Priorities/Recommendations: Workforce Development (DRAFT - 01/27/2012)


Goal: Accelerate development of HIT skill sets in the LTPAC workforce

Rationale & Background:
Foundational to advancing HIT adoption in the LTPAC setting is the development of a workforce possessing the skills necessary to implement and advance health information technology and achieve its’ meaningful use. LTPAC has deployed and used financial and MDS/OASIS systems for many years however, research shows that providers typically utilize only 30% of software capabilities. (Howard Degenholtz, University of PIttsburg, 2011) With healthcare moving towards interoperable EHRs, health information exchange, and service delivery and payment reforms supported by health IT, LTPAC organizations must have enlightened leadership and skilled staff with advanced HIT skills to fully adopt and use technology to remain viable in the future.

Advancing HIT in LTPAC requires a workforce with the following expertise:
  • Leadership
  • Information system and IT project management
  • EHR management and informatics
  • Nursing informatics
  • Data analytics

Efforts to build a LTPAC workforce with these requisite skills can be accelerated by leveraging the ONC Workforce Development initiative. The ONC initiative identifies six key roles for supporting health IT and provides specific curriculum and competency exams for each of the following roles:
  • Practice Workflow & Information Management Redesign Specialist
  • Clinician/ Practitioner Consultant
  • Implementation Support Specialist
  • Implementation Manager
  • Technical/ Software Support Staff
  • Trainer

Objectives:
  1. Promote provider awareness of the need for and engagement/employment of trained HIT professionals
  2. Promote LTPAC specific HIT training curriculum
  3. Identify and evaluate the costs/benefits of LTPAC HIT certification/credential that recognizes HIT expertise

Strategies:
  1. Promote provider awareness of workforce skill sets required for adoption and meaningful use of EHRs and participation in health information exchange
  2. Launch a Collaborative Workforce Strategy Workgroup to advance Workforce Development objectives.
    • Attract trained HIT professionals to LTPAC
    • Outreach to existing participants in ONC workforce development programs
    • Outreach to students at higher education institutions offering information technology and informatics programs (e.g. community colleges, colleges, universities)
    • Advocate for internship/mentoring programs in LTPAC provider settings
    • Build awareness of LTPAC workforce needs with academic institutions, professional assiciations, and certification/credentialing bodies
    • Monitor ONC and QIO initiatives impacting HIT workforce development and promote inclusion of LTPAC needs in such initiatives
  3. Building off of the ONC Workforce development program:
    • Identify core skills necessary for adoption and meaningful use of EHRs in LTPAC (e.g. IT leadership, workflow re-design, project management, data analytics and use of data for decision making)
    • Identify core skills necessary for LTPAC participation in health information exchange
    • Facilitate development of HIT educational programs that are targeted to an LTPAC audience
    • Identify and develop staffing roles and models that support implementation and meaningful use of HIT in LTPAC settings
    • Develop career ladders for LTPAC HIT workforce members
    • Develop model job descriptions that incorporate HIT skill sets (e.g. retool job description of facility HIM and administrative nursing staff)
    • Develop LTPAC HIT certification/credential that recognizes HIT expertise and leadership skills
  4. Collaborate with Vendors/Vendor Associations to identify opportunities to address gaps in workforce HIT skills and knowledge




Suggested Summit program:
  1. Good Samaritan/Dakota State University representatives to discuss HIM HIT educational program and partnership




NOTES:
10/28/11: Greg reported that AMIA has an academic forum looking at a broad range of credentialing issues that could include LTPAC. Understanding of credential programs and differences will be important. Also need to describe the difference between certificate vs. certification. Liz can pull together a meeting with ONC staff on workforce programs to leverage the work that has been done (both community college and university programs). ANA would also be interested in a conversation with AMIA. A number of professional associations are beginning to recognize the education deficits which will be advantageous to coordinate.

Follow-Up/Action:
- Sue and Greg will meet to coordinate and work with Liz to meet with ONC on workforce direction.


NOTES FROM SEPTEMBER F2F ON WORKFORCE DEVELOPMENT

ONC Goal V:Achieve Rapid Learning and Technological Advancement (Goal V focuses on ways to enable innovation and appropriate use of health information to improve knowledge about health across populations.)

Goal: To advance provider awareness, adoption and use

Rationale:

Objectives:
  • Provider education messages
  • RECs-evaluate how to leverage if at all (not LTPAC focused as part of their mission)
  • HIT is no longer a luxury but an essential tool to survival in maintaining quality and payment

Strategies:
(Leading Age)
  • Look at the number of LTPAC systems that are becoming certified (module or comprehensive) (AOD – module; HealthMedX – Comprehensive);
  • Creating a workgroup to understand the best practices in selection and implementation; will determine what certification and standards implementation will mean to providers.
    • Help members select and implement technology
      • Tools in existing toolkits haven’t been as helpful (e.g. as Stratis Toolkit) – don’t always know what to do with the resources
    • Suggested to include some of the priority topics we have identified
    • Note: CIO Consortium and NASL are also conducting surveys
  • Provider Education Campaign
    • Huge need for educating providers on HIT
    • Link to issues like transition of care, information exchange, longitudinal care (Survival in the 21st Century)
      • What do organizations need to do? (e.g. connect with your hospitals, push standards and certification with vendors)
      • Need associations to push messages to their member (ACTION to define messages)
(AHIMA)
  • ICD-10 Implementation
    • Lack of training on I-10
    • Vendor systems need to reflect future needs and proper coding resources (many outdated, user defined and/or not updated regularly)
    • Focus has been on payment
    • HIT issues:
      • Used in problem lists (and proper way to record the problem list) and coordination between care givers
      • Quality measures
      • E-Prescribing and attaching I-10 to the med orders
      • X12 – evaluate new proposed operating rules related to billing are going out for physicians; AQH – will hit LTC based on the physician side (Shelly)
    • AHIMA Launching a joint workgroup to develop training plans for LTPAC settings and ensure the best implementation by 10/1/2013
    • Need alignment on specifications from ONC and CMS to educate providers on the purpose and value
  • Workforce
    • Dakota State University - HIT Education Programs – tailoring to LTPAC
      • Good Sam is developing LTC specific modules using ONC’s programs
    • Action for the Collaborative to identify LTPAC
    • Leverage ONC HIT Training and delivery methods (web-based, CE) which can be tailored to LTPAC needs
    • Needs to be part of a bigger Workforce strategy
    • Need to develop creative ways to engage workforce
    • Believe our efforts need to be around usability

Suggested Speaker(s) at Summit: