Proposal for a Minor in Health Information Systems Management

Transcription

1 Proposal for a Minor in Health Information Systems Management Kuang-Wei Wen, Information Systems Department October 18, 2012 Synopsis As an important milestone of its strategic repositioning initiative, the Information Systems (IS) department is proposing to establish a new undergraduate minor program in health information systems management (HISM). The potential students of this program will come from all non-is business majors and health-related disciplines on the UW-L campus. The objective of the HISM minor is to infuse pertinent, up-to-date health information systems knowledge into the students who will take on responsibilities in using information systems to manage medical practice and/or make clinical decisions to improve the quality and efficiency of healthcare delivery. While graduates of this program will become more proficient in healthcare information technology and be ready to join technology project teams in the healthcare industry, the program does not intend to produce electronic medical record (EMR) or electronic health record (EHR) coders. EMR/EHR coders and specialists are the main products of associate or bachelor degree programs in Health Information Technology (HIT) or Health Information Management (HIM) programs. By offering this minor program the IS department will not only directly use its newly developed expertise in the health information area to benefit UW-L students, but also favorably position itself to complement the Health Management program the CBA is developing. Since both the HISM minor and the Health Management program have been identified as the top priority in the CBA s strategic plan, adequate resource support for developing and operating these programs has also been committed by the College. To date, the IS department has, through its two-year long participation in the establishment of the UW consortium online Health Information Management and Technology (HIMT) program, developed sufficient faculty expertise for offering the proposed HISM program. In fact, the on-site versions of five out of the six courses the IS department has developed for the HIMT program will form the core curriculum of the HISM program; these courses have been cross-listed with IS course numbers in UW-L s undergraduate catalog. All the remaining courses for the proposed minor curriculum are existing courses. In sum, the HISM program consists of all existing courses which either have been offered regularly or can be offered immediately. Drawing on its experience in having been successfully offering the IS minor since 2004 and the recent faculty capacity building in helping to establish the HIMT program, the IS department is able and ready to start a new minor program in HISM that is in high demand on the UW-L campus. This new initiative will provide the impetus to the IS department s modernization effort, strengthen the CBA s expected Health Management program, and enhance the marketability of many UW-L majors in the healthcare-dominated new economy. 1

2 The Need of the HISM Program With an aging population, retirement of the boomers, and extended life expectancy the Americans have been experiencing a steady increase of healthcare consumption. In 2011, the share of healthcare expenditure accounted for 17.2% of the national GDP, the highest level among all industrialized nations in terms of both real dollars and percentage. However, given the near $8,000 per capita healthcare cost, the quality of healthcare in the U.S. is still out-ranked by a few developed nations which spend less than $5,000 per capita. As the high cost and inefficiency of U.S. healthcare have been widely recognized as a national crisis, the Federal Government has subscribed to using IT to help counter the problem through regulation and economic stimulation. After the Health Information Portability and Accountability Act (HIPAA) and the American Recovery and Reinvestment Act (ARRA) along with its Health Information Technology for Economic and Clinical Health (HITECH) provision were signed into laws, tremendous resources have been poured into improving the efficiency and effectiveness of the U.S. healthcare industry. As a part of this trend, when healthcare-related organizations are required to adopt electronic health record (EHR) in delivering care and managing practice, the professions of health information management (HIM) and health information technology (HIT) have been undergoing an e- transformation. Nationally, the demand increase of the health IT professionals has been projected to significantly out-pace the supply 1, thus fueling the trend of adding relevant academic programs in the areas by institutions of higher education. 2 For the state of Wisconsin, the imbalance of the HIM and HIT labor markets was carefully studied by the UW System in 2009, 3 and led to the establishment of the online consortium Health Information Management and Technology (HIMT) program which is offered the first time in fall If we liken the U.S. healthcare crisis to a chronic disease, the modernization of the HIM and HIT professions to boost care delivery efficiency would be an energy shot. To date, quick and visible improvement on the quality and portability of medical information has been made by the HIM and HIT departments staffed by IT-proficient new professionals, mainly due to compliance pressure and reimbursement requirements. Yet, as a lead scholar in health informatics had pointed out, 5 the real solution to the U.S. problem entails an industry-wide e-transformation, which amounts to strengthening the immune system of our body in the above analogy. In our view, quick adoption and utilization of health IT by the medical records and technology departments can lead the transformation of the healthcare industry, but the necessary impetus for completing the transformation must come from raised information managing ability and IT competency of healthcare workers. It is not difficult to see that practice management personnel must have working knowledge about the information systems they use in daily routines to ensure the confidentiality, integrity, availability and privacy of health-related information, which are the prerequisite for all accurate, secure and timely transactions. On the other hand, it is also obvious that the clinical teams must be able to use reliable health records and relevant medical literature to help make 1 See The National Center for Education Statistics (NCES, 2010). 2 See Dean & Provost, Vol. 11, Issue 6, 2010, Wiley Periodicals, Inc. 3 Supply and Demand for Medical Informatics Education: Custom Research Report, by Eduventure, The IS department of UW-L has been a partner of this consortium since its formation in spring 2010, and has committed to offering six courses to the program. However, UW-L does not confer degrees to the program. 5 Integrating Carbon, Silicon, and Fiber for Health & Healthcare: Concept, Education & Training, Keynote lecture delivered by Don Eugene Detmer (U. of Virginia) in the 2010 Spring Health Informatics Workshop sponsored by the Claremont Graduate University in California. 2

