Computerworld.com 09-07-04
- By Julia King – Staying Power

**~52%**

**~15%**

**~8%**

**~10%**

**~21%**

**~30%**

**The U.S. IT Workforce is aging and there will be a heavy  competition to get skilled and experienced IT professionals.  How are we going to maintain our skilled workforce in this environment?**

**Notes:**
Still, the effects of aging workforce is coinciding with growing needs for health transformation

## Top five projected Health-related Job Openings– 2000 to 2010

| 

Profession/Occupation | 
Employment

2000 | 
(thousands)

2010 | 

Percent Change | Job openings
including
replacements,
2001-10
(thousands) |
| --- | --- | --- | --- | --- |
| Computer software engineers, applications | 380 | 760 | 100% | 1 |
| Personal and home care aides | 414 | 672 | 62.3% | 322 |
| Medical assistants | 329 | 516 | 56.8% | 274 |
| Physician assistants | 58 | 89 | 53.4% | 43 |
| Medical records and health information technicians | 136 | 202 | 48.5% | 97 |

**Source:  US Bureau of Labor Statistics**

## Health Information Management Professional Domain

- Data content, structure and standards
- Privacy and security management
- Electronic health record life cycle
- Data administration and analytics
- Personal health information management
- Reimbursement, regulatory compliance and fraud surveillance
- Organization and management

## Baccalaureate education since 1935
Degree programs:
HIM Master’s and baccalaureate education – 50 programs
Associate degree – health information technician – 180 programs
Sample college-based certificate programs – post graduate and pre-degree: Privacy and security, Applied informatics, Clinical coding, Disease registries, Medical transcription

- Baccalaureate education since 1935
- Degree programs:
- HIM Master’s and baccalaureate education – 50 programs
- Associate degree – health information technician – 180 programs
- Sample college-based certificate programs – post graduate and pre-degree: Privacy and security, Applied informatics, Clinical coding, Disease registries, Medical transcription

## An internet-based learning lab available for HIM students with an array of healthcare technology software
Lessons and activities for student practice; instructor training support

Sample Components

- An internet-based learning lab available for HIM students with an array of healthcare technology software
- Lessons and activities for student practice; instructor training support
**Sample Components**

- SDS HealthPort® EDMS
- Chart analysis
- Completion management
- E-Signature and redaction tools
- Workflow management
- Read-only chart repository for coding and document retrieval

- QuadraMed MPI Suite
- Front-end registration
- Tools for analysis of data integrity
- Tools for resolving duplicate records

**Notes:**
HIM students need access to health information software to practice health information management skills in an electronic environment
Systems are costly to build, expensive to maintain
Many HIM instructors have not worked with current technologies

80 enrolled schools as of July 1; about 4000 potential students
User webcasts and face-to-face training have been offered for over 300 instructor training contacts
Lab and Lesson Development - 	
Continue adding lessons
Add new lab applications and data for exercises in data analysis

## Since 2002, AHIMA’s strategic focus is on electronic health information management (e-HIM® )  
	Our goals are to: 
Promote the migration from paper to an electronic medical records information infrastructure, 
Reinvent how institutional and personal health information and medical records are managed, and 
Deliver measurable cost and quality results from improved information management. 

- 	Our goals are to:
- Promote the migration from paper to an electronic medical records information infrastructure,
- Reinvent how institutional and personal health information and medical records are managed, and
- Deliver measurable cost and quality results from improved information management.

## “Boot camps” for health information management technicians, medical assisting and other skilled technicians
Utilize community college network 
Recruit work flow specialists from industry
Vendor sponsored apprenticeships
Teams with informatics/managerial-level HIM lead and technician implementers

- “Boot camps” for health information management technicians, medical assisting and other skilled technicians
- Utilize community college network
- Recruit work flow specialists from industry
- Vendor sponsored apprenticeships
- Teams with informatics/managerial-level HIM lead and technician implementers

## Slide 12

## Work Force Summit – November 2005

-   AHIMA, AMIA Alliance
-   48 stakeholders to discussed action steps to build the skilled workforce for HI transformation

## Jointly define a multi-year work force research agenda
Define basic competencies for those who use the EHR in daily work
Engage informatics and information management education leaders to prepare a vision of the academic resources and network needed in the US
Seek federal and private funding to support initiatives
Secure legislative solutions for work force development and retraining shortfalls

- Define basic competencies for those who use the EHR in daily work
- Engage informatics and information management education leaders to prepare a vision of the academic resources and network needed in the US
- Seek federal and private funding to support initiatives
- Secure legislative solutions for work force development and retraining shortfalls

