If hospital chief information officers and vendor hiring managers think it's tough to find qualified health IT workers now, just wait until technology implementation moves beyond EHR installation, data capture and moderate interoperability to a full-blown effort to transform a broken healthcare industry.
Those who are training the workforce of the future are having to adapt to the impending changes almost as much as would-be health IT professionals, attendees of the annual American Medical Informatics Association conference heard here Tuesday.
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Less than five years after passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act that, among other things, appropriated $500 million for health IT training and workforce development, curriculum for those training programs already needs to be updated.
The Midwest Community College Health IT Consortium, based at Cuyahoga Community College in Cleveland, convened subject-matter experts earlier this year, including CIOs and human resources managers, to ask what new skills and knowledge they were looking for. The consortium decided on four core competencies for six-month health IT certificate programs: understanding the change management and team-based care needed for the patient-centered medical home model; meaningful use of EHRs; population management; and health information exchange, said Norma Morganti, executive director of the consortium.
"Managing change is a huge, huge, competency in all of these areas, including meaningful use," Morganti said.
The consortium subsequently developed a workforce competency tool that is available by sending a request to helpdesk@hitrc.org. This is a "discrete roadmap" for schools to follow in designing curriculum for health IT training, according to Morganti, one that she said has been aligned with secondary, role-based frameworks on the Office of the National Coordinator for Health Information Technology's website.
The consortium also has created four hours of e-learning modules to support practice transformation and recently completed an introduction to Lean management principles for the patient-centered medical home, Morganti reported.
"I wanted to emphasize one thing: F-R-E-E. All these resources are free," interjected Judy Murphy, RN, the deputy national coordinator for programs and policy at ONC. Murphy said the Department of Veterans Affairs has been able to train thousands of employees with the free curriculum, downloadable at www.onc-ntdc.org.
ONC also reported that 24,000 people have completed community college-based health IT training programs through the Health IT Workforce Development Program.
Still, a 2012 survey by the College of Healthcare Information Management Executives found that 71 percent of CIOs at hospitals and health systems thought that health IT worker shortages could put enterprise IT projects in jeopardy. But, as William Hersh, MD, chair of the Department of Medical Informatics and Clinical Epidemiology at Oregon Health & Science University, pointed out, just 12 percent of CHIME members surveyed said they had hired graduates from ONC-funded workforce development program, even though two-thirds were aware of the federally supported effort.
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More than a few hospital chief information officers and health IT hiring managers have complained that newly minted graduates of federally funded health IT certificate programs lack the necessary experience to make them good job candidates. "That's true of any profession," Hersh told Healthcare IT News after his presentation. "I understand that CIOs need these types of [experienced] people, but you have to start somewhere."
He recommended that graduates of both the community college training and university-based master's programs, funded by a $32 million ONC grant, that Hersh is in charge of developing curriculum for, consider internships to build their résumés. "Internships are important," Hersh said.
Still, both Murphy and Hersh said schools have to react to the demands of the job market, which is exactly why the Midwest Community College Health IT Consortium held its forum with those in need of proficient employees, then developed its list of core competencies.
On the university side, Hersh recommended a focus on instructing students to understand and apply data and analytics. "The most sought-after people are those who know data," he said, adding that medical schools can be slow to react to changes in the real world.
Universities and community colleges alike must pay attention to the needs of potential employers, said Paul Grundy, MD, founding president of the Patient-Centered Primary Care Collaborative and director of global healthcare transformation at IBM. But those who train people for health professions often fail to realize that skills taught in the classroom might not be so useful in actual jobs. "We're the last business that thinks that way," Grundy said of healthcare.
"Medical schools are sometimes the most backwards places," added Hersh. "The real change that needs to take place is in the medical schools."
The same problem may exist in nursing schools. One person in the audience, Carol Bickford, senior policy fellow at the American Nurses Association, said that the American Association of Colleges of Nursing requires accredited schools to teach informatics, but does not say how much or to what extent.
Grundy recommended cutting back on traditional inpatient training since care is starting to shift from hospitals to outpatient clinics and even patient homes. "We have too many [inpatient] beds," Grundy said. "It's really a huge, fundamental change."