3 sound clinical decisions in practicing evidence-based medicine. Additionally, as the operating environment of healthcare delivery has become increasingly complex due to occurrence of new diseases, advances in medicine and technology, and ever-changing regulations, team-based IT projects are used pervasively. Consequently, all healthcare personnel need to know how to manage a HIS project from a participant s or the manager s perspective. It is these fundamental requirements for improving healthcare delivery in the U.S. that motivate the development of the proposed minor program in health information systems management. HISM Minor Programs in the Region While the need to increase HISM capability among all healthcare workers is running high, the supply of academic programs to meet this demand has been low. Nationally, there are only a small number of minor programs in HISM available, though there exist many specialized HIM, HIT, and health informatics programs. Regionally, to our knowledge, there is no HISM minor program being offered. Our extensive online research on academic programs at all UW system universities, University of Minnesota systems, all Minnesota State Universities, and public universities in Iowa and Illinois did not turn up any minor programs of this nature. The closest available program is the 24-credit Healthcare Informatics Certificate program offered by the College of Health Sciences and School of Information Studies jointly at the University of Wisconsin-Milwaukee. However, given that this program is designed for working healthcare professionals to gain deeper knowledge in HIT, it is not an equivalent of the proposed HISM program. In sum, our proposed minor program will be unique in the Upper Midwest region. Campus Demand for the Program In order to know student reception of and demand for the proposed HISM program on campus, the IS department administered an online survey to all UW-L students on September 26, A cover message briefly explaining the objective, nature, and requirements of the proposed program along with a Qualtrics link was ed to 10,174 student addresses. Within one week 869 questionnaires were completed, which overwhelmingly showed students keen interest in the HISM program. Key numbers from the survey result are provided in the three tables below. (All answers are based on 5-point Likert scale and tallied under the three UW-L colleges.) Table 1: Awareness/Importance of HISM (Q6 in the survey) Answers CBA CLS SAH Total % all responses Extremely Important (5) % Very Important (4) % Sub Total % Table 2: Extent UW-L Teaches HISM (Q15 in the survey) Answers CBA CLS SAH Total % all responses Not at All (1) % A Little (2) % A moderate Amount (3) % Sub Total % 3

4 Table 3: Interest in HISM Minor (Q16 in the survey) Answers CBA CLS SAH Total % all responses Definitely (5) % Somewhat Likely (4) % Maybe (3) % Sub Total % Table 1 shows the numbers of students who think concepts of health information systems management (HISM) are very important (4) to extremely important (5) in the three colleges. Taken together, 63.5 % of all respondents believe HISM is an important subject to study. On the local supply side, Table 2 shows students perception about the lack of HISM education at UW-L % of all respondent feel UW-L teaches no (1) to a moderate amount (3) of HISM. The feeling is particular strong among CBA and SAH students. Finally, the most important result of the survey is lucidly shown in Table 3, which summarizes the numbers of students in the three colleges who are interested in the HISM program. Overall speaking, 69.1 % of all respondents expressed some level of interest in the HISM minor. But what is remarkable is the 310 students who showed significant interest (answered 4 or 5 to Q16) in the program. Among them, an impressive 62% came from the SAH and 27 % from the CBA. In fact, these favorable responses have come from 48 different academic programs on campus, representing a vast majority of UW-L departments. And the six most interested departments excluding IS are: Biology (55), Health Professions (32), Exercise and Sport Science (26), Accountancy (20), Management (19) and Health Education and Promotion (18). With all these encouraging numbers showing campus-wide interest, we are convinced of the popularity of the proposed program as well as its potential demand. Many very positive student opinions on the proposed program were also given as comments in the survey; a sample of them is copied verbatim in Appendix C. The survey results also serve to facilitate estimation of the initial size of the HISM program. Using a method akin to projecting actual sales from expressed purchase intent in marketing, we can apply a conversion rate (CR) on the number of interested students to derive the rough size of the program. However, since current seniors will almost have no chance to take the minor when it is offered, they should be excluded from the calculation. And to be conservative, relatively low conversion rates are used in the following pro forma estimation. Table 4 Estimation of the Initial Program Size Answers to Q16 Number CR Expected Number Definitely (5) % 22 Somewhat Likely (4) % 16 Maybe (3) % 8 Total % 46 Even though many factors may affect students final decisions on taking the proposed minor after they have expressed various degrees of interest in the program, we believe the combined conversion rate of less than 9% is realistic and thus, the projection of 46 students joining the pro- 6 The most recent conversion rate of the online HIMT program was 20.6% for this category. 4

