ten14_11.pdf

ETA Advisory File Text

2 Electronic health records will become the primary means of documenting transmitting and securing patient information. The EHR goal will impact the day-to-day work for healthcare providers working in a variety of medical settings including medical and dental practices rural and urban healthcare centers and clinics hospitals and laboratories. Implementing a national EHR system requires a workforce with leadership skills project management ability patience and vision. However it is not only healthcare workers who will be impacted. Trained professionals with IT skills as well as knowledge of the business and culture of health care will be in demand too. The following diagram illustrates the intersection of the Health and IT sectors related to the implementation of EHRs and the specific types of workers that will be interacting with EHRs. 3. Resources . ETA has worked closely with HHS the Department of Education Office of Vocational and Adult Education and subject matter experts in the health industry to develop an EHR industry competency model that documents the IT competencies for health workers who will interface with the new technology daily. All of ETA s competency models can be found at the Competency Model Clearinghouse CMC Website at http www.careeronestop.org competencymodel pyramid.aspx EHR Y . Local Health Information Technology Regional Extension Centers HITRECS offer technical assistance guidance and information on best practices to support and accelerate healthcare providers efforts to become meaningful users of EHRs. There are an estimated 70 HITRECs supporting primary care providers in achieving meaningful use of EHRs and enabling nationwide health information exchange in a defined geographic area. 3 4. Action Requested . States and grantees should distribute this technical assistance information to the appropriate staff and encourage its use in local efforts to prepare the health EHR workforce. ETA is asking for your assistance with two key activities First please share the EHR model and materials with your organization s key stakeholders especially the workforce investment boards for their use in developing workforce planning strategies. The EHR model is posted and available for downloading on the Competency Model Clearinghouse CMC Web site at http www.careeronestop.org competencymodel pyramid.aspx EHR Y . Second ETA encourages you to collaborate with your local Health Information Technology Regional Extension Centers. See Attachment B for a complete list of HITRECs to determine if there is a center in your vicinity. If you have a HITREC in your region we encourage you to convene interested stakeholders as soon as possible including health care employers State Offices of Rural Health and educators to discuss this critical workforce Describe the types of occupations associated with Health IT EHR professions and the skills needed to perform successfully in these roles Locate sources of Health IT EHR training assessment vouchers and employment opportunities and Learn about transferrable skills and work experiences from a prospective Health IT employer using the Health EHR competency model. 5. Inquiries . Questions concerning this Training and Employment Notice should be directed to businessrelations dol.gov . 6. Attachments . Attachment 1 The EHR Competency Model is a resource for program planners curriculum developers and business service representatives in articulating the changing needs of the healthcare workers who will be impacted by the implementation of EHR. Attachment 2 A Resource Guide for Health Information Technology is a reference providing program planners and service providers with practical information about the HHS Office of the National Coordinator for Health Information Technology and its initiatives and grant investments to prepare the emerging Health-IT workforce. 1 Attachment 1 Electronic Health Record EHR Competency Model Electronic Health Records EHR The model is available on the Competency Model Clearinghouse Web site http www.careeronestop.org competencymodel pyramid.aspx EHR Y 2 Table of Contents About the Model ............................................................................................................. 3 Tier One Personal Effectiveness Competencies ....................................................... 4 Interpersonal Skills .................................................................................................... 4 Integrity....................................................................................................................... 4 Professionalism .......................................................................................................... 5 Initiative ...................................................................................................................... 5 Dependability and Reliability .................................................................................. 6 Adaptability and Flexibility ..................................................................................... 6 Lifelong Learning ...................................................................................................... 7 Tier Two Academic Competencies ............................................................................. 8 Reading ....................................................................................................................... 8 Writing ........................................................................................................................ 8 Mathematics ............................................................................................................... 9 Science and Technology ........................................................................................... 9 Communication Listening and Speaking .......................................................... 10 Critical and Analytical Thinking ........................................................................... 10 Basic Computer Skills ............................................................................................. 11 Information Literacy ............................................................................................... 12 Tier Three Workplace Competencies ....................................................................... 13 Teamwork ................................................................................................................. 13 Customer Focus ....................................................................................................... 13 Planning and Organizing ....................................................................................... 14 Problem Solving and Decision Making ................................................................ 15 Working with Tools and Technology ................................................................... 16 Scheduling and Coordinating ................................................................................ 16 Checking Examining and Recording .................................................................. 17 Workplace Fundamentals ...................................................................................... 17 Tier Four Industry-Wide Technical Competencies ............................................... 18 Health Industry Fundamentals ............................................................................. 18 Healthcare Delivery ................................................................................................ 19 Health Information .................................................................................................. 20 Health Industry Ethics ............................................................................................ 21 Laws and Regulations ............................................................................................. 21 Worker Health and Safety ...................................................................................... 22 Tier Five Industry-Wide Technical Competencies ................................................ 24 Health Information Literacy and Skills ................................................................ 24 Health Informatics Skills Using the EHR ............................................................. 24 Privacy and Confidentiality of Health Information ........................................... 25 Health Information Data Technical Security ..................................................... 26 Resources Reviewed ..................................................................................................... 27 3 About the Model The Electronic Health Records EHR Competency Model is depicted in a graphic consisting of several tiers. The arrangement of the tiers in a pyramidal shape is not meant to be hierarchical or to imply that competencies at the top are at a higher level of skill. The model s shape represents the increasing specialization and specificity in the application of skills as you move up the tiers. Tiers 1-5 have been developed and are divided into blocks. The blocks represent competency areas that is the applied skills knowledge abilities essential to successful performance in the increasingly electronic environment of the health industry. A table of the competency definitions and associated key behaviors follows the graphic. Tiers 1 through 3 contain foundation competencies which form the foundation needed to be ready to enter the workplace. Tier 1 Personal Effectiveness Competencies are shown as hovering below the pyramid because these competencies are essential for all life roles. Often referred to as soft skills personal effectiveness competencies are generally learned in the home or community and reinforced and honed at school and in the workplace. They represent personal attributes that may present some challenges to teach or assess. Tier 2 Academic Competencies are critical competencies primarily learned in a school setting. They include cognitive functions and thinking styles. Academic competencies are likely to apply to all industries and occupations. Tier 3 Workplace Competencies represent motives and traits as well as interpersonal and self- management styles. They generally are applicable to a large number of occupations and industries. Tiers 4 and 5 contain industry competencies which are specific to an industry or industry sector. Cross-cutting industry-wide technical competencies make it possible to create career lattices within an industry wherein a worker can move easily across industry sub-sectors. Rather than narrowly following a single occupational career ladder this model supports the development of an agile workforce. Tier 4 Industry-Wide Technical Competencies represent the knowledge and skills that are common across sectors within a broader industry. These technical competencies build on but are more specific than competencies represented on lower tiers. Tier 5 Industry-Sector Technical Competencies represent a sub-set of industry technical competencies that are specific to an industry sector. The upper tiers represent the specialization that occurs within specific occupations within an industry. Information on occupational competencies is available through O Net OnLine http online.onetcenter.org . Competency A cluster of related knowledge skills and abilities that affects a major part of one s job a role or responsibility that correlates with performance on the job that can be measured against well- accepted standards and that can be improved via training and development. 