448Applied Clinical Informatics


© Schattauer 2012

448Applied Clinical Informatics

S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article

Health Information Technology Knowledge and Skills Needed by HIT Employers S.H. Fenton1; E. Joost1; M.J. Gongora-Ferraez1 1Health Information Management, Texas State University

Keywords Health information technology, workforce, biomedical and health informatics, clinical informatics

Summary Objective: To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. Methods: Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics. Results: HIT employers reported needing an HIT workforce with diverse knowledge and skills rang- ing from basic to advanced, while covering information technology, privacy and security, clinical practice, needs assessment, contract negotiation, and many other areas. Consistent themes were that employees needed to be able to learn on the job and must possess the ability to think critically and problem solve. Many employers wanted persons with technical skills, yet also the knowledge and understanding of healthcare operations. Conclusion: The HIT employer focus groups provided valuable insight into employee skills needed in this fast-growing field. Additionally, this information will be utilized to develop a statewide HIT workforce needs assessment survey.

Correspondence to: Susan H. Fenton, PhD, RHIA Health Information Management Texas State University 601 University Drive Health Professions Building, 302 San Marcos, TX 78666 United States E-mail: susan.fenton@txstate.edu

Appl Clin Inf 2012; 3: 448–461 doi:10.4338/ACI-2012-09-RA-0035 recieved: September 15, 2012 accepted: November 16, 2012 published: December 5, 2012 Citation: S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. Health Information Technology knowledge and skills needed by HIT employers. Appl Clin Inf 2012; 3: 448–461 http://dx.doi.org/10.4338/ACI-2012-09-RA-0035

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 449Applied Clinical Informatics

1. Introduction There is an increasing worldwide need to understand how health information technology (HIT) can be most effectively used in today’s healthcare delivery systems [1–9]. A competent workforce is required in order for HIT to be effective in a healthcare organization. According to a recent report by the Institute of Medicine (IOM), “We are at a unique time in health care. Technology – which has the potential to improve quality and safety of care as well as reduce costs – is rapidly evolving, changing the way we deliver health care. At the same time, health care reform is reshaping the healthcare land- scape [10]. “Meaningful Use” of the electronic health record (EHR), which is funded by the Health Information Technology for Economic and Clinical Health (HITECH) Act of the American Re- covery and Reinvestment Act (ARRA), includes investment in workforce development [11]. Due to this act the demand for health information technology professionals is growing, with the U.S. Office of the National Coordinator (ONC) estimating an additional 50,000 workers will be needed [12]. These professionals will help to support the implementation and effective use of EHRs in hospital and provider settings.

Texas has one of the largest physician populations in the nation [13], approximately 600 licensed hospitals [14], four of the nation’s largest metropolitan areas for attracting venture capital [15], thir- teen state-supported local health information initiatives [15], and a number of private payors and as- sociations offering support to physicians and others who are interested in adopting HIT [15]. The strong healthcare industry, accounting for more than $100 billion in economic activity for this state, requires a well qualified HIT workforce to support the large and growing Texas population [15].

In response to the HITECH-ARRA legislation the current HIT workforce will need to evolve. HIT workers must possess a wide variety of skills to quickly react and adapt to their current practices to future work surrounding industry and regulatory changes. The Texas HIT Workforce Development project, funded by a Wagner-Peyser grant and supported by the Texas Workforce Commission, was initiated as a direct result of this growing need in the Texas healthcare industry. One of the initial pro- ject goals was to conduct a state-wide HIT workforce needs assessment from all industry stake- holders in order to understand the HIT workforce knowledge and skills needed by HIT employers, as well as the numbers of workers needed now and in the future.

