Expanding and Strengthening the Health IT Workforce

Today the administration announced two additional programs to support the development of the skilled workforce needed to support broad adoption and use of health IT.  Awards totaling $32 million to establish or expand university-based health IT training programs and $6 million dollars to develop a health IT competency testing program will complement the previously announced workforce development program grants established through the Recovery Act.

Understanding the technology and how it functions is not the only requirement for successful implementation of electronic health records systems nationwide.  The successful incorporation of health IT into patient care includes accessing information at the point of care to inform clinical decisions, changing dynamic workflows within the clinic, and supporting constantly evolving systems.

Ensuring the adoption of EHRs, redesign of workflows within health care settings, and information exchange among health care providers and public health authorities all depend on having a pool of skilled health IT professionals working closely with providers to support the implementation and sustainability of the technology over time.  As a whole, the workforce development program is expected to generate sufficient additional individuals trained in key roles to meet 85 percent of the estimated need for expansion of the health IT professional workforce.

You can learn more about the workforce development program grants at http://www.healthit.gov/policy-researchers-implementers/workforce-development-program.

19 Comments

  1. Glen Marshall says:

    Why not establish a program to re-employ the many skilled workers laid-off from healthcare IT vendors due to the economic downturn? There is no need to train them, and they are available immediately.

  2. Jeremy Engdahl-Johnson says:

    Federal funding may be encouraging a move toward EHR, but there’s more to it than just installing systems. How can healthcare data pooling lead to a better system? More at http://www.healthcaretownhall.com/?p=1903

  3. A. Cavale, MD, FACE, FACP says:

    Successful implementation of IT in healthcare will require not only technical knowledge but intricate knowledge and experience in medical practice. Only physicians can bring this type of experience to the table. Simply training IT workers will only exacerbate the problem. It would be interesting to know if ONc is thinking along these lines.

    • Joe Moore says:

      There are many other roles in healthcare besides physicians that bring something to the table. In the end it will be the physicians staff that has to do the lions share of the work outside of caring for patients and I think that’s how it should be. Since the office staff will be tasked with making the systems work for the doctor they should be heavily involved too. From the physicians perspective I would think the EMR needs to be as seemless as a clip board and paper jacket. Only the office staff can make that happen for you. Just my opinion though…

    • John Byrne BSN, MSIS, RN-BC; Senior Integration Engineer says:

      I believe the previous comments are on point. Seems what is needed are healthcare clinicians from many levels, who have bridged into healthcare IT. Healthcare clinicians working in healthcare IT will likely lead efforts into the next generation of healthcare applications. Clinicians are aware that applications need to be user-centric. Clinicians understand the importance of efficient interfacing to the healthcare workflow in a variety of different clinical settings and clinical systems. We are seeing tremendous advances in common nomenclatures and interfacing standards today. The successful products of the future will be able to leverage these advances, while keeping the end user and patient needs at the center of an easily supported, accessible, platform.

      Seems what’s needed is more healthcare IT preparation in the entry healthcare educational programs. I believe many healthcare IT workers today have some experience in building our own bridges to the healthcare IT workplace. Until relatively recently, there were very few established healthcare IT paths or programs available for clinicians. It’s very encouraging to see these new healthcare educational and certification incentives. The informatics educational programs available today will likely produce the clinically-based, healthcare IT workers that are needed. Early IT preparation in the healthcare entry programs will help a great deal with the “change” challenges seen in healthcare. This is an encouraging beginning.

      • Joe Moore says:

        There is already evidence to support your comments John. Some radiology technologist training programs have for a few years offered additional education for rad techs who wish to further specialize in PACS (Picture Archive and Communication System) administration. An effective PACS administrator must be equally qualified in information technology and the clinical operations of radiology. They must be able to effectivley implement, maintain, and troubleshoot systems, software, and networks while at the same time have an intelligent conversation with physicians and other clinicians so they can understand and address their needs. These programs have provided a much needed influx of qualified PACS administrators.

        This model of offering additional education in health IT in all clinical programs would be the best way to create a workforce that understands both the clinical and technical aspects of electronic records.