4 Tier One Personal Effectiveness Competencies 1. Interpersonal Skills Demonstrating the ability to work effectively with others. Demonstrating concern for others Show sincere interest in others and their concerns Demonstrate sensitivity to the needs and feelings of others Look for ways to help people and pitch in to help others Demonstrating insight into behavior Recognize and accurately interpret the verbal and nonverbal behavior of others Show insight into the actions and motives of others Recognize when relationships with others are strained Maintaining open communication Maintain open lines of communication with others Encourage others to approach him her with problems and successes Establish a high degree of trust and credibility with others Respecting diversity Demonstrate sensitivity and respect for the opinions perspectives customs and individual differences of others Value diversity of people and ideas Deal with a wide range of people with flexibility and open-mindedness Listen to and consider others viewpoints Work well and develop effective relationships with diverse personalities 2. Integrity Displaying accepted social and work behaviors. Behaving ethically Abide by a strict code of ethics and behavior Choose an ethical course of action and do the right thing even in the face of opposition Encourage others to behave accordingly Acting fairly Treat others with honesty fairness and respect Make decisions that are objective and reflect the just treatment of others Taking responsibility Take responsibility for accomplishing work goals within accepted timeframes Accept responsibility accountability for one s decisions and actions and for those of one s group team or department Attempt to learn from mistakes 5 3. Professionalism Maintaining a professional demeanor at work. Demonstrating self-control Demonstrate self-control by maintaining composure and keeping emotions in check even in very difficult situations Deal calmly and effectively with stressful situations Professional appearance Maintain a professional demeanor Dress appropriately for occupation and its requirements Maintain appropriate personal hygiene Wear appropriate identification Remain free from substance abuse Maintains a positive attitude Project a professional image of oneself and the organization Demonstrate a positive attitude towards work Take pride in one s work and the work of the organization 4. Initiative Demonstrating a willingness to work. Persisting Pursue work with energy drive and a strong accomplishment orientation Persist and expend extra effort to accomplish tasks even when conditions are difficult or deadlines are tight Persist at a task or problem despite interruptions obstacles or setbacks Taking initiative Go beyond the routine demands of the job Take initiative in seeking out new work challenges and increasing the variety and scope of one s job Seek opportunities to influence events and originate action Assist others who have less experience or have heavy workloads Setting challenging goals Establish and maintain personally challenging but realistic work goals Exert effort toward task mastery Bring issues to closure by pushing forward until a resolution is achieved Working independently Develop own ways of doing things Perform effectively even with minimal direction support or approval and without direct 6 supervision Strive to exceed standards and expectations Exhibit confidence in capabilities and an expectation to succeed in future activities 5. Dependability and Reliability Displaying responsible behaviors at work. Fulfilling obligations Behave consistently and predictably Fulfill obligations reliably responsibly and dependably Diligently follow through on commitments and consistently meet deadlines Demonstrate regular and punctual attendance Attending to details Check work to ensure that all essential details have been considered Notice errors or inconsistencies that others have missed and take prompt thorough action to correct errors Complying with policies Follow written and verbal directions Comply with organizational rules policies and procedures 6. Adaptability Flexibility Displaying the capability to adapt to new different or changing requirements. Employing unique analyses Employ unique analyses and generate new innovative ideas in complex areas Integrate seemingly unrelated information to develop creative solutions Develop innovative methods of obtaining or using resources when insufficient resources are available Entertaining new ideas Remain open to considering new ways of doing things Actively seek out and carefully consider the merits of new approaches to work Embrace new approaches when appropriate and discard approaches that are no longer working Dealing with ambiguity Take effective action when necessary without having to have all the necessary facts in hand Change gears in response to unpredictable or unexpected events pressures situations and job demands Change plans goals actions or priorities to deal with changing situations 7 7. Lifelong Learning Displaying a willingness to learn and apply new knowledge and skills. Demonstrating an interest in learning Demonstrate an interest in personal learning and development Seek feedback from multiple sources about how to improve and develop and modify behavior based on feedback or self-analysis of past mistakes Participating in training Take steps to develop and maintain knowledge skills and expertise necessary to achieve positive results Participate fully in relevant training and professional development programs Pursue opportunities to develop knowledge and skills Anticipating changes in work Anticipate changes in work demands and searches for and participates in assignments or training that address these changing demands Treat unexpected circumstances as opportunities to learn Identifying career interests Take charge of personal career development by identifying occupational interests strengths options and opportunities Make insightful career planning decisions based on integration and consideration of others feedback and seek out additional training to pursue career goals 8 Tier 2 Academic Competencies 1. Reading Understanding written sentences and paragraphs in work-related documents. Comprehension Locate understand and interpret written information in prose and in documents such as manuals reports memos letters forms graphs charts tables calendars schedules signs notices applications and directions Understand the purpose of written materials Attain meaning and comprehends core ideas Locate definitions of unfamiliar terms Critically evaluate and analyze information in written materials Integrate and synthesize information from multiple written materials Attention to detail Identify main ideas implied meaning and details missing information and trends Note details facts and inconsistencies Application Integrate what is learned from written materials with prior knowledge Apply what is learned from written material to follow instructions and complete specific tasks Apply what is learned from written material to future situations 2. Writing Using standard English to compile information and prepare written reports. Organization and development Prepare reports that are easy to understand using proper terminology Communicate thoughts ideas information messages and other written information which may contain technical material in a logical organized and coherent manner Present ideas that are well developed with supporting information and examples Mechanics Use standard syntax and sentence structure Use correct spelling punctuation and capitalization Use appropriate grammar e.g. correct tense subject-verb agreement no missing words Write legibly Proof read finished documents for errors Tone Write in a manner appropriate for industry Use language appropriate for the target audience Use appropriate tone and word choice e.g. writing is professional and courteous 9 3. Mathematics Using principles of mathematics to solve problems. Quantification Read and write numbers Count and place numbers in sequence Recognize whether one number is larger than another Computation Add subtract multiply and divide with whole numbers fractions decimals and percents Calculate averages ratios proportions and rates Convert decimals to fractions Convert fractions to percents Measurement and estimation Take measurements of time temperature distances length width height perimeter area volume weight velocity and speed Use and report measurements correctly Convert from one measurement to another e.g. from English to metric or International System of Units SI or Fahrenheit to Celsius Application Perform basic math computations accurately Translate practical problems into useful mathematical expressions Use appropriate mathematical formulas and techniques 4. Science and Technology Using scientific methods and technology to solve problems. Comprehension Understand basic scientific principles and how to use commonly available technology Understand the scientific method i.e. identifies problems collects information forms opinions and draws conclusions Knowledge of Biology Chemistry Nutrition Anatomy Physiology Physics Application Understand overall intent and proper procedures for set-up and operation of equipment Apply basic scientific principles and technology to complete tasks 5. Communication Listening Speaking Giving full attention to what others are saying and speaking in English well enough to be understood by others. Speaking Express information to individuals or groups taking into account the audience and the nature of the information e.g. technical or controversial 10 Speak clearly and confidently Speak using common English conventions including proper grammar tone and pace Track listener responses and reacts appropriately to those responses Effectively use eye contact and non-verbal expression Listening Receive attend to interpret understand and respond to verbal messages and other cues Pick out important information in verbal messages Understand complex instructions Appreciate feelings and concerns of verbal messages Two-way communication Practice meaningful two-way communication i.e. speak clearly pay close attention and seek to understand others listen attentively and clarify information Attend to nonverbal cues and respond appropriately Persuasion influence Influence others Persuasively present thoughts and ideas Gain commitment and ensure support for proposed ideas 6. Critical Analytical Thinking Using logic reasoning and analysis to address problems. Reasoning Possess sufficient inductive and deductive reasoning ability to perform job successfully Critically review analyze synthesize compare and interpret information Draw conclusions from relevant and or missing information Understand the principles underlying the relationship among facts and apply this understanding when solving problems Mental agility Identify connections between issues Quickly understand orient to and learn new assignments Shift gears and change direction when working on multiple projects or issues 7. Basic Computer Skills Using a computer and related applications to input and retrieve information. Comprehending the basics Understand and efficiently use basic computer hardware e.g. Pcs printers and software e.g. Word processing software spreadsheet