Many organizations, such as the American Health Information Management Association, the Health Information Management and Systems Society, the American Medical Informatics Associ- ation, and the International Medical Informatics Association, among others, have developed docu- ments describing the skills and knowledge needed by HIT (or health informatics) workers. The re- search team was able to identify different lists of competencies which had been published for health information managers or health information technicians [16–20]. Several of the competency lists were compiled or created by professional organizations [16,17, 20]. The Huang (2007) framework surveyed the literature and extracted data from journal articles while other researchers included rec- ommendations for defining competencies [19, 21, 22]. These efforts are to be lauded. However, the Texas research team identified a significant gap, a lack of feedback from employers – those who hire health information technology workers. The Texas-based project wished to “start anew” gathering knowledge and skills information from HIT without bias from one group or another or any previous skills or knowledge compilations. This article describes the findings from the HIT employer focus groups.

2. Methods

A qualitative research method, or inquiry method, for the initial phase of this project was chosen as no data-based evidence of employer needs was available. That is to say, the previous skills and know- ledge documents were compiled by expert consensus; however validation of the content and/or sur- veys determining actual numbers of employees needed with the different knowledge and skills could not be found. The methods used were approved through Texas State University’s Institutional Re- view Board (IRB) according to federal guidelines.

Prior to setting up the focus group meetings, a professional focus group facilitator was hired to eliminate any bias from the researches who work in the HIT field. Conference calls were conducted

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Research Article 450Applied Clinical Informatics

to establish the ideal responder characteristics, desired number of participants, and the type of ques- tions that would be utilized in the focus groups. A prepared topic guide, which is shown in �Table 1, provided the framework for each focus group meeting. The session began with an introduction by the facilitator describing the purpose of the focus groups and a brief explanation regarding the meet- ing process.

At the beginning of each focus group the facilitator would introduce the purpose and rules of the session informing the participants that her role as an independent moderator was to discover their attitudes, needs, desires, perceptions and interests related to the HIT industry. She explained that their anonymous qualitative responses would provide the background information to build a quantitative survey to distribute across the state. The participants were asked to concentrate on their workforce needs related to employees who were managing or participating in EHR design, imple- mentation, connectivity, security, and data analysis as opposed to doctors, nurses and staff who were using computers as a tool to complete a work function, such as data entry of patient information. HIT workers are employed in a number of settings ranging from providers to public health to EHR vendors to consulting companies. The different types of HIT employers targeted for participation in the focus groups are listed in �Table 2.

Recruitment of the focus group participants consisted of e-mailed flyers and forms sent to poten- tial respondents who fit the stakeholder requirements. The stakeholders were grouped by HIT em- ployer type, but the stakeholders who responded to the recruitment materials ranged from the Chief Information Officer (CIO), to the Office Manager, to the Nurse Informaticist, or other organization- identified appropriate responsible person. Persons interested in participating in a focus group com- pleted a brief registration form (�Fig. 1) and returned it to the Texas HIT Workforce Development Team via email. Focus group sites were found with assistance from local workforce development boards and universities in the selected cities. They also provided assistance with outreach to qualified responders from the targeted HIT employer organizations.

Before the focus group sessions, participants were asked to complete a form (�Fig. 2) gathering demographic data such as the healthcare market or location, the organization type and size, the size of the community, the types of issues HIT employers are facing currently and/or expect to face in the future, and the status of their organization’s EHR implementation. An additional question invited initial feedback on the competencies needed for current and future HIT workforce.

The focus group invitation process was a collaborative effort involving many regional stake- holders from multiple organizations. Initially, grant staff contacted each potential collaborator by email or telephone explaining the purpose of the study and describing the ideal responder. After sup- port was garnered, some collaborators shared their email list for invitations while others preferred to keep their contact lists confidential, sending the invitation and registration form to their internal mailing lists. Because of this, an exact number of those invited to participate is unknown, however, we feel confident that a minimum of 20 stakeholders were invited to each focus group. There were 106 total participants in the focus group population. �Table 3 provides a detailed breakdown of the participants by their profession. The desired number of participants for the 12 focus groups was 144, or an average of 12 people per focus group. A minimum of 20 people per focus group were invited to participate, for an estimated total of 240 invited. The rate of participation in the focus groups was 106/144 = 74%.