5 gram likely. Assuming it takes two years for the interested students to enter the program, we can expect the size of the first class to be around 23. Centrality of the Proposed Program to Institutional Missions As the minor is designed to strengthen students knowledge in health information systems and to foster their ability to better manage and use health information, graduates will enhance their marketability for initial jobs in their respective disciplines, and also increase their chance of success in careers involving extensive use of health information systems. These program outcomes support the following institutional missions: UW-L Mission: [UW-L] is fully engaged in supporting student success. [UW-L] prepares students to take their place in a constantly changing world community. CBA Mission: [CBA] provides educational experience that fosters the professional development of its students. Objective 5: Our teaching, scholarship, and program development is directed by the need to provide well-trained candidates for positions of responsibility in local, state, national, and international organizations. Given the geographical location of UW-L which is characterized by many health organizations of varying sizes, our program outcomes are particularly meaningful because many graduates will seek and be employed by these organizations and contribute to improving healthcare delivery in the region. The Proposed Minor Program The HISM minor can be taken by non-is CBA majors and majors in non-cba colleges. For CBA majors the minor program consists of 7 courses (6 required, one elective) totaling 19 credits: Required courses Number Title Credit Timing HP 250 Medical Terminology (Online) 1 F,Su IS 321 Survey of IT in Healthcare 3 F IS 340 Ethics, Security and Compliance 3 F IS 370 Healthcare Systems: Analysis and Design 3 F IS 420 Healthcare Systems: Project Management 3 S IS 435 Data Communications & Networks in Healthcare 3 S Elective (one from) IS 320 Computer-based Decision Support Systems 3 S IS 360 Management of Information Technology 3 F For non-cba majors the minor program consist of 8 courses (7 required, one elective) totaling 23 credits: 5

6 Required courses Number Title credit Timing HP 250 * Medical Terminology (Online) 1 F,Su IS 220 Information Systems for Business Management 4 F,S,Su IS 321 Survey of IT in Healthcare 3 F IS 340 Ethics, Security and Compliance 3 F IS 370 Healthcare Systems: Analysis and Design 3 F IS 420 Healthcare Systems: Project Management 3 S IS 435 Data Communications & Networks in Healthcare 3 S Elective (one from) IS 320 Computer-based Decision Support Systems 3 S IS 360 Management of Information Technology 3 S * Waived for non-cba students who have taken this course. Rationale for Program Design As the HISM was conceived in parallel with the consortium online HIMT program, some program design ideas and activities were shared by the two programs. However, the programs were developed for different purposes. The HIMT program uses two tracks to produce HIM and HIT bachelor degrees separately, though the tracks do share a 16-course common core. The HISM minor on the other hand targets business and health-related majors who will seek employment in the healthcare or public health areas. Although some graduates might eventually work in the HIM or HIT department in health organizations, they are not the focus of the program. With this program orientation in mind, we have strived to identify the necessary knowledge and abilities most future healthcare workers should possess. This task was accomplished by the aids of two reference curricula, professional feedback, and a set of design principles. References While currently there does not exist any design paradigm for a HISM minor program, we resort to employing two prominent curricula as the foundation of our program design. Since the essential HISM proficiencies the proposed program will deliver also lie in the areas of HIT and HIM, we identify the following two relevant references: a) the Health IT Workforce Curriculum developed by the Office of the National Coordinator (ONC) 7 for Health Information Technology, Department of Health and Human Services under the HITECH program, and b) the Health Information Management Bachelor s Curriculum defined by the American Health Information Management Association (AHIMA). 8 Professional Feedback In the process of developing the common core (16 courses) for the HIMT program, which is a super set of the HISM courses, Dr. Wen of the IS Department personally interviewed and discussed with three important local healthcare professionals about HIS competencies of healthcare workers: the IT director of Gundersen Lutheran Hospital, the HR director of Winona Health, and the president of Allergy Associates. A framework of the core based on the feedback of these pro- 7 The ONC of the HHS Department has been leading the U.S. in developing a standard HIT curriculum. 8 The AHIMA is the de facto accreditation body of the HIM profession and education. 6

7 fessionals and the two reference curricula was then defined by Dr. Wen and submitted to the HIMT program development consortium led by the UW Extension. This framework was subsequently brain stormed by the consortium and commented by many additional healthcare professionals in clinics, managed care, insurance companies, education and training, and public health. The ensuing rounds of revision had culminated in the final curriculum for the HIMT program. In the end, many valuable industry feedbacks in this process have also helped us narrow down the HIMT core to the HISM core (6 courses). Design Principles The IS Department has followed three principles in determining the curriculum for the HISM minor program. 1. The program should have a core that focuses on enhancing the most important abilities of healthcare workers for adopting, managing, and using information systems, while also provide them additional options to build strength in decision making using knowledge or in managing practice using IT. 2. The program will be forward-looking so as to better prepare students for new requirements called for by the healthcare environment of the future. One example is to train students to take on work responsibilities defined by the forthcoming Stage III Meaningful Use requirements Leverage the existing expertise of the IS department to build strong features in the program. By having applied the design principles to the reference curricula and also incorporated professional feedback in coursework determination, we developed a compact program that logically corresponds to the more general elements of the two reference curricula. The proposed program maps into 10 out of 20 knowledge categories in ONC s Workforce Curriculum (see Appendix A for details) and partially maps into all five categories in AHIMA s HIM curriculum (see Appendix B for details). Two strong features characterize the advanced design of the program: extensive training in project management and broad coverage of data communications in healthcare. Students with these specialties will stand out even against graduates from existing HIT, HIM, and health informatics programs. Program Objectives and Learning Outcomes of the HISM Minor Using IS to improve care quality, reduce flaws and frauds, and raise delivery efficiency is the national strategy for transforming the healthcare industry. However, adoption of IS brings along changes, and changes always meet resistance. Fourteen years after the passage of HIPAA, the adoption rate of EHR (a major health information system) in the U.S. barely exceeded 50% by the end of Without wide adoption and deep penetration of EHR, further significant improvement on healthcare through IS will be extremely difficult. Fortunately, as the anemic adoption of HIS seems insurmountable, a feasible solution to it exists on the user side. It is not novel to the profession of information systems management that user participation and education could effectively facilitate IS adoption. With this conviction, our overall goal of the HISM minor pro- 9 See Meaningful Use Stage 3 Emphasizes Better Decision Support, InformationWeek, August 6, See EHR Adoption Crosses 50% Threshold, InformationWeek, December 13,