software to perform tasks Understand common computer terminology e.g. program operating system and possess familiarity with the fundamental capabilities of computers 11 Entering data Enter data into computer files quickly with an acceptable degree of accuracy Double check data entry carefully Notice when data are missing or look wrong Take steps to ensure computer files are complete and accurate Preparing documents Use word processing programs to create edit and retrieve document files Type materials quickly and accurately Check work carefully and identify correct typographical errors Use basic reference materials and tools e.g. spell check to ensure accuracy Keyboarding and word processing Skillfully use word-processing software Streamline document processing by employing a variety of common software functions Use correct style and format even when confronted by uncommon requirements that deviate from standard guides Consult appropriate manuals when uncertain about the correct style and format Internet applications Effectively use the internet and web-based tools to manage basic workplace tasks e.g. timekeeping maintaining employee records conducting information searches Understand and perform internet functions requiring the use of log-in and password information Understand and comply with guidelines surrounding internet usage Understand and comply with information security processes and guidelines E-mailing Compose professional e-mails to communicate business-related information to coworkers colleagues and customers Understand the company e-mail system and its basic functions e.g. replying to forwarding messages using electronic address books attaching files Ensure that key stakeholders are kept informed of communications by copying i.e. ccing them on important e-mails when appropriate Spreadsheets Use spreadsheet software to enter manipulate edit and format text and numerical data Effectively create and save worksheets charts and graphs that are well organized and useful 12 8. Information Literacy Functional and critical thinking skills related to information media and technology. Locate and Evaluate Information Locate information efficiently time and effectively sources Evaluate information critically and competently Review information obtained for relevance and completeness Recognize important gaps in existing information Take steps to eliminate those gaps Use and Manage Information Use information accurately and creatively for the issue or problem at hand Manage the flow of information from a wide variety of sources Organize reorganize information as appropriate to get a better understanding of a problem Analyze Media Understand both how and why media messages are constructed and for what purposes Examine how individuals interpret messages differently how values and points of view are included or excluded and how media can influence beliefs and behaviors 13 Tier 3 Workplace Competencies 1. Teamwork Working cooperatively with others to complete work assignments. Acknowledging team membership and role Accept membership in the team Identify the roles of each team member Show loyalty to the team Determine when to be a leader and when to be a follower depending on what is needed to achieve the team s goals and objectives Encourage others to express their ideas and opinions Identify and draw upon team members strengths and weaknesses to achieve results Learn from other team members Establishing productive relationships Develop constructive and cooperative working relationships with others Exhibit tact and diplomacy and strive to build consensus Show sensitivity to the thoughts and opinions of other team members Deliver constructive criticism and voice objections to others ideas and opinions in a supportive non-accusatory manner Respond appropriately to positive and negative feedback Identifying with the team and its goals Identify the goals norms values and customs of the team Cooperate with others and contribute to the group s effort Use a group approach to identify problems and develop solutions based on group consensus Effectively communicate with all members of the group or team to achieve team goals and objectives Resolving conflicts Bring others together to reconcile differences Handle conflicts maturely by exercising give and take to achieve positive results for all parties Reach formal or informal agreements that promote mutual goals and interests and obtain commitment to those agreements from individuals or groups 2. Customer Focus Actively looking for ways to meet customer or client needs. Understanding customer needs Demonstrate a desire to understand client patient needs Listen to what clients patients are saying and asks questions as appropriate 14 Providing personalized service Provide prompt efficient and personalized assistance to meet the requirements requests and concerns of clients patients Provide thorough accurate information to answer clients patients questions Actively look for ways to help clients patients by identifying and proposing appropriate solutions and or services Establish boundaries as appropriate for unreasonable client patient demands Acting professionally Deal with internal or external customers in a pleasant courteous and professional manner Develop constructive and cooperative working relationships with clients patients and display a good-natured cooperative attitude Deal with difficult clients patients in a calm and empathetic manner Represent the organization to the public Keeping customers informed Follow up with clients patients Keep clients patients up to date about decisions that affect them 3. Planning Organizing Planning and prioritizing work to manage time effectively and accomplish assigned tasks. Planning Approach work in a methodical manner Plan and schedule tasks so that work is completed on time Keep track of details to ensure work is performed accurately and completely Work concurrently on several tasks Anticipate obstacles to project completion and develop contingency plans to address them Takes necessary corrective action when projects go off-track Prioritizing Prioritize various competing tasks and perform them quickly and efficiently according to their urgency Find new ways of organizing work area or planning work to accomplish work more efficiently Allocating resources Estimate resources needed for project completion Allocate time and resources effectively and coordinate efforts with all affected parties Keep all parties informed of progress and all relevant changes to project timelines 15 Project Management Project management requires team work team building goal setting organization adaptation communication 4. Problem Solving Decision Making Applying critical-thinking skills to solve problems by generating evaluating and implementing solutions. Identifying the problem Anticipate or recognizes the existence of a problem Identify the true nature of the problem by analyzing its component parts Evaluate the criticality of the situation Use all available reference systems to locate and obtain information relevant to the problem Recall previously learned information that is relevant to the problem Document the problem and corrective action Locating gathering and organizing relevant information Effectively use both internal resources e.g. internal computer networks manuals policy or procedure guidelines and external resources e.g. internet search engines to locate and gather information Examine information obtained for relevance and completeness Recognize important gaps in existing information and take steps to eliminate those gaps Organize reorganize information as appropriate to gain a better understanding of the problem Refer the problem to appropriate personnel when necessary Generating alternatives Integrate previously learned and externally obtained information to generate a variety of high-quality alternative approaches to the problem Use logic and analysis to identify the strengths and weaknesses the costs and benefits and the short- and long-term consequences of different approaches Choosing a solution Choose the best solution after contemplating available approaches to the problem Make difficult decisions even in highly ambiguous or ill-defined situations Implementing the solution Commit to a solution in a timely manner and develop a realistic approach for implementing the chosen solution Observe and evaluate the outcomes of implementing the solution to assess the need for alternative approaches and to identify lessons learned 16 5. Working with Tools Technology Selecting using and maintaining tools and technology to facilitate work activity. Selecting tools Select and apply appropriate tools or technological solutions to frequently encountered problems Carefully consider which tools or technological solutions are appropriate for a given job and work with IT to consistently choose the best tool or technological solution for the problem at hand Set up and adjust equipment Monitor equipment and alert IT department if system is malfunctioning Keeping current Demonstrate an interest in learning about new and emerging tools and technologies Seek out opportunities to improve knowledge of tools and technologies that may assist in streamlining work and improving productivity Read technical operating service or repair manuals to identify information Troubleshooting Clean inspect and maintain equipment Troubleshoot tools and technologies Identify possible defects or other problems 6. Scheduling Coordinating Making arrangements and scheduling appointments. Informing Respond to the schedules of others affected by arrangements Inform others of arrangements giving them complete accurate and timely information Ensure that others receive needed materials in time Verifying Take steps to verify all arrangements Recognize problems generate effective alternatives and take corrective action Coordinating in distributed environments Coordinate schedules of colleagues co-workers and clients to ensure that inconvenience is minimized and productivity is enhanced Leverage technology e.g. internet teleconference to facilitate information sharing in distributed work environments Shiftwork Disseminate crucial information in an organized manner to rapidly bring employees up to speed at the start of their shifts 17 Ensure that employees are updated on work completed on past shifts and work that still needs to be completed 7. Checking Examining Recording Entering transcribing recording storing or maintaining information in written or electronic magnetic format. Completing forms Select and complete appropriate forms quickly and completely Attend to and follow through on important information in paperwork Forward or process forms in a timely and accurate manner Obtaining information Obtain appropriate information signatures and approvals promptly Verify that all information is complete and accurate before forwarding materials Maintaining logs File documentation in accordance with agency requirements Keep logs records and files that are up-to-date and readily accessible Update logs files and records noting important changes in status Detecting errors Detect and correct errors and inconsistencies even under time pressure Identify vague or ambiguous documentation Route to appropriate person to correct documentation 8. Workplace Fundamentals Knowledge of basic business principles trends and economics. Situational awareness Understand the organization s mission and functions Recognize one s role in