Building the Health IT Workforce

We frequently talk about health IT with an emphasis on the technology. But at the heart of the transformation of our health system, it’s really all about people. Above all, it’s about improving care for all Americans.

Health care providers are passionate about the work they do. As the nation moves toward meaningful use of health information technology, it is also about preparing a well-trained, equally passionate health IT workforce. Although there are many excellent training programs currently in place, the nation needs more health IT workers than the current training capacity can produce, and it needs individuals specifically trained for a very wide range of important roles.

Working with the educational community, we have identified 12 specific health IT workforce roles. All 12 roles are required to support adoption of health IT and sustain its meaningful use. Six of the 12 roles can be addressed through intensive short-term training based in community colleges, and the other six require longer programs university-based training. Every person trained to undertake each of these roles must understand, in ways appropriate to that role, BOTH health care AND information technology.

Now, we have laid the foundation for building the health IT workforce by allocating $84 million in grants to domestic institutions of higher education. These grants are distributed over four complementary programs that together will rapidly begin meeting the nation’s needs. Two of the programs will directly support greatly expanded training in community colleges and universities. Another program will create and disseminate high quality educational materials that will be used in the community college program, but will also be available to the entire nation. The fourth will create health IT competency examinations to help verify that trainees have the knowledge and skills required to be effective in their jobs.

Because the workforce need is acute, these new programs will ramp up very quickly. Training in community colleges and universities will begin this fall. All programs of study will be intense and highly rigorous to produce trained workers as quickly as possible. The programs will be flexibly designed to meet the needs of adult learners. We expect that many of the trainees will come to the program with prior training in either health care or IT. The program will move them into the workforce as rapidly as possible by building on what they already know and filling in any gaps in their knowledge.

Finally, as the nation recovers from the recession, health IT will be a source of increasing numbers of well-paying, fulfilling jobs. At full capacity, the community colleges directly supported by these grants will produce over 10,000 workers per year.

These programs will position us for success in transforming health care through meaningful use of information technology.

24 Comments

  1. Mike Squires says:

    Thought it would be useful for readers to see the listing and full set of descriptions of the 12 roles based on selected excerpts from the two Funding Announcements:

    “Competencies associated with six of the roles listed below can, for qualified individuals, be attained through six month programs based in community colleges. These roles (noted with an asterisk, below) are specifically targeted by the Community College Consortia to Educate Health Information Technology Professionals FOA (Funding Opportunity (FOA) . The other six roles listed below, that are not marked with an asterisk are addressed by” the FOA entitled Information Technology Professionals in Health Care: Program of Assistance for University-Based Training

    LIST OF TWELVE ROLES, GROUPED IN THREE CATEGORIES

    CATEGORY 1: Mobile Adoption Support Roles
    “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, vendors, or state/city public health agencies.

    *Implementation support specialist
    *Practice workflow and information management redesign specialist
    *Clinician consultant
    *Implementation manager”

    CATEGORY 2: Permanent Staff of Health Care Delivery and Public Health Sites
    “These roles are needed for ongoing support of health IT at office practices, hospitals, health centers, Long Term Care (LTC) facilities, health information exchange organizations and state and local public health agencies.

    Clinician/public health leader
    *Technical/software support staff
    *Trainer
    Health information management and exchange specialist
    Health information privacy and security specialist”

    CATEGORY 3: Health Care and Public Health Informaticians
    “These individuals will be based in universities, research centers, government agencies, and research and development divisions of software companies.

    Research and development scientist
    Programmers and software engineer
    Health IT sub-specialist”

    * Asterisked roles above are focus of Community college training.

    DETAILS OF THE TWELVE HEALTH IT PROFESSIONAL ROLES

    CATEGORY 1: Mobile Adoption Support Positions
    “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. Workers in these roles might be employed by regional extension centers, providers, vendors, or state/city public health agencies, and would work together in teams. Preparation for this set of roles will typically require six months of intense training for individuals with appropriate backgrounds.”