Focus group methods used included face-to-face and online HIT employer meetings. The face- to-face focus group sessions were held in Brownsville, College Station, Dallas, El Paso, Houston, Lub- bock, and San Antonio. Additional focus groups were conducted with rural providers and nursing informatics professionals using the web conferencing software Adobe Connect. The focus groups were conducted in relaxed settings in the afternoon and early evening. Participants were notified that the sessions were being recorded and reassured that the recordings would remain confidential, there were no right or wrong answers. Participants were asked to speak one at a time. The recordings were downloaded into a secure online collaborative tool and transcribed. The data was manually analyzed by the Texas HIT Workforce Development Project team using grounded theory.

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 451Applied Clinical Informatics

3. Results An average of five people attended each face-to-face focus group; while the online focus groups had an average attendance of eight people per session. Trends, themes, and patterns emerged from the data gathered. Initially, it was noted that health care providers (clinics and hospitals) and non-pro- viders (public health, insurance, and so on) had similar, but not identical knowledge and skill needs. Within each of these categories the skills were further divided into basic/entry level skills, intermedi- ate skills, and advanced skills. HIT employers often used these words: basic, intermediate, and ad- vanced; to describe different skills or knowledge needed for their HIT workforce.

The basic skills were those one might expect of clerks or other entry-level positions, including understanding medical terminology, basic computer and interpersonal communication skills. Inter- mediate skills ranged from an understand of EHR “meaningful use” to knowledge of privacy and se- curity regulations to knowledge of HIT vendor products to data report writing to project manage- ment skills. Advanced skills were very broad and included standard management and strategic plan- ning skills, with contract negotiation, the ability to use data analytics and the interpersonal skills necessary for interactions with senior administration. HIT employer respondents specified that each level subsumed the lower levels. For example, an advanced HIT worker creating a strategic plan would need to have an understanding of privacy and security regulations to ensure the practicality of the plans. The entire breakout of skills resulting from the focus groups can be found in �Table 4.

4. Discussion

The results outlined in �Table 4 were the main trends found consistently across the focus groups. The breakout of skills was illuminating, especially in the areas of data management and contract ne- gotiation, areas which might not usually be considered HIT-related. This list of knowledge and skills will serve as the foundation of follow-on work, specifically an HIT employer workforce needs assess- ment survey to quantify the full-time HIT workforce needed by Texas HIT employers. The need is anticipated to be high. One participant stated “today we have 21 or 22 but we have 5 or 6 open posi- tions out of that, and would like to actually probably hire a couple more, I say a couple more, but probably 4 or 5 more to get us over the meaningful use hump. But there is no point you know, we can’t fill the open positions.”

The focus groups were revealing of the differences and similarities, as well as the challenges in health information technology workforce across the state. Overall, HIT employers are interested in people who can think and learn. As one participant stated, “[The HIT Workforce doesn’t] under- stand the bigger picture in the interface with the doctor’s office and getting the medication reconcili- ation for the doctor’s office to the ER, they don’t have that picture.” Yet another said, “The most im- portant thing is their ability to learn. I know that sounds stupid, but honestly that is what I look for when I am hiring anybody, is somebody that can come in and pick up and I can teach them.”

As a rule, HIT employers struggle with the mixed nature of health information technology. One stated, “One of the things you need is a survey of career options split between clinical, or within tech- nology, because there is a lot of gray areas in there, a lot of hybrid,” while others said, “Trying to find the right mix of clinicians versus informatics or IT slanted folks as well because you need both in a perfect world. It is just hard to know what the right balance is.” The clinicians themselves had this feedback “…of not taking that time to actually to truly sit down and understand what the needs are so that you are not hurrying up and throwing in a system and then have a major impact on us doing direct patient care.” Yet another, “So, business process analysis background, process improvement background, and then just understanding how a clinic functions or how an inpatient nursing unit functions enough to say that is a good workflow process or that it is not.” Getting the clinical/tech- nical mix will be very important as the country continues to implement health information technol- ogy.