the functioning of the organization and understand the potential impact one s own performance can have on the success of the organization Grasp the potential impact of the organization s well-being on employees Business ethics Demonstrate respect for coworkers colleagues and customers Act in the best interest of the client patient the organization the community and the environment Comply with applicable laws and rules governing work and reports loss waste or theft or company property to appropriate personnel 18 Tier 4 Industry-Wide Technical Competencies 1. Health Industry Fundamentals Knowledge of the basic components and emerging principles and concepts that impact the Health industry. Critical Work Functions Understand the culture of the Health Industry the key stakeholders command and control processes and workflow and the concept that errors or negligence may result in harm to the patient Understand how changes in laws regulations or policies or new and emerging technologies impact the industry Understand the components of the Health Industry and services provided by each Identify one s role in the department organization and overall health environment Technical Content Areas Components of the Health Industry Practitioners Such as offices of Physicians and Osteopaths Dentists Chiropractors Optometrists Podiatrists Physical and Occupational Therapists Psychologists Audiologists Speech and Language Pathologists Treatment Facilities Hospitals Such as Medical and Surgical Psychiatric and Substance Abuse Specialty Critical Access and Long Term Acute Care Outpatient Centers Medical and Diagnostic Laboratories Ambulatory Surgery Centers Home Healthcare Services Other Ambulatory Services 19 Nursing and Residential Care Facilities Such as Skilled Nursing Facilities Residential Facilities for People with Disabilities Residential Care Facilities assisted living for the Elderly Health Industry Related Such as Public Health Agencies Health Research Organizations Pharmaceutical research companies Health industry product vendors 2. Healthcare Delivery Knowledge of the practices and procedures used to deliver quality patient care. Critical Work Functions Describe the organizational structure and functions of major components of healthcare delivery Understand and implement patient safety practices that promote quality health outcomes patient security and health information security Understand the basic healthcare delivery models and their impact on work processes and information exchange. Differentiate among types of health insurance Understand the importance of licensure and scope of practice Understand patient rights and responsibilities Maintain professional boundaries Secure and maintain certification and licensure requirements for duties as required Technical Content Areas Roles and Responsibilities of Health Industry Workers in Healthcare Delivery Models such as Physicians Surgeons and Osteopaths Dentists Hospitalists Physician Assistants Nurse Practitioners Registered Nurses Licensed Practical Nurses Nurses Aides Therapists Laboratory Technologists Technicians Dieticians Pharmacists 20 Purpose and Functions of Diagnostic Procedures Patient Safety Procedures Radiology and Scans Laboratory Tests Therapeutic Procedures Pharmaceutical Dispensing Procedures Use of new technology e.g. Telehealth Diagnoses Monitoring Treatment Scope of Practice Licensure accreditation and certification requirements State and federal legislation statues that govern the delivery of health services Impact one s own performance can have on the success of the organization Health Insurance Health insurance options HMO PPO EOP POS etc. Medicaid Medicare compliance guidelines Record-keeping such as billing records appropriate health documentation. Confidentiality and accuracy of insurance information 3. Health Information Knowledge of types of health information and rules and regulations surrounding their use. Critical Work Functions Understand the role and importance of health information Identify and understand health documentation requirements Identify and understand health insurance documentation requirements Maintain the security and confidentiality of patient records per HIPAA other related regulations Understand the two-way flow of information and data through the medical organization originating with both patient and provider Ensure documentation in health records reflect completeness accuracy timeliness appropriateness quality integrity and authenticity as required. Use medical terminology within a scope of practice in order to interpret transcribe and communicate information data and observations Use appropriate procedures for submitting and accessing medical information through a Health Information Exchange Transmit documents via internet or fax in a secure manner Dispose of patient information and records appropriately 21 Technical Content Areas The Medical Health Record paper electronic hybrid History - What care has been provided and what is outstanding SOAP Subjective Objective Assessment Plan Outcomes of care provided and responses to the plan of care Current patient status assessments Support decisions based on assessments to drive new plans of care Diagnoses Treatments Procedures Progress notes Laboratory results Consents Nursing and other therapeutic monitoring reports Administrative and referral documentation Discharge summary and instructions Health Information Exchange Software Access retrieval and submission procedures Medical terminology foundations Diagnostic and procedure terms Roots prefixes suffixes eponyms Abbreviations Acronyms Record keeping and documentation procedures Confidentiality Release of information documentation 4. Health Industry Ethics The discipline of evaluating and applying the merits risks and social concerns of activities in the field of health care. Critical Work Functions Act in the best interests of the client patient Report and prevent abuse and neglect Protect confidentiality of client patient records Differentiate between ethical and legal issues impacting health care Make ethical decisions Respect clients rights and responsibilities Demonstrate an awareness of cultural competence in the context of cultural social and ethnic diversity 22 Technical Content Areas Morality and ethics as they relate to health industry outcomes Ethical and legal issues impacting the health industries Confidentiality Problem solving techniques when confronted with ethical dilemmas or issues Problem sensitivity the negative consequences of action inaction Malpractice liability and negligence Expressed informed implied and involuntary consent Patient s Bill of Rights National Standards on Culturally and Linguistically Appropriate Services CLAS Cultural sensitivity Language assistance services e.g. bilingual staff and interpreter services Service area demographics 5. Laws and Regulations Knowledge of relevant local state and federal laws and regulations that impact the Health industry Critical Work Functions Apply the fundamentals of privacy and confidentiality policies and procedures Comply with applicable federal and state laws policies regulations and legislated rights of clients Practice responsibly within the ethical framework of the Patients Bill of Rights Understand the legal responsibilities limitations and implications of actions Comply with policies and requirements for documentation information security and record keeping Keep up to date on standards and government regulations Follow agency facility policies and procedures Technical Content Areas Client Patient Client Patient Bill of Rights Good Samaritan Law Client patient advocacy Laws and Regulations Such as Relevant state and local laws and regulations Privacy and confidentiality policies and procedures Protected Health Information PHI Health Insurance Portability and Accountability Act of 1996 HIPAA and updates Occupational Safety and Health Administration OSHA 23 Clinical Laboratory Improvement Amendments CLIA Regulations Needle Stick Prevention Act Emergency medical treatment and active labor act EMTALA regulations Voluntary Accreditation Joint Commission regulations American Osteopathic Association regulations 6. Worker Health and Safety The procedures and protocols necessary to ensure a safe and healthy work environment. Critical Work Functions Understand and follow established personal safety security and environmental practices Ensure that equipment is being used safely Comply with local state federal and organization health safety security and environmental policies and regulations Follow emergency procedures and protocols Technical Content Areas Disease prevention Infection control Universal Precautions Safety signs symbols and labels Material Safety Data Sheets 24 Tier 5 Industry-Sector Technical Competencies 1. Health Information Literacy and Skills Knowledge of the existing and emerging principles and concepts of health records. Critical Work Functions Describe the principles of structure design and use of health information such as individual comparative reports and trended data . Differentiate between the types of patient health records such as paper-based electronic health record personal health record Be aware of complex workflows practiced in the delivery of patient care and in related business operations in order to efficiently and optimally migrate to a computerized environment Communicate health medical information using standard definitions vocabularies terminologies and or relevant data sets as used in the organization s health information systems Demonstrate knowledge of health information systems used by the organization including resources routes and flow of information Describe e-health initiatives as they relate to business and consumers e.g. personal health scheduling screenings evaluations assessments Identify barriers associated with computerized health data Know and apply policies and procedures regarding release of any patient-specific data to authorized users Technical Content Areas Content and uses of health information Knowledge of anatomy physiology disease processes pharmacology and medical terminology Content and format of types of medical records Organization policy regarding storage and transfer of information Health data sets for example OASIS HEDIS UHDDS Health terminologies and classification systems Health information systems Interoperability 2. Health Informatics Skills Using the EHR Using technology to control and safeguard the collection organization structure processing and delivery of health information. Critical Work Functions Understand use of technology in maintaining electronic health records Create and update documents within the electronic health record EHR and the personal health record PHR using electronic tools and applications including portable computing 25 devices word processing spreadsheet database and desktop presentation applications Locate and retrieve information in the electronic health record for various purposes Understand the organization s mission and functions as it pertain to its EHR s application and its meaningful use Utilize mainstream software to complete job-specific tasks and understand the interaction between mainstream and EHR technology. Follow security and privacy policies and procedures to the use of networks including intranet and Internet. Follow confidentiality and security measures to protect electronic health information. Differentiate between primary and secondary health data