    1. Practice workflow and information management redesign specialists: (Community college-trained)
    “Workers in this role assist in reorganizing the work of a provider to take full advantage of the features of health IT in pursuit of meaningful use of health IT to improve health and care. Individuals in this role may have backgrounds in health care (for example, as a practice administrator) or in information technology, but are not licensed clinical professionals. Workers in this role will:

    » 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 implement revised workflows
    » Evaluate process workflows to validate or improve practice’s systems”

    2. Clinician/practitioner consultants: (Community college-trained)
    “This role is 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. In addition to the activities noted above, workers in this role will:

    » 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
    » Advocate for users’ needs, acting as a liaison between users, IT staff, and vendors”

    3. Implementation support specialists: (Community college-trained)
    “Workers in this role provide on-site user support for the period of time before and during implementation of health IT systems in clinical and public health settings. The previous background of workers in this role includes information technology or information management. Workers in this role will:

    » Execute implementation project plans, by installing hardware (as needed) and configuring software to meet practice needs
    » Incorporate usability principles into design and implementation
    » Test the software against performance specifications
    » Interact with the vendors as needed to rectify problems that occur during the deployment process”

    4. Implementation managers: (Community college-trained)
    “Workers in this role provide on-site management of mobile adoption support teams for the period of time before and during implementation of health IT systems in clinical and public health settings. Workers in this role will, prior to training, have experience in health and/or IT environments as well as administrative and managerial experience. Workers in this role will:

    » 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”

    CATEGORY 2: Permanent Staff of Health Care Delivery and Public Health Sites
    “These roles are needed for ongoing support of health IT that has been deployed in office practices, hospitals, health centers, long-term care facilities, health information exchange organizations and state and local public health agencies. Preparation for this set of roles will typically require six months of intense training for individuals with appropriate backgrounds.”

    5. Clinician/Public Health Leader: (University-trained)
    “By combining formal clinical or public health training with training in health IT, individuals in this role will be able to lead the successful deployment and use of health IT to achieve transformational improvement in the quality, safety, outcomes, and thus in the value, of health services in the United States. In the health care provider settings, this role may be currently expressed through job titles such as Chief Medical Information Officer (CMIO), Chief Nursing Informatics Officer (CNIO). In public health agencies, this role may be currently expressed through job titles such as Chief Information or Chief Informatics Officer. Training appropriate to this role will require at least one year of study leading to a university-issued certificate or master’s degree in health informatics or health IT, as a complement to the individual’s prior clinical or public health academic training. For this role, the entering trainees may be physicians (see footnote below for definition of physician used) or other clinical professionals (e.g. advanced-practice nurses, physician assistants) or hold a master’s or doctoral degree(s) in public health or related health field. Individuals could also enter this training while enrolled in programs leading directly to degrees qualifying them to practice as physicians or other clinical professionals, or to master’s or doctoral degrees in public health or related fields (such as epidemiology). Thus, individuals could be supported for training if they already hold or if they are currently enrolled in courses of study leading to physician, other clinical professional, or public-health professional degrees.”

    6. Technical/software support staff: (Community college-trained)
    “Workers in this role maintain systems in clinical and public health settings, including patching and upgrading of software. The previous background of workers in this role includes information technology or information management. Workers in this role will:

    » Interact 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”

    7. Trainers: (Community college-trained)
    “Workers in this role design and deliver training programs, using adult learning principles, to employees in clinical and public health settings. The previous background of workers in this role includes experience as a health professional or health information management specialist. Experience as a trainer in from the classroom is also desired. Workers in this role will:

    » Be able to 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 users
    Track training records of the users and develop learning plans for further instruction”

    8. Health Information Management and Exchange Specialist: (University-trained)
    “Individuals in these roles support the collection, management, retrieval, exchange, and/or analysis of information in electronic form, in health care and public health organizations. We anticipate that graduates of this training would typically not enter directly into leadership or management roles. We would expect that training appropriate to this role would require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in Health Information Management, health informatics, or related fields, leading to a university-issued certificate or master’s degree.”

    9. Health Information Privacy and Security Specialist: (University-trained)
    “Maintaining trust by ensuring the privacy and security of health information is an essential component of any successful health IT deployment. Individuals in this role would be qualified to serve as institutional/organizational information privacy or security officers. We anticipate that training appropriate to this role would require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in health information management, health informatics, or related fields, leading to a university-issued certificate or master’s degree.”

    CATEGORY 3: Health Care and Public Health Informaticians
    “These individuals will be based in universities, research centers, government agencies, and research and development divisions of software companies.”