- AHIMA and AMIA Work Force Goals

## AHIMA/AMIA 2007 Project: DevelopCore Competencies for the Health Work Force

**Core Competency Domains**
- Health information literacy and skills
- Health Informatics skills – using the EHR and PHR
- Privacy, confidentiality of health information
- Health information/data technical security
- Fundamental Computer literacy skills

## Sample Core CompetenciesDomain: Health Information Literacy and Skills

- Use health record data collection tools (such as input screens, document templates) (C,P)
- Apply standard data definitions, vocabularies, terminologies, and/or relevant healthcare data sets (such as OASIS, HEDIS, UHDDS) as used in the organization’s health information systems. (C)
- Differentiate between the types and content of patient health records (such as paper-based, electronic health record, personal health record) (C)
- Adhere to health record documentation requirements of external agencies and organizations (such as those specified by the Joint Commission, licensure, reimbursement, discipline-specific “good practice”) (C,A)
- Adhere to organizational health record documentation requirements, policies and procedures. (C, A)
- Ensure that your documentation in the health record reflects timeliness, completeness, accuracy, appropriateness, quality, integrity and authenticity. (C, A)

## HR 1467-10,000 Trained by 2010 Act

- Authorizes grants to higher-education institutions to develop and offer education and training programs
- Authorizes grants for research and informatics research centers
- Research: $13.6 million from 2008-2011
- Centers: $18.6 million from 2008-2011
- Capacity building grants to establish or improve undergrad and master’s degree information programs
- $37.2 million from 2008-2011
- $29.2 million from 2008-2011 (Science and Advanced Technology Act of 1992)

**Notes:**

Representatives David Wu (D-OR), Bart Gordon (D-TN), Ralph Hall (R-TX) and Phil Gingrey (R-GA)
Gordon and Hall—Chairman and Ranking Minority Member of the House Science and Technology Committee
Wu and Gingrey—Chairman and Ranking Minority Member of the Subcommittee on Technology and Innovation

Bill Introduced on March 9, 2007
Passed Science and Technology Committee by unanimous voice vote on May 23, 2007
Passed House by unanimous voice vote on June 6, 2007
Referred to the Senate Health, Education, Labor and Pensions Committee

Research and informatics research centers:
Information Studies
Population Informatics
Translational Informatics
Data security, integrity and confidentiality

Capacity Building Grants—Establish or improve undergraduate and master’s degree information programs:
Develop and revise curriculum
Establish degree and certificate programs
Creating opportunities in information research
Equipment and testbed networks
Provide opportunities to work with agencies, private industries and academic institutions
Collaborations between academic institutions
Student internships
Bridge programs between community colleges and universities
Other activities 

## Provide federal guidance to support health information technology and training.
Pass legislation to strengthen programs and increase funding for health information/informatics education programs, student recruitment and retention, and faculty training.
Through the Centers for Medicare & Medicaid, create an incentive to help cover the cost of training requirements.
Standardize Department of Labor occupational codes in informatics and information management.
Fund training programs for applied practitioners in addition to existing training programs for informatics researchers.
Create a Department of Labor/Department of Education collaborative effort to provide health information specialist training.
Work with the US government Departments of Labor, Education, and Health and Human Services and professional groups to ensure that the health information specialist is recognized as a distinct skill set and profession, and establish and/or augment career training programs.
Establish a viable apprentice model for the health information work force similar to that utilized for residency training programs in medicine.

- Provide federal guidance to support health information technology and training.
- Pass legislation to strengthen programs and increase funding for health information/informatics education programs, student recruitment and retention, and faculty training.
- Through the Centers for Medicare & Medicaid, create an incentive to help cover the cost of training requirements.
- Standardize Department of Labor occupational codes in informatics and information management.
- Fund training programs for applied practitioners in addition to existing training programs for informatics researchers.
- Create a Department of Labor/Department of Education collaborative effort to provide health information specialist training.
- Work with the US government Departments of Labor, Education, and Health and Human Services and professional groups to ensure that the health information specialist is recognized as a distinct skill set and profession, and establish and/or augment career training programs.
- Establish a viable apprentice model for the health information work force similar to that utilized for residency training programs in medicine.

## Get workforce squarely on the Health Information strategy map
Get the issue before the State e-Health Alliance
Some states are leading workforce and job retraining programs
Encourage special focus by Bureau of Labor Statistics
Adopt useful and standard health information/IT occupation classifications
Commission a special study 
Study successful models of training and IT deployment and management
Engage the college and university community in goals of NHIN  Job retraining focus

- Get workforce squarely on the Health Information strategy map
- Get the issue before the State e-Health Alliance
- Some states are leading workforce and job retraining programs
- Encourage special focus by Bureau of Labor Statistics
- Adopt useful and standard health information/IT occupation classifications
- Commission a special study
- Study successful models of training and IT deployment and management
- Engage the college and university community in goals of NHIN  Job retraining focus