sources and databases Identify classification and systematic health-related terminologies for coding and information retrieval Know the policies and procedures related to populating and using the health data content within primary and secondary health data sources and databases Resolve minor technological problems associated with using an EHR Utilize basic IT troubleshooting processes to identify the root cause of an IT-related problem Utilize IT Help Desk for problem resolution where necessary to maximize efficiency effectiveness Technical Content Areas Computerized Provider Order Entry CPOE Quality improvement and reporting E-Prescribing Specialized health information software applications e.g. computer-based documentation systems for point-of-care computerized physician order entry coding Mainstream software applications e.g. spreadsheets databases email Web 2.0 mobile applications Hardware and communication technologies and formats related to personal health records 3. Privacy and Confidentiality of Health Information Using standard documentation procedures to collect and communicate appropriate health information within legal and regulatory requirements. Critical Work Functions Identify and apply legal and regulatory requirements related to the use access and disclosure of protected health information Explain legal responsibility limitations and implications of actions Identify what constitutes authorized use of protected health information Report any possible breaches of confidentiality in accordance with organizational policies 26 Technical Content Areas Legal and regulatory requirements for the storage and transfer of information Client Patient Bill of Rights Client Patient advocacy Protected Health Information PHI 4. Health Information Data Technical Security Applying confidentiality and electronic security measures to store and protect health information. Critical Work Functions Adhere to applicable policies and procedures for the use of networks including intranet and internet applications to facilitate the electronic health record EHR personal health record PHR public health records Implement administrative physical and technical safeguards Follow access protocols for entry to an electronic health record Understand and apply fundamental documentation requirements in the electronic creation and recordkeeping environment Recognize components of risk management contingency planning and data recovery procedures Report any possible breaches of confidentiality in accordance with organizational policies Resolve minor technology problems associated with using an electronic information application Technical Content Areas Documentation principles and requirements Data storage and retrieval Data accessibility Data recovery procedures Data integrity business continuity disaster recovery encryption ID management Security policies and procedures Privacy confidentiality legal and ethical issues 27 Resources Reviewed Developer Resource URL Alaska Vocational Technical Center Certified Nurse Assistant http www.avtec.alaska.edu CNA - A.htm American Association of Colleges of Nursing Curriculum Standards http www.aacn.nche.edu Education c urriculum.htm American Health Care Association Competencies for Senior Nurse Leaders in LTC http www.ahcancal.org qual ity impro vement leadership excellence Document s competencies report.pdf American Health Information Management Association Registered Health Information Administrator Competency Statements http www.ahima.org downloads pdfs certification RHIA Job Analysis.pdf American Health Information Management Association Registered Health Information Technician Competency Statements http www.ahima.org downloads pdfs certification AHIMA 20RHIT 20Job 20Analysis 20Report with 20Addendu m.pdf American Health Information Management Association Certified C oding Associate http www.ahima.org downloads pdfs certification CCA 20Exam 20Blueprin t 20Crosswalk.pdf American Health Information Management Association Certified in Healthcare Privacy and Security http www.ahima.org downloads pdfs certification CHPS Content Outline.pd f American Health Information Management Association Joint Work Force Task Force Health Information Management and Informatics Core Competencies for Individuals Working with Electronic Health Records AMIA AHIMA http www.ahima.org schools FacReso urces RESOURCEworkforce 2008.pdf American Medical Informatics Association Health Informatics Master s Degree http www.ahima.org schools FacReso urces CurriculumMapHI 2010.pdf American Society of Health Informatics Managers Certified Health Informatics Systems Professional CHISP Certification http ashim.org certification Association for Healthcare Documentation Integrity Certified Medical Transcriptionist http www.ahdionline.org Professional Practices BestPracticesandStandardGuide lines CompensationforMedicalTranscript ionists MedicalTranscriptionistJobDescri ptions tabid 278 Default.aspx Austin Community College ACAP Reports for Addictions Counseling Clinical Assistant Dental Assistant Dental Hygienist Hemodialysis Technician Licensed Vocational Nurse Medical Assistants Medical Coding Specialist Medical Lab Technician Medical Transcriptionist Molecular Diagnostics Paramedic Patient Access Representative Pharmacy Technician Phlebotomy Technician Registered Nurse Sterile Processing Technician http irt.austincc.edu ids curriculum a capReport.php Bellevue Community College Medical Informatics http bellevuecollege.edu programs de grees proftech medit California Department of Education Health Science and Medical Tec hnology Industry Sector http www.cde.ca.gov ci ct sf docum ents ctestandards.pdf 28 Center for Excellence for Information and Computing Technology Description of Healthcare Informatics Certificate http www.coeforict.org research healt h Center for Public Health Informatics Competencies for Public Health Informaticians 200 9 http www.cphi.washington.edu resou rces PHICompetencies.pdf Certification Commission for Healthcare Information Technology An Introduction to Health IT Certification http ehrdecisions.com wp- content files CCHITIntroToHealthIT200 90324.pdf Cincinnati State Technical and Community College Health Information Technology HIM http www.cincinnatistate.edu real - world-academics academic- divisions health-public-safety programs- certificates-1 hps-curriculum health- information-management-technology- curriculum College of Direct Support Community Support Skill Standards http www.collegeofdirectsupport.com CDS50 content CDSContent csss.htm Commission on Accreditation for Health Informatics and Information Management Education Curriculum Requirements for Health Information Management http www.cahiim.org policiescurricul um.html Cosumnes River College Los Rios Community College Health Information Technology Course Descriptions Curriculum http www.crc.losrios.edu Areas of St udy Careers and Technology Health In formation Technology Courses.htm Cuyahoga Community College Health Information Management curriculum http www.tri - c.edu programs healthcareers healthinf ormation Pages ProgramSequenceHealt hInformationManagement.aspx Education Development Center INC IT Across Careers http itac.edc.org Healthcare Education Industry Partnership Healthcare Core Curriculum http www.healthforceminnesota.org P rograms Curriculum Health care Information and Management Systems Society Web site http www.himss.org ASP index.asp Hospital Corporation of America Code of Conduct http hcaethics.com CPM Code 20Of 20Conduct 20Booklet.pdf Institute for Caregiver Education Nursing Assistant Training Curriculum http www.caregivereducation.org pro ducts products.htm Job Corps Certified Electronic Health Record Specialist Module Hard Copy National Alliance for Direct Support Professionals NADSP Competency Areas https www.nadsp.org dsp- credentialing 15-competency-areas.html 29 National Association of State Directors of Career Technical Education Career Cluster Resources for Health Science Human Services and Science Technology Engineering and Math http www.careerclusters.org National Center for Healthcare Leadership NCHL Health Leadership Competency Model http www.nchl.org ns documents Co mpetencyModel-short.pdf National Consortium on Health Science and Technology Education Health Sciences Framework http www.healthscienceconsortium.org health science cluster.php National Consortium on Health Science and Technology Education National Healthcare Foundation Standards and Accountability Criteria http www.healthscienceconsortium.org healthcare standards.php National Consortium on Health Science and Technology Education Health Informatics Pathway Standards and Accountability Criteria http www.healthscienceconsortium.org docs health info pathway.pdf National Organization of Nurse Practitioner Faculties Nurse Practitioner Core Competencies http www.nonpf.org displaycommon. cfm an 1 subarticlenbr 14 North Carolina Community College System Health Information Technology Curriculum Standard http www.nccommunitycolleges.edu Programs docs Curric Standards 45 A 45360 Health Info Tech FA11 v3.pdf Northern Virginia Community College Health Information Technology Associate in Applied Science Degree http www.nvcc.edu curcatalog progr ams pdf HLT-HIM-AAS.pdf Office of Apprenticeship Work Process Schedules for Home Health Aide Diet Therapy Specialist Diagnostic Imaging Specialist Dental Assistant Health Services Management Medical Laboratory Technician Medical Service Nurse Licensed Practical Optometry Pharmacy Specialist Public Health Specialist Health Support Specialist Medical Coding Medical Transcriptionist http www.careeronestop.org Compete ncyModel search.aspx Ohio Department of Education Health Science Technical Content Standards http www.ode.state.oh.us GD Templa tes Pages ODE ODEPrimary.aspx page 2 TopicRelationID 1769 Oregon Department of Education Health Informatics Knowledge and Skill Statements http www.ode.state.or.us teachlearn s ubjects oregonskillsets healthserv hltha dminoper focusarealevel hlthinfomaticsf aksall.pdf Passaic County Community College Health Information Technology Course list http prod.campuscruiser.com q pg de partments listCourses tg DepartmentLi stCourses action reset cmp F22.0- 27.0 7 cx 22.173-27.14336 Pitt Community College Health Information Technology Degree or Diploma curriculum and core competencies http www.pittcc.edu academics progr ams health-sciences health-information- technology HIT.pdf Rochester Institute of Technology Medical Informatics Curriculum http www.ist.rit.edu pagefiles MICS MS Worksheet.pdf 30 Southern Illinois Collegiate Common Market Health Information Technology Curriculum http www.siccm.com HIT 20CURRIC ULUM.htm St. Petersburg College A.S. Healthcare Informatics Program Curriculum http www.spcollege.edu program HC INF-AS St. Petersburg College Healthcare Informatics Certificate Curriculum http www.spcollege.edu program HC INF-CT Tennessee Department of Education Health Informatics http state.tn.us education cte hs prof curr doc hs healthinform profstu.pdf Tidewater Community College Virginia Beach Campus Associate of Applied Science Degree Health Information Management Curriculum http www.tcc.edu academics division s healthprofessions hit packet.PDF University of Alabama at Birmingham Health Information Management Bachelor of Science Curriculum http main.uab.edu shrp default.aspx pid 32639 US Department of Health and Human Services Health Information Technology Web Site http www.hhs.gov healthit US Department