  4. uberVU - social comments says:

    Social comments and analytics for this post…

    This post was mentioned on Twitter by ehana: Coming soon: more skilled IT workers. HHS announces several new grants aimed at healthcare IT training: http://bit.ly/6Vk9Vk…

  5. Audrey Southwick says:

    Along the lines of what Glen says, I would add “and why not seek first to employ the physicians’ office staff that has been ‘reduced’ by using EHRs. These casualties of EHR use seem to be overlooked. Their job losses are lauded as progress in the cost cutting realm of EHR-using providers. People with experience in a medical office would, along with IT vendors’ former employees, make a great basis for these new programs and would most likely be a vast improvement over other unskilled community college students.

    • Maria McCarthy says:

      When we re-organize and set up an office with new software we rely on the staff to educate us in their work flow processes and office protocols just as much as they need us to facilitate, train and support their software implementations. We do become as Tony said, that someone trusted to facilitate necessary change while protecting their interests, but for the day to day these physicians rely on their loyal office staff. Most primary care physician offices consist of 2 or 3 employees. These employees multitask between the front desk and the exam room. The success or failure of an EHR implementation rests on the acceptance and cooperation of this staff. It is truly a team effort.

      The EHR vendor has to stay in the role of sales only. You can’t effect change without trust, and you won’t have trust if there is the threat of job loss. You have to keep the harmony and balance of the practice in tact. Training the existing staff is essential.

  6. Maria McCarthy says:

    I work with many physicians and their staff in private practive settings. The one thing that terrifies them is change. When you propose a disruption in workflow of this magnitude and learning new technology you have to offer more than 13 hours of implemtation, training and configuration, which is what the top 10 EHR/EMR vendors provide. According to the HBMA White Paper there is 72% EHR/EMR failure rate after one year.

    Why not use local IT and billing professionals? My doctors trust me to have their best interest. It would be much less intimidating if they knew someone was going to be around after the training ended. I don’t know how the selection process works, but maybe they could let small local companies apply for these grants, have them go through a training program and certification to ensure compliance, and then let them be responisble for the implementaion, training, configuration and ultimately day to day support.

    • Tony Dotson, MHM says:

      I agree whole-heartedly with you regarding most physicians’ hypersensitivity to change. Most physicians are reliant upon someone trusted like you to facilitate necessary change while protecting their interests and ability to practice medicine in the manner they prefer. This is why I am confident we will see the small, local businesses you referenced benefitting from these grants. It is my belief that graduates of these programs will either start up or join consulting firms that service the local physician communities; many existing consultants may even complete the courses. The 72% failure rate is not an option beginning in 2011, so there will definitely be a demand for these services “after the training ended” as you described.

  7. Stephanie L. Jones, CPC, CEMC says:

    The American Society of Health Informatics Managers (ASHIM) believes IT professionals with health care skills and knowledge are needed to best serve Doctors who are using and adopting Health IT. Whether the IT position is short term (EHR Consultants and Project Managers) or permanent (IT staff and HIT Trainers), the hiring public and our Doctors need a means to differentiate the skills of IT professionals and to validate their current health care industry knowledge. Job applicants and current HIT staff need a means to inform employers of their qualifications and readiness with respect to the healthcare industry. Without this, at a minimum, our Doctors are at risk for needless distractions from patient care. These FOAs are a powerful step toward supporting the successful development of a HIT workforce.

  8. Blue Oak Consulting LLC says:

    Common sense needs to rule the day:
    a “successful EMR implementation” is one that requires the additional staffing during the transition of “go live” (does not prematurely layoff employees), and then transitions the extra staffing to other positions.

    In every EMR installation I have completed, any downsized staff which supervisors selected to retain were retrained as medical assistants, entry-level billing support, or techs for new clinical offerings.

    Unfortunately, the majority of “skilled workers laid-off from healthcare IT vendors” are healthcare sales reps who had been brought in from other areas such as imaging equipment or devices. Their skill is sales and they have not been involved in the direct support of the provider’s clinical workflow (as seen in that the vendors provide this support through an entirely separate set of personnel: apps educators).

    The preliminary educational plan of the ONC for the HITECH workforce is impressive in its depth, scope and funding.