    10. Research and Development Scientist: (University-trained)
    “These individuals will support efforts to create innovative models and solutions that advance the capabilities of health IT, and conduct studies on the effectiveness of health IT and its effect on health care quality. Individuals trained for these positions would also be expected to take positions as teachers in institutions of higher education including community colleges, building health IT training capacity across the nation. We anticipate that training appropriate to this role will require a doctoral degree in informatics or related fields for individuals not holding an advanced degree in one of the health professions, or a master’s degree for physicians or other individuals holding a doctoral degree in any health professions for which a doctoral degree is the minimum degree required to enter professional practice.”

    11. Programmers and Software Engineer: (University-trained)
    “We anticipate that these individuals will be the architects and developers of advanced health IT solutions. These individuals will be 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. As such, the solutions they develop would be expected to reflect a sophisticated understanding of the problems being addressed and the special problems created by the culture, organizational context, and workflow of health care. We would expect that training appropriate to this role would generally require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in health informatics or related field, but a university-issued certificate of advanced training in a health-related topic area would as also seem appropriate for individuals with IT backgrounds.”

    12. Health IT Sub-specialist: (University-trained)
    “The ultimate success of health IT will require, as part of the workforce, a relatively small number of individuals whose training combines health care or public health generalist knowledge, knowledge of IT, and deep knowledge drawn from disciplines that inform health IT policy or technology. Such disciplines include ethics, economics, business, policy and planning, cognitive psychology, and industrial/systems engineering. The deep understanding of an external discipline, as it applies to health IT, will enable these individuals to complement the work of the research and development scientists described above. These individuals would be expected to find employment in research and development settings, and could serve important roles as teachers. We would expect that training appropriate to this type of role would require successful completion of at least a master’s degree in an appropriate discipline other than health informatics, but with a course of study that closely aligns with health IT. We would further expect that such individuals’ original research (e.g. master’s thesis) work would be on a topic directly related to health IT.”

    Definition of Physician: For purposes of the University-based training programs, ”the term “physician” is defined as an individual holding one or more of the following degrees: doctor of medicine or osteopathy, doctor of medical dentistry, doctor of optometry, doctor of podiatric medicine, doctor of chiropractic. This definition is consistent with the definition of a physician in the Medicare program (Section 1861(r) of the Social Security Act (42 U.S.C. 1395w—4), which is the established by SSA Section 1848(o), as added by the Recovery Act, as the definition of professionals eligible for the Medicare incentives for meaningful use of certified EHR technology authorized by the HITECH Act.”

  2. Vanessa says:

    Rhode Island has just released a report titled Community College of Rhode Island: Building a 21st Century Workforce. It was researched and written by the Workforce Strategy Center (WSC).

    The Providence Business Journal has an article about the report, including a link to the report itself….

    http://www.pbn.com/stories/49178.html

  3. That is a big challenge on management and leadership. I guess the upcoming Augmented Reality Technology will increase the efficiency of any training and will change the way a lot of people work, particularly in the health care industry.

  4. drive a man wild says:

    One of the goal to implementing health information and communication technology is the requirement for a skilled workforce that understands health care, information and communication technology, and the people and organizational challenges involved.

  5. TM Claude says:

    Yes I agree the nation is in need of more health IT workers. Maybe more institutions will adopt this approach and help to improve a very weak economy…

  6. John Lynn says:

    I have mixed feelings about these programs. Mostly because the money is going to take so long to filter down these “educated” people where they can actually help the industry.

    It also seems interesting that I’ve seen no tie between this money and the money supporting RECs. Although, maybe there’s some good reason for not connecting those programs.

  7. The immediate need is for a workforce that is hard to find .

    A person with experience both in software implementation and work-flow adaptation in a practice is hard to find. The complexities of understanding a clinical workflow in itself is challenging in addition to the EPM side and what we call as the socio-technical challenges can be daunting.

    How long till the workforce be ready through these programs?

  8. Nancy Doad says:

    Good article and information on Health IT. Thanks to Mike Squires for listing the details of the 12 roles.
    I am an IT support consultant specifically managing Medical practices. I’ve learned the flow of medical practices by experience while supporting their IT infrastructure and EMR. Good to know about the upcoming future courses that could help us IT professionals jump start in Health IT direction. During my years of experience in implementing and supporting EMR, I’ve learned that to get a successful paperless office, the Doctors and the office staff need to have the basic knowledge of the technology and the will to learn something new.

  9. Fantastic idea and a great start towards more organized health-care. In Singapore, we have always embraced IT and we need to be efficient to figure how to release the funds and have a proper way of determining results. In our chiropractic office. we use IT to manage our patients info and scheduling.