8 gram is set to preparing students to be knowledgeable health information systems adopters and competent users. To be a knowledgeable adopter, the student must be able to understand, analyze, evaluate, and appreciate the health information systems that are used to perform or support practice management and clinical tasks as well as related decision making. And to be a competent user, the student should know how to properly manage the data, software, and communications components of the systems that have been adopted. With this elaboration the three main program objectives along with their more detailed learning outcomes are identified below. OBJECTIVE 1: To prepare students to be knowledgeable HIS adopters Learning Outcome 1: Understand basic healthcare terminology Learning Outcome 2: Demonstrate knowledge of various health information systems for practice management and clinical decision making Learning Outcome 3: Demonstrate knowledge of the regulatory environment and compliance requirements of the healthcare industry Learning Outcome 4: Demonstrate ability to analyze, evaluate and make adoption decision for HIS in a team-based work environment OBJECTIVE 2: To prepare students to be competent HIS users Learning Outcome 1: Demonstrate knowledge of the basics of electronic health records Learning Outcome 2: Demonstrate knowledge of the building blocks of information systems Learning Outcome 3: Demonstrate knowledge of healthcare data collection, storage, maintenance, and exchange Learning Outcome 4: Understand the process of HIS development and the role of end users Learning Outcome 5: Demonstrate ability to apply principles of security, privacy, and ethical issues in using HIS to handle health data OBJECTIVE 3: To prepare students to be sound HIS managers and/or health-related decision makers Learning Outcome 1: Demonstrate knowledge of HIS outsourcing and project management Learning Outcome 2: Demonstrate knowledge of the basics of health information exchange (HIE) and inter-organizational data sharing standards Learning Outcome 3: Demonstrate knowledge of strategic use of HIS Learning Outcome 4: Demonstrate ability to use and integrate IS to support medical decision making Learning Outcome 5: Demonstrate ability to apply analytics to obtain knowledge from medical data The following matrix provides the mapping of the HISM courses (in columns) to the learning outcomes (in rows) stated above. 8

9 Objectives - Outcomes Core Courses Electives HP 250 IS 220 IS 321 IS 340 IS 370 IS 420 IS 435 IS 320 IS 360 OBJECTIVE 1 Leaning Outcome 1 F Leaning Outcome 2 F Leaning Outcome 3 F Leaning Outcome 4 F P OBJECTIVE 2 Leaning Outcome 1 F Leaning Outcome 2 F P Leaning Outcome 3 P P P Leaning Outcome 4 F Leaning Outcome 5 F P OBJECTIVE 3 Leaning Outcome 1 F P Leaning Outcome 2 P F Leaning Outcome 3 P F Leaning Outcome 4 F Leaning Outcome 5 F F: full mapping P: partial mapping While assessment of the learning outcomes will be carried out in the mapped courses, the IS 420 course will be used as a quasi-capstone course to assess the overall outcome of the program. By requiring the students to demonstrate their knowledge about and competency in performing various activities in managing a HIS project, this course is the ideal choice for program assessment. Coursework Sequences The following two diagrams show planned paths through the minor program for non-is CBA majors and non-cba majors respectively. Typical Coursework for Non-IS CBA Majors Junior Senior Fall HP IS 321 IS 340 IS 370 Required Course Elective Spring IS 435 IS 420 IS 320/360 9

10 Typical Coursework for Non-CBA Majors Junior Senior Fall HP IS 220 IS 340 IS 370 Required Course Elective IS 321 Spring IS 435 IS 420 IS 320/360 Description of Courses 11 HP 250 Medical Terminology for Health Professions (1 credit) Students in various allied health fields will learn to use medically related terms in their professional communication. This covers the study of the language of medicine used in clinics, hospitals, and other health agencies. The student will develop a working knowledge of terms, word roots, and abbreviations with emphasis on spelling, definitions, and pronunciation. An introduction to health care records, disease process, operative, diagnostic, therapeutic, and symptomatic terminology of body systems will be covered as they pertain to medical practice. Online course. Offered Fall, Summer. IS 220 Information Systems for Business Management (4 credits) This course provides the basic level of management information systems literacy. Students will be exposed to the building blocks of computer-based information systems, the various organizational aspects of utilizing information systems, and the role of information technology in the digital economy. To stress the importance of user participation, the systems development life cycle will be introduced from end-users' perspective. Additionally, students will acquire essential skills of personal productivity tools through hands-on training in small classes. Offered Fall, Spring. IS 320 Computer-based Decision Support Systems for Management (3 credits) An examination of how various software application packages such as spreadsheets, database management systems, and other software tools, are employed to support decision making in business environments. Topic areas include modeling, decision-support systems, data ware- 11 All courses are listed and described in the UW-L Undergraduate Catalog,