Rural HIT employers shared their unique struggles attracting and retaining qualified HIT staff. One participant said, “Within our IT/ HIT Department specifically we have a lot of trouble just at- tracting IT talent to a rural area and I see that as becoming a more acute need for rural facilities in particular, just attracting IT talent.” Another rural provider in a different focus group shared this

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Research Article 452Applied Clinical Informatics

© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

sentiment saying “For us in the rural area, the problem is there is no HIT workforce. I have my own, but that is strictly by virtue of my husband having the background that he does. But as far as the other locations around here being able to hire someone to do their HIT, there isn’t.”

One of the focus group participants seemed to sum it up best with this, “We have a need for some- body who is probably like a unicorn. I could really use somebody who understands the physician practice and the workflow there, I need somebody who understands the politics, policies and tech- nologies of large healthcare systems and then somebody who can understand when a vendor is feed- ing us a line or is actually telling us something that could happen.”

Study Limitations

A major limitation of this study is the restriction of the data collection to a single state within the U.S. Additionally, focus groups were chosen to enable the collection of free-form input from HIT em- ployers; however, the focus group participants were volunteers. It is acknowledged that those who volunteered are probably those who are experiencing the most difficulty with HIT workforce recruit- ment and retention or those who possess an innate interest in the topic. Participant representation is also a limitation as it is not possible to determine whether the roles and titles of those who did par- ticipate are in proportion to or include the full breadth of HIT employers in Texas. Finally, the find- ings of this work are focused on a particular geographical area at a time of great upheaval in HIT and EHR implementation in the healthcare industry. The findings are valid for a limited time as the field and needs of employers continue to evolve as the technology and government regulations change over time.

5. Conclusions

The HIT employer focus groups confirmed that they require a skilled and diverse workforce to effec- tively implement health information technology across the different provider and related organiz- ations, including public health. They also provided the information needed to build a statewide workforce needs assessment. Apparently, the entire healthcare industry is looking for well-trained employees, sometimes in two fields, who can demonstrate critical thinking. The challenge for edu- cational institutions is now to work with employers to meet those needs in a constantly changing, evolutionary field.

Clinical Relevance Providers need to recruit and retain skilled HIT workers to support their use of HIT. These find- ings will assist them in fully describing the skills and knowledge needed in their organizations.

Conflicts of Interest The authors declare that they have no conflicts of interest in the research.

Protection of Human Subjects The study was performed in compliance with the World Medical Association Declaration of Hel- sinki on Ethical Principles for Medical Research Involving Human Subjects, and was reviewed by Texas State University’s Institutional Review Board according to Federal guidelines.

Acknowledgements The Texas HIT Workforce Development Project wishes to thank the Office of the Texas Governor, the Texas e-Health Alliance, and the University of Washington Workforce Research Center for their sup- port during this project. Additionally, the authors wish to thank Cheryl T. Perez for her invaluable as- sistance with manuscript preparation.

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© Schattauer 2012

S.H. Fenton; E. Joost; M .J. G

ongora-Ferraez. HIT Know ledge and Skills N

eeded by HIT Em

ployers

Research A rticle

453 A

p p lied

C lin

ica l In

fo rm

a tics

Fig. 1 Focus Group Registration Form

 

Sponsored by a Wagner-Peyser Grant Supported by the Workforce Commission

Academic Medical Center

Major Urban-metro area w/population 750,000+

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 454Applied Clinical Informatics

Market:________________________ Date: _____________ Time:_____________

HEALTH INFORMATION TECHNOLOGY WORKFORCE

PARTICIPANT

PRE-FOCUS GROUP INFORMATION SHEET

1. Name:_________________________________(will only be used to ensure comments during focus group are associated with correct organization type, community size, etc.)