  9. Elisa Cousins says:

    All of this is great and dandy…but which schools offer IT health training and/or higher ed curricula?!
    Some info on that would NOT be wasted-especially in this economy !!!
    Thank you!

    • John Byrne BSN, MSIS, RN-BC; Senior Integration Engineer says:

      Please try a web search on the term “informatics”. Put the defining terms, healthcare, nursing, medical, in front of informatics, depending upon your area of interest. I hope this helps…

  10. John Dzivak says:

    Has there been any consideration to view technology as a medical specialty? If you think about it that way, how does technology differ from cardiology or neurology in care delivery? Incorporating the technology department in residency rotations would, at a minimum, help future clinicians and providers gain a fundamental understanding of the technologies they will employ during their careers that they currently lack, and might possibly allow the freight of developing the technology experts these new grants and programs are trying to create to be carried by existing programs. I guess my questions is, would it make more sense to leverage established medical education and training programs for the field of medical technology than to create something new?

  11. Chris Wessells says:

    I have been implementing practice management solutions and eletronic medial records solutions for a variety of customers. I have worked with single physician practices up to 250 bed hospitals. I have also experienced varying levels of success. I have had a “Nurse Informaticist” lead an EMR project that was very successful with nurse adoption and problems with the physicians. I have had a system administrator lead an EMR project that was successful with nursing, physicians and office staff.

    You can have successful “Healthcare Information Technology” staff that rise through the clinical ranks and others that rise through the technical ranks. The key is understanding healthcare business processes, understanding the technologies involved, and communication skills. In my experience someone with a clinical background who is very technical (more than a super user) gains credibility faster, but staff of this nature are hard to find. I was lucky enough to have 1 nurse with very technical background of a 600+ nurse pool.

    In my experience it is easier to find an IT person who understands business processes, or business process person who understands IT. In my experience it is also faster to train an IT person on healthcare business processes, than train a clinician in IT. To help with successful implementation of a practice management solution or electronic medical record the team doesn’t necessarily have to be a clinician, but they have to understand the tool and how it fits into the clinicians business processes.

    To ensure the system continues to be used, it is important to have regular follow up and maintenance. There needs to be an active group of care-takers for the EMR. The vendor also needs to remain engaged in the maintenance phase of the software lifecycle. In my experience the successful practices who have implemented and are using an EMR, follow the software lifecycle model unconsciously. This is vital to the success of any software implementation, to understand the distinct phases of the software lifecycle.

    We shall see how it works out….

  12. Karen Bruchey, RHIT says:

    I am currently working on my bachelor’s in HIT; and I must say, I am thrilled in regards to the implementation of funding for advancement of HIT professionals, however, I find several key issues need to be addressed: lack of willingness on the part of organizations to afford future graduates practical experience (so in essence, there needs to be some kind of portal established for students to access; that offers contact information of facilities/organizations offering practical experience intership/externship); the federal contractor for which I work was adept enough to utilize my credentials to help win our contract and numerous others, however they are unwilling to provide any educational assistance, because the college I attend is not listed as a member of a business affiliation of the company! Third issue: My degree plan curriculum is not up to speed with HIT needs…..little to no practical IT coursework curriculum – does this mean I will be able to take only pertinent IT coursework offered by HITECH ACT to enhance my degree and credentials? I questioned the Vice Chair of HIM Department for my college as to whether or not they would be applying for HITECH grant funding…..the college doesn’t even seem to be aware of this funding! Bottom line is this all looks great on paper…attaining financial assistance continues to be a nightmare, as well as finding someone who actually wishes to help HIM grads attain practical on the job experience.

  13. me-pages.com says:

    I believe the previous comments are on point. Seems what is needed are healthcare clinicians from many levels, who have bridged into healthcare IT. Healthcare clinicians working in healthcare IT will likely lead efforts into the next generation of healthcare applications.

    In my experience it is easier to find an IT person who understands business processes, or business process person who understands IT. In my experience it is also faster to train an IT person on healthcare business processes, than train a clinician in IT. To help with successful implementation of a practice management solution or electronic medical record the team doesn’t necessarily have to be a clinician, but they have to understand the tool and how it fits into the clinicians business processes.

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