11 houses, on-line analytical processing, and data mining. Prerequisites: CS 120; IS 220. Offered occasionally. IS/HIMT 321 Survey of Information Technology in Health Care (3 credits) In this course essential information technologies in health care (HITs) will be surveyed. Many important health care information systems (HISs) are built upon three categories of HITs: data processing technologies, information reporting technologies, and decision supporting technologies. Specific subjects pertaining to these technologies will be identified and introduced. (Crosslisted with HIMT 320; may only earn credit in IS or HIMT.) Offered Fall, Spring. IS/HIMT 340 Ethical Issues, Security Management and Compliance (3 credits) This course introduces three broad subjects: 1) evidence-based medical ethics pertaining to health care information management; 2) framework of health care information security management including security principles, policies and procedures, security management models, risk assessment, and protection mechanisms; and 3) health care regulations and compliance with focuses on the legislative systems, policies, and legal environment of health care in the U.S. and the existing health information laws, regulations and standards. Also addressed are the elements and development of compliance programs. (Cross-listed with HIMT; may only earn credit in IS or HIMT.) Offered Fall, Spring. IS/HIMT 370 Health Care Systems: Analysis and Design (3 credits) This is the first course in a two-course sequence that addresses methods and techniques of health care information system (IS) analysis and design as performed within the system development life cycle. Included will be the definition of the problem, fact gathering, analysis, logical design, selection and evaluation of alternative health care information systems solutions from the point of view of the health provider and user. The course focuses on the problem solving process that leads to the development of logical IS solutions to applied health care problems. Prerequisite: IS 220 or HIMT 300. (Cross- listed with HIMT; may only earn credit in IS or HIMT.) Offered Fall, Spring. IS/HIMT 420 Health Care Systems: Project Management (3 credits) This course addresses the phenomenal impact information system (IS) projects have had on health care delivery. Students learn how IS health care projects affect organizations, doctors, patients, and chronic-illness treatments, as well as individuals interested in managing their own health care. Concepts and tools for IS health care project management, process reengineering and work redesign are introduced. The purpose of this course is to expose students to IS project management activities in health care settings. Topics covered include recent IS health care project trends, budgeting, scheduling, resource management, scope, risk analysis, and deployment controls. The genesis of health care project management is covered using specific cases and examples. (Cross-listed with HIMT; may only earn credit in IS or HIMT.) Offered Fall, Spring. 11

12 IS/HIMT 435 Data Communications and Computer Networks in Health Care (3 credits) This course provides fundamentals of data communications and networking techniques, and examines the linkage of information technology strategies and technological solutions enabling effective communication within and between health care organizations. Major topics include fundamental concepts of data communications and applications, network communication devices, basic technologies of the Local Area Network, Wireless Local Area Network, Wide Area Network, Internet and the Web, the OSI stack, health care information system standards, and the HIE, RHIN, and the NHIN. Prerequisite: IS 220 or HIMT 320 (Cross-listed with HIMT; may only earn credit in IS or HIMT.) Offered Fall, Spring. IS 360 (MGT 370) 12 Management of Information Technology (3 credit) An examination of issues that both MIS and non-mis managers face in managing information and information technology within an organization. The course is a topics course and will, of necessity, vary from semester to semester to stay current with the technological changes which managers would face in the workplace. Topics include strategic uses of information technology, technological trends and their implications, the relationship between organizational structure and information technology, evaluation of the effectiveness of information technology, end user computing, management of new and existing systems and ethical and international issues. Prerequisite: junior standing. Offered occasionally. Relationships of the Proposed HISM Minor to Other UW-L Programs Through regular course offering the HISM program will directly support the two existing IS programs as well as the Healthcare Management program under development in the CBA. To date, due to resource constraints the IS department has not been able to offer more than one elective course to its major and minor programs. However, the HISM minor will re-activate two important courses that are on the IS elective list: IS 320 (Computer-Based Decision Support Systems for Management) and IS 360 (Management of Information Technology), but have not been offered for many years. As the subject areas of these two courses remain highly relevant to the two existing IS programs, up-to-date contents will be provided once they are offered again. In fact these courses will also benefit students in the Computer Science programs and the Management Department as many of their students will be interested in the topics and able to harness the knowledge acquired from these courses to advance their future career. The proposed HISM curriculum will provide a significant component for the future Healthcare Management program. Depending on the design and focus of this new program, two to four of the required courses of the HISM program can serve as core or elective courses. 13 If the design does not focus on information technology management, then the HISM will be a viable minor program to complement the Health Management program. 12 The LX process is under way to change course designation from MGT 370 to IS Based on our survey of existing programs in healthcare management/administration, courses similar to IS 321 and 340 are typically in the core curriculum, whereas IS 370 and 420 are electives in general, but are required by programs with an emphasis on information technology management such as the UW-Milwaukee program. 12