2. Below, please find a table adapted from the Health Information Management Systems Society EMR Adoption Model. Please indicate which stage most closely represents your organization in regards to EMR adoption:_________________

EMR Adoption

Stage

Major ancillaries (lab, Rx, radiology) installed

Clinical data repository; with basic conflict checking

Clinical document- tation installed with some level of clinical decision support; some medical imaging installed

Computer- ized physician order entry (CPOE); clinical decision support with evidence- based medicine protocols

Electronic medication administra- tion with bar coding or radio frequency ID integrated with CPOE and pharmacy

Full MD document- ation installed; radiology PACS available via network

Clinical information can be readily shared electronic- ally with all entities within a regional health network

0 No No No No No No No 1 Yes No No No No No No 2 Yes Yes No No No No No 3 Yes Yes Yes No No No No 4 Yes Yes Yes Yes No No No 5 Yes Yes Yes Yes Yes No No 6 Yes Yes Yes Yes Yes Yes No 7 Yes Yes Yes Yes Yes Yes Yes

3. Issues facing your organization s HIT Workforce:

Today: ______________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Fig. 2 Pre-Focus Group Data Collection Form

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 455Applied Clinical Informatics

Future: ______________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

4. Competencies needed for your organization s HIT workforce:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Fig. 2 Pre-Focus Group Data Collection Form (Continued)

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 456Applied Clinical Informatics

Table 1 Focus group topic guide; Prost Marketing, Inc., May 2011; Health Information Technology (HIT) Focus Groups

Introduction Background notes

● HIT is where the internet was in the 90’s (wild, wild west) ● Overall want to understand what Texas employer needs are related to

HIT workforce ● Likely doing a lot within the HIT industry; working your way through ● Want to have the right type of workforce (skills) – now and for the fu-

ture ● Want to have the Right type of training so that employers have em-

ployees with the right competencies Foundational work – to make all the computer technology work

Purpose of Group ● The purpose of this discussion is to learn about your attitudes, needs and desires, perceptions and interests relating to Health IT

● Main focus on people whose job is totally concerned with the HIT (example would be network security, systems analyst, data analyst, CIO, health information manager, etc.)

● Rather than clinical or other staff (such as front-line physicians, nurses and other therapists) who use health IT as a tool.

● End Goal: We Will Be Building A Survey From The Focus Group Information.

Ground Rules ● One at a time, all participate, no cell phones/pagers ● Audio-taping, confidentiality, no right or wrong answers ● Independent of group sponsor

Introduction of Partici- pants

Overview of HIT Industry

Name and Organ- ization

Interest in HIT

Current Trends you see in HIT Workforce within your Organiz- ation.

Frustrations/Bar- riers

How important is

Needs for the fu- ture for the HIT Workforce – gen- eral Overview; ask open ended First and then Probe

Current Trends/ Comply with

● Job title/function ● Length of time in this job ● Years working in the field ● How you got into field ● Brief overview of organization/city/size Where Organization is on Adoption Model

 

● Role of Information Technology within healthcare delivery organizations ● How large of a priority within organizations (extremely high to not a

priority at all) ● Why a priority/not a priority?

● A well-trained workforce capable of developing, implementing, and evaluating health information technology (HIT) in your healthcare re- lated facility. (Description from 2010 Hersh article) – Extremely important (5) – Somewhat Important (4) – Neutral (3) – Not too important (2) – Not important at all (1)

 

● Is your workforce ready? ● How will you get ready? ● What do you need?

● Immediate ● 3–5 years ● Long term

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 457Applied Clinical Informatics

HIT Work- force

Target Seg- ments of the Work- force using EHRS – Who are primary Users?

Description of current Work Force

Do you currently have HIT Work- force?

Compensation Model

Clinically fo- cused: Phys- icians,. Nurses, Therapists, Phar- macy, etc.