of Health and Human Services National Standards on Culturally and Linguistically Appropriate Services CLAS http minorityhealth.hhs.gov templates browse.aspx lvl 2 lvlID 15 US Department of Labor Job Corps Training Achievement Record TAR for Certified Electronic Health Record Specialist Hard Copy US Department of Labor Occupational Information Network O NET Reports for Registered Nurse Personal and Home Care Aide Home Health Aide Medical Assistant Medical Records and Health Information Technicians Pharmacy Technician Dental Assistant Dental Hygienist Physical Therapist Mental Health and Substance Abuse Social Worker Rehabilitation Counselor Medical and Public Health Social Worker Surgical Technologist Occupational Therapist Physician Assistant Medical Transcriptionists Medical Secretaries Health Educator Medical Equipment Repairer Informatics Nurse Specialists http www.onetonline.org find industr y i 62 g Go Western Interstate Commission for Higher Education A Closer Look at Healthcare Workforce Needs in the West Health Information Technology http www.wiche.edu pub 11530 Wisconsin Department of Public Instruction Health Science Portfo lio http dpi.wi.gov cte doc healthsc.doc 1 Attachment 2 A Resource Guide for Health Information Technology A Resource Guide for Health Information Technology is a reference providing program planners and service providers with practical information about the HHS Office of the National Coordinator for Health Information Technology ONC and its initiatives and grant investments to prepare the emerging Health-IT workforce. Table of Contents Background .2 Developing a Health IT Workforce ..2 Building a Regional Partnership .. .3 Understanding Health IT Occupations .. .. .. .5 Education and Employment Resources 9 Appendix A Key Definitions .12 Appendix B Health Information Technology Regional Extension Centers HITRECs 14 Appendix C Health and Human Services Office of the National Coordinator HHS ONC Community College Consortia Members 17 2 Background Developing a Health IT Workforce The use of technology across the health and human services industry is fragmented. Although some providers have implemented medical records management software there is still an extensive use of hard copies for forms exchanged between doctors labs hospitals clinics and other health and human services providers. The use of technology for information exchange has proven to save administrative time contain costs and reduce errors. Health and human service providers are currently taking advantage of a unique opportunity to implement and meaningfully use EHRs. The federal government has committed unprecedented resources to support the adoption and use of EHRs. The installment of an EHR system now is a solid investment for the future because It s where the profession is going 90 of medical students consider it important or very important to have an EHR where they choose to practice. 8 It s what patients want Four out of five adults believe that online personal health records would be beneficial in managing their health and health care. 9 It makes coordinated care a reality EHRs are an essential component of health care innovation efforts such as the Patient Centered Medical Home and Accountable Care Organizations. Incentives now available For healthcare providers that are eligible there is a limited window of opportunity to take advantage of Medicare and Medicaid EHR Incentive Programs designed to support the implementation of certified The Health Information Technology for Economic and Clinical Health HITECH Act enacted as part of the American Recovery and Reinvestment Act ARRA of 2009 promotes the adoption and meaningful use of health information technology HIT . The Office of the National Coordinator for Health Information Technology ONC located within the Office of the Secretary for the U.S. Department of Health and Human Services HHS is charged with coordinating the nationwide efforts to implement and use the most advanced health information technology to enable the electronic exchange of health information. The ONC set a goal for the utilization of an Electronic Health Record EHR for each person in the United States by 2014. To support this objective the ONC has coordinated a suite of investments to educate health information technology professionals. 3 EHRs. A fully functional certified EHR will be essential to participation in both public and private pay-for-performance programs expected in the future. Due to the legislative timeline and incentives to health providers to be early adopters of EHR many health and human services providers are changing existing workflows and processes to effectively implement EHR. Some have only just begun while others have not yet started. Building a Regional Partnership The information found in this resource is provided for use by workforce investment partners to support collaboration with the Health Information Technology Regional Extensions Centers HITRECs and schools in the Health and Human Services Office of the National Coordinator HHS ONC Community College Consortia see Attachment C to educate assess and employ the workforce required for EHR implementation efforts. In support of this collaboration we have developed an EHR competency model and the blocks represent competency areas that is the applied skills knowledge abilities essential to successful performance in the increasingly electronic environment of the health industry. The EHR model is posted and available for downloading on the Competency Model Clearinghouse CMC Web site at http www.careeronestop.org competencymodel pyramid.aspx EHR Y . We are asking workforce system leaders in regional areas to convene with interested stakeholders including health care employers and educators to discuss this critical workforce with the Health Information Technology Regional Extension Centers HITRECs . HITRECS offer technical assistance guidance and information on best practices to support and accelerate health care providers efforts to become meaningful users of Electronic Health Records EHRs . There are an estimated 70 HITRECs supporting primary care providers in achieving meaningful use of EHRs and enabling nationwide health information exchange in a defined geographic area. See Attachment B for a complete list of HITRECs to determine if there is a Center in your vicinity. Rural health providers and State Offices of Rural Health face special geographic challenges in their effort to deliver quality care. The realities of distance and attracting and retaining qualified professionals can complicate health care delivery. The widespread adoption of Health information technology health IT can help ameliorate some of those problems. However rural health care providers face several barriers to health IT implementation. These include Lack of broadband internet access Limited career pathways for the health information workforce and Insufficient financial capital to implement electronic health record EHR systems. The ONC has developed a Rural Health IT Adoption Toolbox available on-line at http www.hrsa.gov healthit toolbox RuralHealthITtoolbox index.html that 4 includes useful information about getting started program planning and project staffing and management. The HITREC is a resource to help foster regional collaboration to meet the following objectives Describing the types of occupations associated with Health IT EHR professions in your region and the skills needed to perform successfully in these roles Locating sources of Health IT EHR training assessment vouchers and employment opportunities and Learning about transferrable skills and work experiences from prospective Health IT employers. The outcomes from a coordinated approach include Establishing a plan for continued collaboration with HITRECs Developing a process for working with local employers that have employment opportunities and Identifying training opportunities by working with local education providers. About this Resource This resource has four sections that will guide your conversation Developing a Health IT Workforce Understanding Health IT Occupations Education and Employment Resources Appendices o Key Definitions o Health Information Technology Regional Extension Centers HITRECs o Health and Human Services Office of the National Coordinator HHS ONC Community College Consortia Members 5 Understanding Health IT Occupations Successful EHR implementation requires enhanced workforce skills at several junctures Project management during implementation Training and staff support for ongoing operation and maintenance New and enhanced skills for staff who interact daily with new technology ONC initiatives and investments focus on training the IT workforce who will provide support for the implementation and maintenance of EHR. Over the past year the Employment and Training Administration ETA has worked with federal agencies and industry partners to identify the core competencies required to develop the training needed to prepare new and existing healthcare workers with the knowledge and skills to effectively use EHR. Refer to the EHR Competency Model for more information on the knowledge and skills required of the healthcare workforce. The Intersection of Health and IT in Figure 1 demonstrates the commonality of foundation competencies and the distinction in focus in the industry wide and industry technical competencies. Health workers need a broad knowledge of the health industry supplemented with IT concepts whereas the Health-IT worker needs a strong background in IT concepts as they might apply to the culture and business of healthcare delivery. Figure 1. 6 A Health IT worker depicted to the right in Figure 1 is someone who is qualified to support the adoption and implementation of Electronic Health Records EHRs information exchange across health care providers and public health authorities and the redesign of workflows within health care settings to gain the quality and efficiency benefits of EHRs. It is anticipated that implementation efforts will be supported a mobile project management team as well as a permanent support staff at a health provider s location. Mobile Project Management Team Positions The project management team must have leadership skills management ability patience and vision. The team must realize that the implementation of a health IT system is a large multifaceted project that will not always go as planned. The ability to deal with frustration constructively and seek opportunities in the face of adversity is a definite asset. Good communication skills both verbal and written communication skills among team members and with the administration are essential for ensuring that a project is well managed and organized. With the increasing complexity of clinical system implementations the need for well trained skilled project managers is expected to increase. These members of the workforce will support implementation at specific locations for a period of time and when their work is done will move on to new locations. They might be employed by regional extension centers hospitals critical access hospitals provider offices vendors or state city public health agencies. The team would consist of Position Workers in this role will Past experience and anti cipated training required Implementation support specialists execute implementation project plans install hardware as needed configure software to meet practice needs incorporate usability principles into design