13 With its potential benefits to the IS department, the CBA and other academic units, the proposed HISM program will be a valuable, synergistic addition to the program array of UW-La Crosse. Faculty Readiness On recognizing the need to reposition the IS department for the changing economy of the U.S. and under the encouragement of the last UW-L provost and the CBA dean, the four ranked IS faculty have been engaged in developing new expertise in health information management and technology areas through active participation in the development of and teaching in the UW- Extension s consortium online HIMT program. The strategic goals of this undertaking are 1) to offer on-site academic programs in the emerging areas of health information systems, and 2) to train faculty for online course development and teaching. IS Faculty capacity building activities have begun in April of Through attendance of workshops, conferences and symposiums, plus diligent self-study of materials as well as taking online courses 14 in the healthcare-related areas, the four tenure-track IS faculty have been gradually developing expertise in their respective teaching subjects in the HIMT program. Also by closely working with the UW-Extension s instructional media specialists the Department is on schedule to develop six robust online courses for the HIMT program by fall, Until then, three IS faculty will have taught four different HIMT courses which are cross-listed with the proposed coursework of the HISM minor. With this new faculty experience and capacity the IS department will be on the launch pad to start the proposed HISM minor, support CBA s anticipated health management program, and collaborate with area healthcare or IT organizations on research projects in the new program areas. Resource Requirements Even though seven additional courses per year must be offered to sustain the HISM minor program, only one full-time tenure-track position will be required. By carefully balancing the course demand from its three programs (the IS major and minor programs and the HISM minor) and optimizing class size and sections offered, the IS department will be able to fully utilize the requested position to simultaneously satisfy the operational need of the proposed program and maintain or even enhance the quality of the existing programs. This inter-program synergy will continue to exist until the HISM program reaches its economic limit of 40 to 45 students. Program size beyond this level will require additional faculty resource to sustain. Since all current IS faculty have developed subject area expertise for certain courses in the HISM program, they will offer the set of new courses initially. Consequently, six out of the seven sections of existing IS courses left behind by them will be taught annually by the new hire at assistant professor level. The new faculty will be strongly encouraged to also develop expertise in the health information area so that the Department could have the flexibility in covering all courses required by the academic programs. This back-filling approach will allow the CBA to economically allocate an existing healthcare-related GQA FTE position to the proposed program without needing extra budget to hire a high-value Ph.D. in health informatics from a business program. 14 All courses were taken from the AHIMA with completion certificates. These credentials are kept in the IS Office. 13

14 Appendix A: Mapping of HISM Coursework to ONC s Health IT Workforce Curriculum Components I. ONC Health IT Workforce Curriculum Components 15 Category Component Name Component Description 1 Health Introduction to Health Care and Public Health in the U.S. A survey of how health care and public health are organized and services delivered in the U.S. Covers public policy, relevant organizations and their interrelationships, professional roles, legal and regulatory issues, and payment systems. Must 2 Health The Culture of Health Care 3 Health Terminology in Health Care and Public Health Settings 4 IT Introduction to Information and Computer Science 5 Health IT History of Health Information Technology in the U.S. 6 Health IT Health Management Information Systems 7 Health IT Working with Health IT Systems also address health reform initiatives in the U.S. For individuals not familiar with health care, this course addresses job expectations in health care settings. It will discuss how care is organized inside a practice setting, privacy laws, and professional and ethical issues encountered in the workplace. Explanation of specific terminology used by workers in health care and public health. Note that this is NOT a course in data representation or standards. For students without an IT background, provides a basic overview of computer architecture; data organization, representation and structure; structure of programming languages; networking and data communication. Includes basic terminology of computing. Traces the development of IT systems in health care and public health, beginning with the experiments of the 1950s and 1960s and culminating in the HITECH act. Introduces the concept of meaningful use. A theory component, specific to health care and public health applications. Introduction to health IT standards, health-related data structures, software applications; enterprise architecture in health care and public health organizations. A laboratory component. Students will work with simulated systems or real systems with simulated data. As they play the role of practitioners using these systems, they will learn what is happening under the hood. They will experience threats to security and appreciate the need for standards, high levels of usability, and how errors can occur. Materials must support hands-on experience in computer labs and on-site in health organizations. 15 Appendix C of American Recovery and Reinvestment Act of 2009 Information Technology Professionals in Health Care: Program Guidance and Funding Opportunity Announcement, Fiscal Year 2010 published by the Office of the National Coordinator for Health Information Technology, Department of Health and Human Services. 14

15 Category Component Name Component Description 8 Health IT Installation and Maintenance of Health IT Systems Instruction in installation and maintenance of health IT systems, including testing prior to implementation. Introduction to principles underlying configuration. Materials must support hands-on experience in computer labs and on-site in health organiza- 9 Health IT Networking and Health Information Exchange 10 Health IT Fundamentals of Health Workflow Process Analysis & Redesign tions. More in-depth analysis of data mobility including the hardware infrastructure (wires, wireless, and devices supporting them), the ISO stack, standards, Internet protocol, federations and grids, the NHIN and other nationwide approaches. Fundamentals of health workflow process analysis and redesign as a necessary component of complete practice automation; includes topics of process validation and change management. 11 Health IT Configuring EHRs A practical experience with a laboratory component, addressing approaches to assessing, selecting, and configuring EHRs to meet the specific needs of customers and end-users. 12 Health IT Quality Improvement Introduces the concepts of health IT and practice workflow redesign as instruments of quality improvement. Addresses establishing a culture that supports increased quality and safety. Discusses approaches to assessing patient safety issues and implementing quality management and reporting through electronic systems. 13 Health IT Public Health IT For individuals specifically contemplating careers in public health agencies, an overview of specialized public health applications such as registries, epidemiological databases, biosurveillance, and situational awareness and emergency response. Includes information exchange issues specific to public health. 14 Environment Special Topics Course on Vendor-Specific Systems 15 Environment Usability and Human Factors 16 Soft Skills Professionalism/Customer Service in the Health Environment Provides an overview of the most popular vendor systems highlighting the features of each as they would relate to practical deployments, and noting differences between the systems. Discussion of rapid prototyping, user-centered design and evaluation, usability; understanding effects of new technology and workflow on downstream processes; facilitation of a unit-wide focus group or simulation. Development of skills necessary to communicate effectively across the full range of roles that will be encountered in health care and public health settings. 17 Soft Skills Working in Teams An experiential course that helps trainees become team players by understanding their roles, the importance of communication, and group cohesion. 18 Soft Skills Planning, Management and Leadership for Health IT For those preparing for leadership roles, principles of leadership and effective management of teams. Emphasis on the leadership modes and styles best suited to IT deployment. 15