● What types? ● How many? ● What is their level of competency? ● How well have they been trained? ● What type of background do they have?

● What type of training have they received? – Training Source:

Higher Education in HIT Migrate to position within organization Continuing Education On the Job training?

● What types of HIT workforce (roles or general skill sets) do you need now? – For each type, how many would you need? – What type of background, either experiential or educational would

you expect them to have? – What would be the ideal type of worker instead of a set of skills that

would normally require a lot of different workers? ● What can you afford? ● Are you experiencing challenges with paying and retaining your HIT

workforce?

● What types of HIT workforce (roles or general skill sets) do you antici- pate needing in 3–5 years? – For each type, how many would you anticipate needing?

● What type of background, either experiential or educational would you expect them to have?

● How is the compensation model changing? ● What is the impact on the use of health information? ● Anticipate organizations electronically reporting quality measures or try-

ing to implement population health monitoring would have new HIT workforce needs. From the perspective of their organization. – Pay for Performance – Use of incentives to be able to perform more (tasks) – Other the Windows

Basic Computer Literacy Skills ● What types of job titles require these skills? ● What are the core competencies needed here?

– Demonstrate basic computer operating procedures such as login the computer and logoff, opening, closure and saving files.

– Demonstrate proficiency in operating environment. – Resolve minor technical problems associated with use of computers. – Demonstrate Internet/intranet communication skills. – Access and use a Web browsing application. – Demonstrate use of email, addressing, forwarding, attachments, and

netiquette. – Identify and use icons, windows, and menus.

Table 1 Continued

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 458Applied Clinical Informatics

Target Seg- ments of the Work- force using EHRS – Who are primary Users?

Adminis- trative Per- sonnel, Human Re- sources, Clerical Staff, Data Ana- lysts, Public Health Workers, Emergency Medical Per- sonnel, Medical As- sistants, Dietary Workers, Lab or Radi- ology Techs, Nurse Aids….

Clinically fo- cused: Phys- icians,. Nurses, Therapists, Phar- macy, etc.

 

Health Informatics skills using EHRs ● What types of job titles require these skills? ● What are the core competencies needed here?

– Create and update documents within the electronic health record (EHR) and the personal health record (PHR).

– Locate and retrieve information in the electronic health record for vari- ous purposes.

– Perform data entry of narrative information. – Locate and retrieve information from a variety of electronic sources. – Know the policies and procedures related to populating and using the

health data content within primary and secondary health data sources and databases.

– Apply appropriate documentation management principles to ensure data quality and integrity.

– Use software applications to generate reports. – Know and apply appropriate methods to ensure the authenticity of

health data entries in electronic information systems. – Use electronic tools and applications for scheduling patients.

Basic Computer Literacy Sills ● What types of job titles require these skills? ● What are the core competencies needed here?

– Demonstrate basic computer operating procedures such as login the computer and logoff, opening, closure and saving files.

– Demonstrate proficiency in the Windows operating environment. – Resolve minor technical problems associated with use of computers. – Demonstrate Internet/intranet communication skills. – Access and use a Web browsing application. – Demonstrate use of email, addressing, forwarding, attachments, and

netiquette. – Identify and use icons, windows, and menus.

Health Informatics Skills Using EHRs ● What types of job titles require these skills? ● What are the core competencies needed here?

– Create and update documents within the electronic health record (EHR) and the personal health record (PHR).

– Locate and retrieve information in the electronic health record for vari- ous purposes.

– Perform data entry of narrative information. – Locate and retrieve information from a variety of electronic sources. – Know the policies and procedures related to populating and using the

health data content within primary and secondary health data sources and databases.

– Apply appropriate documentation management principles to ensure data quality and integrity.

– Use software applications to generate reports. – Know and apply appropriate methods to ensure the authenticity of

health data entries in electronic information systems. – Use electronic tools and applications for scheduling patients.