## Strongly encourage staff to include health informatics in their personal goals or competencies 
Ensure that appropriately educated and trained personnel lead/are involved in implementations.
Adopt competency-based, cost-effective training strategies that can be used within the work setting 
Participate in projects to share best practices in health information technology implementation.
Support staff training/education
Advocate for federal and state training support 

- Strongly encourage staff to include health informatics in their personal goals or competencies
- Ensure that appropriately educated and trained personnel lead/are involved in implementations.
- Adopt competency-based, cost-effective training strategies that can be used within the work setting
- Participate in projects to share best practices in health information technology implementation.
- Support staff training/education
- Advocate for federal and state training support

## Advocate for adequate technology training budgets and planning at healthcare organizations.
Support availability of sufficient, cost-effective training and support tools to healthcare organizations.
Contribute a portion of dollars from system sales to a national training bank!
Ensure establishment of interdisciplinary teams to validate and field test systems to ensure effective workflow.
Support the creation of tools to increase patient health information literacy, such as well-documented Web sites and CD-ROMs of health information that a patient can view and use for referrals.

- Advocate for adequate technology training budgets and planning at healthcare organizations.
- Support availability of sufficient, cost-effective training and support tools to healthcare organizations.
- Contribute a portion of dollars from system sales to a national training bank!
- Ensure establishment of interdisciplinary teams to validate and field test systems to ensure effective workflow.
- Support the creation of tools to increase patient health information literacy, such as well-documented Web sites and CD-ROMs of health information that a patient can view and use for referrals.

## Wing, Paul, and Margaret H. Langelier. "The Future of HIM: Employer Insights into the Coming Decade of Rapid Change." Journal of AHIMA 75, no.6 (June 2004): 28-32.
Wing, Paul and Edward Salsberg, “How Trends Shape the Workforce Now and in the Future”, Journal of AHIMA, 73, no. 6 (April 2002). 
FORE Foundation Data for Decisions: The HIM Workforce and Workplace Workforce Research Studies, 2002-2004
Employment of HIM Professionals in the U.S.: Current Patterns and Future Prospects http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_023794.pdf
Penetration of HIM Professionals in the Fifty States: an Examination of Geographic Patterns of AHIMA Members  Center for Health Workforce Studies, School of Public Health, University at Albany, 2/12/04 http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_022597.pdf
2002 Member Survey - http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_018947.pdf
2002 Student Survey
 	http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_017650.pdf
2002 Educator Survey
	http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_017651.pdf
Salaries of HIM Professionals, 2003
	http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_023104.pdf
Recommendations to the AHIMA Board of Directors from the Center for Health Workforce Studies
	based on the HIM Workforce Research Study http://library.ahima.org/xpedio/groups/secure/documents/ahima/bok1_023796.pdf

- Wing, Paul, and Margaret H. Langelier. "The Future of HIM: Employer Insights into the Coming Decade of Rapid Change." *Journal of AHIMA* 75, no.6 (June 2004): 28-32.
- Wing, Paul and Edward Salsberg, “How Trends Shape the Workforce Now and in the Future”, *Journal of AHIMA*, 73, no. 6 (April 2002).
- FORE Foundation _[Data for Decisions: The HIM Workforce and Workplace ](http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_022597.pdf)__Workforce Research Studies, 2002-2004_
- Employment of HIM Professionals in the U.S.: Current Patterns and Future Prospects http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_023794.pdf
- Penetration of HIM Professionals in the Fifty States: an Examination of Geographic Patterns of AHIMA Members  Center for Health Workforce Studies, School of Public Health, University at Albany, 2/12/04 http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_022597.pdf
- 2002 Member Survey - http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_018947.pdf
- 2002 Student Survey
-  	http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_017650.pdf
- 2002 Educator Survey
- 	http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_017651.pdf
- Salaries of HIM Professionals, 2003
- 	http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_023104.pdf
- Recommendations to the AHIMA Board of Directors from the Center for Health Workforce Studies
- 	based on the HIM Workforce Research Study http://library.ahima.org/xpedio/groups/secure/documents/ahima/bok1_023796.pdf

## McTeer, Robert. “The Churn. The Paradox of Progress.” Federal Reserve Bank of Dallas. Reprint from 1992 annual report.
Greiner, Ann C., and Elisa Knebel, eds. Health Professions Education: A Bridge to Quality. Washington, DC: Institute of Medicine, 2003, p. 61. Available at www.nap.edu.

- McTeer, Robert. “The Churn. The Paradox of Progress.” Federal Reserve Bank of Dallas. Reprint from 1992 annual report.
- Greiner, Ann C., and Elisa Knebel, eds. *Health Professions Education: A Bridge to Quality. *Washington, DC: Institute of Medicine, 2003, p. 61. Available at www.nap.edu.