  10. Ronny says:

    This article is agreat example of how to drive coordinated adoption of IT. Combining domain knowledge with IT experience is a clear winner. Many IT transformation projects tend to be very large scale these days. We work with both public sector and commercial businesses. For example here in the UK the paperless office is regarded as a myth, even in the health sector where there has been a huge drive to deliver secure collaborative environments. The implications of delivering a secure online collaborative environment where sensitive documents and information can be shared is enormous, and its the size of the task that then deters the initaitive, diverting IT funds to other priorities where “quick-wins” can be shown.Whereas this approach I think is more likely to lend ownership to those with domain expereince delivering practical change where needed.

  11. This is an excellent idea for not only streamlining health care but creating a database for practitioners to reference for professional consulting and cross differential diagnostics, but also a more advanced detailed system of analysis and record keeping. Integrating the IT developments will allow for a more collaborative highly tuned system and process, and hopefully better outcomes for the patients.

  12. chongyim says:

    This program is good but older workers in the Health industry who are not IT savvy may not be able to catch up.

  13. I agree that an IT educated workforce would streamline our employment process. A great deal of time is taken to educate employees about our systems. I would welcome prospective employees who had previous experience with these systems.

  14. Mark says:

    Sounds great! I think the younger employees will no problem with keeping up with the changing of times. My only concern will be with the older employees, the ones that are having to change careers. How steep will the learning curve be for them.

  15. This is the kind of forward thinking that our nation desperately needs right now. To have these IT professionals all trained up and ready to perform this necessary and vital function in our health system is going to be invaluable. I commend Dr, Friedman and the staff at HITECH for the work they are doing to prepare our health community for the future.

  16. Our practice has embraced the importance of IT from its inception. At times, I am shocked at the lack of IT integration in the healthcare industry. For as far advanced as we are, there is still a great deal of room for development. This is needed not only to benefit the workflow and ease of the heath care industries, but to provide better services to patients as well. In my area of the country, there are several IT firms solely dedicated to the health care industry. Forward progress with this is more important now than ever.

  17. Sharon says:

    Training at our community colleges is great. But there is one major problem associated with it: The employers all want a Bachelors Degrees and community colleges provide either Associates Degrees or Certificate programs. I have an Associates Degree in Business Management (3.90 GPA). I also have 15+ years sales/management/consulting experience and 10 years medical experience as a National Ski Patroller and Instructor or Outdoor Emergency care. I recently participated in a 3 month Health Information Technology Certificate Program at NKU, where I did very well, achieved top scores in my program and no one will even give me an interview because I lack a Bachelors Degree! So this is a major disconnect in the program. If people are going to be trained in community colleges, then employers have to accept their training programs!

    • Diana Strong says:

      UPDATE: It is now February 17,2012 The program is still not working and the conditions for employment are still the same for the graduates of this program. No internships for Region E. I passed the hitpro exam in tech support software FEB. 16,2012 and I am unable to gain an entry point.

  18. It is my opinion that health care professionals whom embrace the advancements of IT will flourish. Those who resist it will eventually wither and die. The old ways of doing things may have served you well in the past but the future belongs to a strong and resilient health care system with the support of Heath IT at the forefront.

  19. LPN says:

    I totally agree. That’s why fields like nursing informatics have such tremendous opportunity. Professionals with degrees and experience in computer science just naturally will continue to have more options to choose from as well as a bigger pay check.

  20. As i agree its very important to keep up with the advance in IT Tech. lets not take the care outta health care. nothing will ever replace a hand on the shoulder or good bed side manner.

    • Judy Carney says:

      Point is well taken. In the emphasis and drive of healthcare IT there seems to be a weakening of humanness in patient care. I do hope that in the coursework to support IT that there is some coursework that understands that these are humans that cannot be put into specific quantitative numbers.

  21. The problem as I see it from the physician side of things is that the technology is being developed from the IT side of things. Developers should be required to do internships in medical offices. In that way they can see flow and bottle-necks and what is needed and wanted by the medical staff.

    ~ George W Kukurin DC DACAN

    Avondale Chiropractic

  22. This is the kind of forward thinking that our nation desperately needs right now. To have these IT professionals all trained up and ready to perform this necessary and vital function in our health system is going to be invaluable. I commend Dr, Friedman and the staff at HITECH for the work they are doing to prepare our health community for the future

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