and implementation Experience in i nformation technology or information management Three to six month certificate training for individuals with technical training Practice workflow and information management redesign specialists conduct user requirements analysis to facilitate workflow design integrate information technology functions into workflow document health information exchange needs design processes and information flows that accommodate quality improvement and reporting work with provider personnel to Backgrounds in health care e.g. as a practice administrator or in information technology but are not licensed clinical professionals Three to six month certificate training for health care or information management backgrounds 7 implement revi sed workflows and evaluate process workflows to validate or improve practice s systems Clinician consultants suggest solutions for health IT implementation problems in clinical and public health settings address workflow and data collection issues from a clinical perspective including quality measurement and improvement assist in selection of vendors and software and advocate for users needs acting as a liaison between users IT staff and vendors. Similar to the redesign specialist role listed above but brings to bear the background and experience of a licensed clinical and professional or public health professional Three to six month certificate training for health professionals Implementation managers apply project management and change management principles to create implementation project plans to achieve the project goals interact with office hospital personnel to ensure open communication with the support team lead implementation teams consisting of workers in the roles described above manage vendor relations providing feedback to health IT vendors for product improvement Experience in health and or IT environments as well as administrative and managerial experience. Training in any of the above plus administrative experience Permanent Support Staff Staff of healthcare delivery and public health sites will be needed for the ongoing support and facilitation of health IT systems across the health care industry in organizations such as office practices hospitals health centers long term care facilities health information exchange organizations and state and local public health agencies. These workers provide the support needed to train the health workers in the new processes and procedures to help them become efficient and meaningful users of that technology. Permanent support staff might include 8 Position Workers in this role will Past experience and anticipated training required Clinician l eaders Chief Medical Informatics Information Officer CMIO Chief Nursing Informatics Officer CNIO develop strategic plans for clinical systems and information management align clinical system capabilities with organizational needs oversee IT governance ensure that developments are in line with global trends in medicine informatics and information technology Medical Health Service Manager or Informatics Nurse Specialists One year certificate or masters degree in informatics on top of licensed health care public health professional status Technical software support staff interac t with end users to diagnose IT problems and implement solutions document IT problems and evaluate the effectiveness of problem resolution support systems security and standards Previous experience information technology or information management Six month certificate training for technical specialists Trainer s use a range of health IT applications preferably at an expert level communicate both health and IT concepts as appropriate assess training needs and competencies of learners design lesson plans structuring active learning experiences for user track training records of the users and develop learning plans for further instruction Experience as a health professional or health information management specialist. Classroom experience as a trainer in the classroom is also desired. Six month certificate program for health professionals or health information management specialists Health Information Management and Exchange Specialists support the collection management retrieval exchange and or analysis of information in electronic form in health care and public health organizations Bachelors and masters degrees in Health Information Management and related fields. Health Information Privacy and Security Specialists ensure the privacy a nd security of health information Bachelors or Masters degree in information science 9 Health Care and Public Health Informaticians These individuals will be highly-trained and highly-specialized for academic faculty positions and research and development in various public non-profit and for profit sectors of the health care industry. This workforce might include Position Workers in this role will Past experience and anticipated training required Research and development scientists support effo rts to create innovative models and solutions that advance the capabilities of health IT conduct studies on the effectiveness of health IT and its effect on health care quality Doctoral degrees in informatics or masters degrees for health professionals Programmers and software engineers b e cross -trained in IT and health domains thereby possessing a high level of familiarity with health domains to complement their technical skills in computer and information science Masters programs combining information computer science and health domains Sub -specialists have a knowledge of IT and deep knowledge drawn from disciplines ethics economics business policy and planning cognitive psychology and industrial systems engineering that inform health IT policy or technology Masters or doctoral training in such fields as ethics human factors interfaces cognitive psychology industrial systems engineering Education and Employment Resources Training the Workforce through Community College Consortia Over the past year the ONC provided funding to the Community College Consortia to develop or improve non-degree health IT training programs that can be completed in six 10 months or less. The ONC collaborated with the Department of Education to establish a technical assistance team that provided direction and support to the member institutions. The Consortia comprises five regional groups of more than 70 member community colleges in all 50 states. Each college developed the admission criteria for the certificate programs designed to train mid-level career professionals for Health-IT positions. In late April 2011 HHS announced that 2 280 health information technology professionals graduated from community colleges with 3 000 graduates expected by the end of summer. These graduates represent a portion of the initial health IT workforce that will be trained through the HHS workforce development program this year. Many of the graduates have prior backgrounds in health care or information technology. They will be seeking employment with health providers to implement EHR systems in provider and hospital settings. Workforce Boards and One-Stop Career Centers are encouraged to collaborate with these colleges around training opportunities and to develop strategies for assisting the graduates to find employment. Appendix C contains a complete listing of participating colleges with contact information. Health-IT Competency Exam Potential Health-IT workers will generally require additional training to compete for the openings on implementation and support teams. In April 2010 ONC awarded 6 million in a two-year cooperative agreement to Northern Virginia Community College NOVA to develop health information technology health IT competency examinations for each of the positions on the implementation support team. These HIT Pro exams developed in partnership with Pearson Vu can be taken at 230 Pearson Professional Centers around the country. The competency exams were developed to confirm that an applicant has the experience and skills required to meet the nation s need for health information technology workers. For additional information visit the HIT Pro site at http www.hitproexams.org . The ONC is using the colleges in the Community College Consortia to reach out to perspective students but would also like to use state and local workforce agencies to access those individuals who are not enrolled in the Consortia program and have health care or IT backgrounds. The ONC has provided funds for 27 500 vouchers that enable individuals to take free exams. For more information about the availability of vouchers see http healthit.hhs.gov portal server.pt community healthit hhs gov competency exami nation program 2 1809 Employment Resources Potential sources for the graduate to seek employment include but are not limited to hospitals community health centers medical offices regional extension centers State 11 Offices of Rural Health SOHR vendors managed service providers and consulting firms. The following resources might be consulted to enhance the customary job search techniques such as networking job clubs and Web searches. Resource Web link Niche Job Board HIMSS JobMine http onchitjobs.himss.org home index.cfm site id 12238 Post Jobs Search Job Listings Post Resumes Regional Extension Centers RECs Contact List Appendix B http healthit.hhs.gov portal server.pt community healthit hhs gov rec pr ogram 1495 Health Care Services Hospitals Nursing Home Employer Locator http www.acinet.org employerlocator employerlocator.asp nodeid 18 Search by Industry Select Hospitals and Social Assistance Select a State Select Facility Type State Offices of Rural Health Directory of State Offices and Associations http www.hrsa.gov ruralhealth about directory index.html EHR Product Vendors Certified Health -IT Product List http onc-chpl.force.com ehrcert Search for Vendors View vendor Web site for Career Opportunities Managed Service Providers CompTIA http www.comptia.org membership communities healthcareIT.aspx Career Exploration There are numerous career information and exploration Web sites but there are two that were created with IT in mind. Health Information Careers developed by the Healthcare Information and Management Systems Society HIMSS is a resource to assist current Health-IT professionals to learn grow and advance in their careers. See http www.himss.org ASP CareerServicesHome.asp Health Information Careers developed by the American Health Information Management Association AHIMA is a resource for health information professionals to learn how to use their knowledge of information technology and records management to form the link between clinicians administrators technology designers and information technology professionals. See http www.hicareers.com 12 Appendix A Key Definitions Electronic Health Record EHR Health IT includes the use of electronic health records EHRs instead of paper medical records to maintain people s health information. The widespread use of a system of electronic health records EHR will provide access to a patient s total health information supporting better health care decisions and more coordinated care. A portable EHR makes a patient s health information available when and where it is needed. Electronic Health Records EHRs are longitudinal electronic records of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports. The EHR automates and streamlines the clinician s workflow because it generates a complete record of a clinical patient encounter. EHRs can also support the collection of data for uses other than clinical care such as billing quality management outcome reporting public health disease surveillance and reporting. 