16 Category Component Name Component Description 19 Other Introduction to Project An understanding of project management tools and Management techniques that results in the ability to create and 20 Other Training and Instructional Design follow a project management plan. Overview of learning management systems, instructional design software tools, teaching techniques and strategies, evaluation of learner competencies, maintenance of training records, and measurement of training program effectiveness. Note: Shaded entries are fully or partially covered by HISM coursework. II. Curriculum Mapping ONC Cat. # HISM # Course Title 2 IS 340 Ethics, Security and Compliance 3 HP 250 Medical Terminology 4 IS 220 Information Systems for Business Management 5 IS 321 Survey of IT in Healthcare IS 340 Ethics, Security and Compliance 6 IS 321 Survey of IT in Healthcare 9 IS 435 Data Communications and Computer Networks in Health Care 10 IS 370 Health Care Systems: Analysis and Design 15 IS 370 Health Care Systems: Analysis and Design 17 IS 370 Health Care Systems: Analysis and Design IS 420 Health Care Systems: Project Management 19 IS 420 Health Care Systems: Project Management 16

17 Appendix B: Mapping of HISM Coursework to AHIMA s HIM Curriculum AHIMA 2011 Curriculum Competencies and Knowledge Clusters for Health Information Management (HIM) Education at the Baccalaureate Degree Level HIM Entry-Level Competencies (Student Learning Outcomes) I. Domain: Health Data Management I.A. Subdomain: Health Data Structure, Content, and Standards 1. Manage health data (such as data elements, data sets, and databases). 2. Ensure that documentation in the health record supports the diagnosis and reflects the patient s progress, clinical findings, and discharge status. I.B. Subdomain: Healthcare Information Requirements and Standards 1. Develop organization-wide health record documentation guidelines. 2. Maintain organizational compliance with regulations and standards. 3. Ensure organizational survey readiness for accreditation, licensing and/or certification processes. 4. Design and implement clinical documentation initiatives. I.C. Subdomain: Clinical Classification Systems 1. Select electronic applications for clinical classification and coding. 2. Implement and manage applications and processes for clinical classification and coding. 3. Maintain processes, policies, Knowledge Clusters (Curricular Components) Health Data Structure, Content, and Acquisition Capture, structure, and use of health information (Evaluating, 5) Health information media (paper, electronic) (Evaluating, 5) Data quality assessment and integrity (Evaluating, 5) Secondary data sources such as registries and indexes (Applying, 3) Healthcare data sets (such as HEDIS, UHDDS, OA- SIS) (Analyzing, 4) Health information archival and retrieval systems (Evaluating, 5) Data capture tools and technologies (such as forms; data input screens; templates, other health record documentation tools) (Evaluating, 5) Healthcare Information Requirements and Standards Standards and regulations for documentation (such as Joint Commission, CARF, COP) (Evaluating, 5) Health information standards (such as HIPAA, AN- SI, HL-7, UMLS, ASTM ) (Applying, 3) Patient Identity Management Policies (MPI) (Applying, 3) Clinical Classification Systems Healthcare taxonomies, clinical vocabularies, nomenclatures (such as ICD-9-CM, ICD-10-CM/PCS, CPT, SNOMED-CT, DSM-IV, LOINC) (Understanding, 2) Severity of illness systems (Analyzing, 4) Data integrity, coding audits (Analyzing, 4) CCI, electronic billing, X12N, 5010 (Applying, 3) 17 HISM Courses HP 250

18 and procedures to ensure the accuracy of coded data. I.D. Subdomain: Reimbursement Methodologies 1. Manage the use of clinical data required in prospective payment systems (PPS) in healthcare delivery. 2. Manage the use of clinical data required in other reimbursement systems in healthcare delivery. 3. Participate in selection and development of applications and processes for chargemaster and claims management. 4. Implement and manage processes for compliance and reporting. 5. Participate in revenue cycle management. II. Domain: Health Statistics, Biomedical Research, and Quality Management II.A. Subdomain: Healthcare Statistics and Research 1. Analyze and present data for quality management, utilization management, risk management, and other patient care related studies. 2. Utilize statistical software. 3. Ensure adherence to Institutional Review Board (IRB) processes and policies. II.B. Subdomain: Quality Management and Performance Improvement 1. Provide support for facility- Reimbursement Methodologies Clinical data and reimbursement management (Evaluating, 5) Compliance strategies and reporting (Analyzing, 4) Chargemaster management (Analyzing, 4) Case mix management (Analyzing, 4) Audit process such as compliance and reimbursement (Evaluating, 5) Payment systems (such as PPS, DRGs, APCs, RBRVS, RUGs, MSDRGs) (Analyzing, 4) Commercial, managed care, and federal insurance plans (Analyzing, 4) Revenue cycle process (Analyzing, 4) Healthcare Statistics and Research Statistical analysis on healthcare data (Applying, 3) Descriptive statistics (such as means, standard deviations, frequencies, ranges, percentiles) (Analyzing, 4) Inferential statistics (such as t-tests, ANOVAs, regression analysis, reliability, validity) (Applying, 3) Vital statistics (Applying, 3) Epidemiology (Understanding, 2) Data reporting and presentation techniques (Evaluating, 5) Computerized statistical packages (Understanding, 2) Research design/methods (such as quantitative, qualitative, evaluative, outcomes) (Applying, 3) Knowledge-based research techniques (such as Medline, CMS, libraries, web sites) (Applying, 3) National guidelines regarding human subjects research (Analyzing, 4) Institutional review board process (Understanding, 2) Research protocol data management (Understanding, 2) Quality Management and Performance Improvement Quality assessment, and management tools (such as benchmarking, Statistical Quality Control, and Risk 18 IS 320