Table 1 Continued

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 459Applied Clinical Informatics

Final Com- ments

HIT Resources: EHR Meaningful Use (NEJM article: http://healthpolicyandreform.nejm.org/?p=3732; Accountable Care Organizations: http://www.aha.org/aha/content/2010/pdf/09–26–2010-Res-Synth-Rep.pdf; Implementation of ICD-10: http://www.cms.gov/apps/media/press/factsheet.asp?Counter=3407&intNumPerPage=10&checkDate=&check Key=2&srchType=2&numDays=0&srchOpt=0&srchData=icd%2D10&keywordType= All&chkNewsType=6&intPage=&showAll=1&pYear=&year=0&desc=&cboOrder=date Health information exchange: http://healthit.hhs.gov/portal/server.pt?open=512&objID=1488&mode=2; Affordable Care Act: http://www.healthcare.gov/law/introduction/index.html; Patient-Centered Medical Home: http://www.pcpcc.net/patient-centered-medical-home Immediate – next 1–3 years

What other Is- sues or Topics do we need to cover related to HIT Workforce Devel- opment?

Table 1 Continued

Table 2 HIT employer populations targeted

Table 3 Focus group population categorized by profession

Independent and group physician practices

Information technology and software companies

Healthcare consulting companies

Health plans and clearinghouses

State and local government, especially public health

Rural hospitals

Skilled nursing facilities & long term care facilities

Mid-sized hospitals

Ambulatory clinics

Large hospital systems

Clinical laboratories

State & local government

Home health

Nursing Informatics

Military and VA

HIT Employer Populations

C-Suite Healthcare Director/ Manager

Coordinator/ Administrator

Clinical Financial H/IT

13 (12%) 43 (40.5%) 3 (3%) 3 (3%) 2 (2%) 14 (14%)

Education

26 (24.5%)

Other

2 (2%)

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Research Article 460Applied Clinical Informatics

Health Care Provider Core Competen- cies

Non-Provider Core Competencies

Operational medical terminology knowledge Customer service, communication and inter- personal skills, training

Basic desktop/computer skills, computer/internet navigation

 

Understanding of how patient information should flow in clinical settings

 

Knowledge of HIT products, familiarity with ven- dors, ability to negotiate contracts

Knowledge of HIT products, familiarity with vendors, able to negotiate contracts

Understand “Meaningful Use” and which HIT system can produce the data needed for demon- strating compliance

 

Knowledge of HIPAA, state privacy and security regulations

Knowledge of data management, data min- ing and data sharing

Problem solving and critical thinking skills needed to implement and use HIT systems (such as flowcharting, Root Cause Analysis and exam- ining existing assumptions and evaluating evi- dence)

Advanced clinical knowledge and understanding of uses of HIT for patient management/edu- cation needs

Data management, data mining/report creation, and data sharing skill

Project management (such as initiating, plan- ning, executing, and monitoring EHR/HIT-related projects)

Management skills to direct technical and non- technical staff re: EHR/HIT systems

Strategic thinking related to EHR/HIT implemen- tation/management that is supportive of organ- ization goals and mission

Ability to effectively interact with senior man- agement and above in HIT governance

Ability to use analytics/data from HIT systems for planning

Financial decision-making and negotiating skills: for selecting HIT system purchases and mainten- ance plans that meet external and internal goals/resources

Ability to design HIT databases and systems HIT software/hardware engineering, devel- opment and/or system maintenance

 

 

 

Understand “Meaningful Use” and which HIT system can produce the data needed for demonstrating compliance

Strategic planning and analysis skills Database system and design

HIT systems implementation and manage- ment Software/hardware engineering

 

 

 

 

Skills

Basic/ Entry Level

Intermediate

Advanced

Table 4 Focus group identified skills necessary for future workforce

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© Schattauer 2012 S.H. Fenton; E. Joost; M.J. Gongora-Ferraez. HIT Knowledge and Skills Needed by HIT Employers

Research Article 461Applied Clinical Informatics

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