1 EHRs can support better follow-up information for patients for example after a clinical visit or hospital stay instructions and information can be effortlessly provided to the patient and reminders for other follow-up care can be sent easily or even automatically to the patient. EHRs can improve patient and provider convenience patients can have their prescriptions ordered and ready even before they leave the provider s office and insurance claims can be filed immediately from the provider s office . Electronic Health Record Technology is defined for the purposes of the Medicare and Medicaid Incentive Programs. The software technology must offer the necessary technological capability functionality and security to meet the meaningful use criteria. Electronic Medical Record EMR Sometimes people use the terms Electronic Medical Record or EMR when talking about Electronic Health Record EHR technology. Very often an Electronic Medical Record or EMR is just another way to describe an Electronic Health Record or EHR. Health providers and software or application vendors sometimes use the terms interchangeably. There is however a distinction between EMR and EHR. The EMR can be thought of as the recording of patient information and medical findings in an electronic format. In plain terms it is an electronic version of a patient s chart maintained by medical professionals or treatment facilities. The EMR is specific to and generally the property of the provider. There are numerous software applications available for EMR. EHR technology products and systems are secure can maintain data confidentially and can work with other systems to share information. It is the requirement that EHRs have the capability to share information with other systems that separates them from EMRs. 13 Personal Health Records PHR In addition to EMRs and EHRs you may come across the term Personal Health Record or PHR. A Personal Health Record PHR is an electronic record of health information maintained by the patient. A PHR might contain information about medical conditions allergies medications and doctor or hospital visits. The PHR makes it possible for the patient to store in one place and share information with others as needed. The patient controls how the information is used and who can access it. PHRs are usually accessed through the Internet so information is available anytime or anywhere. See http www.medicare.gov navigation manage-your-health personal- health-records personal-health-records-overview.aspx 14 Appendix B Health Information Technology Regional Extension Centers HITRECS Contacts State Regional E xtension Center Name Email AK Alaska eHealth Networkr rebecca ak-ehealth.org AL Alabama Regional Extension Center info al-rec.org AR HIT Arkansas jfuchs afmc.org AS Hawaii-Pacific HI GM AS CNMI REC aito hawaiihie.org AZ Arizona Health-e Connection AzHeC melissa.rutala azhec.org CA CalHIPSO North info calhipso.org CA CalHIPSO South info calhipso.org CA CalOptima Foundation emoscaritolo caloptima.org CA HITEC-LA HITEC-LA lacare.org CNMI Hawaii-Pacific HI GM AS CNMI REC aito hawaiihie.org CO Colorado Regional Extension Center CORHIO palbritton corhio.org CT eHealth Connecticut scleary gosmacpartners.com DC eHealth DC info ehealthdc.org DE Quality Insights of Delaware bschindele wvmi.org FL Center for the Advancement of Health IT Rural and North Florida Regional Extension Center info AdvanceHealthIT.org FL South Florida Regional Extension Center Collaborative info southfloridarec.org FL PaperFree Florida jwolfson hsc.usf.edu FL Central Florida REC info ucf-rec.org GA Georgia HITREC dmack msm.edu GM Hawaii-Pacific HI GM AS CNMI REC aito hawaiihie.org HI Hawaii-Pacific HI GM AS CNMI REC aito hawaiihie.org IA Health Information Technology Regional Extension Center Iowa HITREC IowaHITREC ifmc.org ID Washington Idaho Regional Extension Center WIREC peggye qualishealth.org IL Chicago Health Information Technology Regional Extension Center CHITREC info chitrec.org IL Illinois Health Information Technology Regional Extension Center IL-HITREC info ilhitrec.org IN HealthBridge Tri-State IN KY OH REC dgroves healthbridge.org IN Purdue University marrowsm purdue.edu KS Kansas Foundation for Medical Care Inc. KFMC recsupport kfmc.org KY HealthBridge Tri-State IN KY OH REC dgroves healthbridge.org KY University of Kentucky Research Foundation kyrec uky.edu LA Louisiana Health Care Quality Forum bikerd lhcqf.org MA Massachusetts Technology Park Corporation rodenstein masstech.org 15 MD Chesapeake Regional Information System for Our Patients info crisphealth.org ME HealthInfoNet info hinfonet.org MI Michigan Center for Effective IT Adoption M - CEITA mceita.info altarum.org MN Regional Extension Assistance Center for Health Information Technology REACH info khaREACH.org MO Missouri HIT Assistance Center EHRhelp missouri.edu MS Mississippi Regional Extension Center rbordelon eqhs.org MT Mountain-Pacific Quality Health Foundation MPQHF kurbanek mpqhf.org NC University of North Carolina AHEC REC tom bacon med.unc.edu ND Regional Extension Assistance Center for Health Information Technology REACH info khaREACH.org NE Wide River Technology Extension Center info widerivertec.org NH Regional Extension Center of New Hampshire jmonahan maehc.org NJ New Jersey Institute of Technology NJIT info njhitec.org NM Lovelace Clinic Foundation-LCF Research Lyndi.Dittmer- Perry LCFResearch.org NV HealthInsight sdonnelly healthinsight.org NY New York eHealth Collaborative NYeC pwilder nyehealth.org NY NYC REACH aparsons health.nyc.gov OH HealthBridge Tri-State IN KY OH REC dgroves healthbridge.org OH Ohio Health Information Partnership OHIP info OHIPonline.org OK Oklahoma Foundation for Medical Quality Inc. OFMQ Dgolder ofmq.com OR Oregon s Health Information Technology Extension Center O-HITEC info ohitec.org PA Quality Insights of Pennsylvania Eastern asomplasky wvmi.org PA Quality Insights of Pennsylvania Western asomplasky wvmi.org PR Ponce School of Medicine jgarcia psm.edu RI Rhode Island Quality Institute RIQI info riqi.org SC Center for Information Technology Implementation Assistance in South Carolina CITIA-SC thornbur mailbox.sc.edu SD healthPOINT amy.townsend dsu.edu TN Qsource jmcanally qsource.org TX North Texas Regional Extension Center info ntrec.org TX West Texas Health Information Technology Regional Extension Center WT-HITREC info wtxhitrec.org TX CentrEast Regional Extension Center tduke tamhsc.edu TX Gulf Coast Regional Extension Center pamela.d.slayer uth.tmc.edu UT HealthInsight sdonnelly healthinsight.org VA VHQC Virginia Health Quality Center lfisher vhqc.org VT Vermont Information Technology Leaders Inc. pforlenza vitl.net WA Washington Idaho Regional Extension Center WIREC peggye qualishealth.org 16 WI Wisconsin Health Information Technology Extension Center jwang metastar.com WV West Virginia Health Improvement Institute Inc. cstandre spreadinnovation.com WY Mountain-Pacific Quality Health Foundation MPQHF kurbanek mpqhf.org NIHB National Indian Health Board NIHB tkauley nihb.org 17 Appendix C Health and Human Services Office of the National Coordinator HHS ONC Community College Consortia School City State Region A Lead Bellevue Community College Bellevue College Bellevue Washington Dakota State University Madison South Dakota Lake Region State College Devil s Lake North Dakota Montana Tech Butte Montana North Idaho College Coeur d Alene Idaho Portland Community College Portland Oregon Pueblo Community College Pueblo Colorado Salt Lake Community College Salt Lake City Utah Region B Lead Los Rios Community College District Butte College Oroville California College of Southern Nevada Las Vegas Nevada Cosumnes River College Sacramento California East LA College Monterey Park California Fresno City College Fresno California Los Rios Community College District Sacramento California Maricopa College Phoenix Arizona Mission College Santa Clara California Orange Coast College Costa Mesa California Pima College Tucson Arizona San Diego Mesa College San Diego California Santa Barbara City College Santa Barbara California Santa Monica College Santa Monica California 18 University of Hawaii College - Kapiolani Honolulu Hawaii Region C Lead Cuyahoga Community College District Cincinnati State Technical Community College Cincinnati Ohio Columbus State Community College Columbus Ohio Cuyahoga Community College Cleveland Ohio Delta College University Center Michigan Des Moines Area Community College Ankeny Iowa Johnson County Community College Overland Park Kansas Kirkwood Community College Cedar Rapids Iowa Lansing Community College Lansing Michigan Macomb Community College Warren Michigan Madison Area Technical College Madison Wisconsin Metropolitan Community College Omaha Nebraska Milwaukee Area Technical College Milwaukee Wisconsin Moraine Valley Community College Palos Hills Illinois Normandale Community College Bloomington Minnesota Sinclair Community College Dayton Ohio St. Louis Community College St. Louis Missouri Region D Lead Pitt Community College Atlanta Technical College Atlanta Georgia Broward College Coconut Creek Florida Catawba Valley Community Hickory North Carolina Central Piedmont Community College Charlotte North Carolina Chattanooga State Community College Chattanooga Tennessee Dallas County Community College District Dallas Texas 19 Delgado Community College New Orleans Louisiana Dyersburg State Community College Dyersburg Tennessee Florence Darlington Technical College Florence South Carolina Hinds Community College Raymond Mississippi Houston Community College Houston Texas Indian River State College Ft. Pierce Florida Itawamba Community College Tupelo Mississippi Jefferson Community Technical College Louisville Kentucky Midland College Midland Texas National Park Community College Hot Springs Arkansas Pitt Community College Winterville North Carolina Santa Fe College Gainesville Florida Tulsa Community College Tulsa Oklahoma Walters State Community College Morristown Tennessee Region E Lead Tidewater Community College Bristol Community College Fall River Massachusetts Bronx Community College Bronx New York Brookdale Community College Lincroft New Jersey Burlington Community College Pemberton New Jersey Camden County College Blackwood New Jersey Capital Community College Hartford Connecticut Community College of Allegheny County Pittsburgh Pennsylvania Community College of Baltimore County Baltimore City Maryland Community College of DC Washington District of Columbia Community College of Vermont Waterbury Vermont 20 Essex County College Newark New Jersey Gloucester County College Sewall New Jersey Kennebec Valley Community College Fairfield Maine Northern Virginia Community College Annandale Virginia Ocean County College Toms River New Jersey Passaic County Community College Paterson New Jersey Raritan Valley Community College Branchburg New Jersey Southern Maine Community College South Portland Maine Suffolk County Community College Brentwood New York Tidewater Community College Virginia Beach Virginia West Virginia Northern Community College Wheeling West Virginia Westchester Community College Valhalla New York For additional information http healthit.hhs.gov portal server.pt community healthit hhs gov community c ollege program 1804