19 wide quality management and performance improvement programs. 2. Analyze clinical data to identify trends that demonstrate quality, safety, and effectiveness of healthcare Apply Quality Management tools. III. Domain: Health Services Organization and Delivery III.A. Subdomain: Healthcare Delivery Systems 1. Evaluate and implement national health information initiatives in the healthcare delivery system for application to information systems policies and procedures. 2. Interpret, communicate, and apply current laws, accreditation, licensure and certification standards related to health information initiatives at the national, state, local, and facility levels. 3. Analyze and respond to the information needs of internal and external customers throughout the continuum of healthcare services. 4. Revise policies and procedures to comply with the changing health information regulations. 5. Translate and interpret health information for consumers and their caregivers. III.B. Subdomain: Healthcare Privacy, Confidentiality, Legal, and Ethical Issues 1. Coordinate the implementation of legal and regulatory requirements related to the health information infrastructure. 2. Manage access and disclosure of personal health information. 3. Develop and implement organization-wide confidenti- Management) (Analyzing, 4) Utilization and resource management (Analyzing, 4) Disease management process (such as case management, critical paths) (Analyzing, 4) Outcomes measurement (such as patient, customer satisfaction, disease specific) (Evaluating, 5) Benchmarking techniques (Creating, 6) Patient and organization safety initiatives (Applying, 3) Healthcare Delivery Systems Organization and delivery of healthcare systems (Evaluating, 5) Components and operation of healthcare organizations including e-health delivery (Evaluating, 5) Accreditation standards (such as Joint Commission, NCQA, CARF, CHAP, URAC) (Evaluating, 5) Regulatory and licensure requirements such as COP, state health departments (Evaluating, 5) Federal initiatives: ONC, CCHIT, Red Flag Rules, Meaningful Use (Evaluating, 5) Healthcare Privacy, Confidentiality, Legal, and Ethical Issues Legislative and legal system (Analyzing, 4) Privacy, confidentiality, security principles, policies and procedures (Evaluating, 5) Identity management (Evaluating, 5) Health information laws, regulations, and standards (such as HIPAA, HITECH, Joint Commission, State laws) (Evaluating, 5) Elements of compliance programs (Evaluating, 5) Professional ethical issues (Evaluating, 5) Legal Health Record, e-discovery guidelines (Eval- 19 IS 340 IS 340

20 ality policies and procedures. 4. Develop and implement privacy training programs. 5. Assist in the development of security training. 6. Resolve privacy issues/problems. 7. Apply and promote ethical standards of practice. 8. Define and maintain elements of the legal health record. 9. Establish and maintain e- Discovery guidelines. IV. Information Technology and Systems IV.A. Subdomain: Information and Communication Technologies 1. Implement and manage use of technology, including hardware and software to ensure data collection, storage, analysis, and reporting of information. 2. Contribute to the development of networks, including intranet and Internet applications to facilitate the electronic health record (EHR), personal health record (PHR), public health, and other administrative applications. 3. Interpret the use of standards to achieve interoperability of healthcare information systems. IV.B. Subdomain: Information Systems 1. Apply knowledge of database architecture and design (such as data dictionary, data modeling, data warehousing) to meet organizational needs. 2. Monitor use of clinical vocabularies and terminologies used in the organization s health information systems. 3. Manage clinical indices/ databases/registries. uating, 5) Information security training (Understanding, 2) Information and Communication Technologies Computer concepts (hardware components, network systems architectures, operating systems and languages, and software packages and tools) (Analyzing, 4) Communications technologies (networks LANS, WANS, WLANS, VPNs) (Understanding, 2) Data interchange standards (such as NIST, HL7, 5010, Reference Information Modeling (RIM)) (Analyzing, 4) Internet technologies (Intranet, web-based systems, standards SGML, XML) (Analyzing, 4) Data, information, and file structures (data administration, data definitions, data dictionary, data modeling, data structures, data warehousing, database management systems) (Evaluating, 5) System interoperability, data sharing, Health Information Exchanges (Evaluating, 5) Nation-wide Health Information Infrastructure NHIN (Applying, 3) Information Systems Leading development of health information resources & systems (Analyzing, 4) Database Architecture and Design (Evaluating, 5) Human factors and user interface design (Applying, 3) Systems Development Life Cycle (systems analysis, design, implementation, evaluation, and maintenance) (Evaluating, 5) Clinical, business, and specialty systems applications (administrative, clinical decision support systems, electronic health record and computer-based 20 IS 435 IS 370