HEALTH INFORMATION TECHNOLOGY

Transcription

1 ENVIRONMENTAL SCAN HEALTH INFORMATION TECHNOLOGY Phase One Overview Orange County Region AUGUST 2009 CENTER OF EXCELLENCE Orange County Region Rancho Santiago Community College District 2323 N. Broadway, Suite 328 Santa Ana, CA (714) An Initiative f

2 Mission: The Centers of Excellence, in partnership with business and industry, deliver regional workforce research customized for community college decision making and resource development. Vision: We aspire to be the premier source of regional economic and workforce information and insight for community colleges Chancellor s Office, California Community Colleges Centers of Excellence, Economic and Workforce Development Program Please consider the environment before printing. This document is designed for double-sided printing.

3 Contents Executive Summary... 4 Introduction... 5 Industry Overview... 6 Occupational Overview... 9 Limitations of Existing Data Workforce Challenges, Needs, and Opportunities College Programs and Response Recommendations for Community Colleges Conclusion and Next Steps References Appendix A: How to Utilize this Report Appendix B: Fastest Growing Healthcare Practitioner & Technical Occupations Appendix C: 2008 California HealthCare Foundation Survey Findings Appendix D: AHIMA 2007 Job Titles of Members Appendix E: Electronic Health Record Core Competencies Appendix F: HIT Training Programs Appendix G: HITECH Act Real-time data to advance California Community Colleges 3

4 ARRA s financial incentives, coupled with the accelerated timeline for installing electronic health records and other HIT services, make it clear that the existing HIT workforce will be insufficient to meet this dramatic increase in demand. The California Health IT Initiative Workforce Workgroup Executive Summary Health information technology (HIT) is defined as the study of the principles and practices of acquiring, analyzing, and protecting digital and paper based medical information vital to providing quality patient care. HIT is the link to clinicians, technology designers, and information technology; it is the value-adding bridge between patients health information and payers, government, and regulating agencies. There are two aspects to the HIT workforce: (1) people who specialize in health information management (HIM), applied clinical informatics, and information technology resource management (IT), referred to as health information specialists, and (2) those who must use HIT and electronic health records (EHRs) to perform their duties. 1 The latter includes physicians, nurses, pharmacists, other allied health professionals, and anyone who provides service to patients that requires the use of EHRs. This report s primary focus is on health information specialists, rather than the medical personnel who use the data. HIT achieved a new prominence in the United States with its inclusion in the American Recovery and Reinvestment Act (ARRA) of ARRA is the federal economic stimulus package signed into law by President Barack Obama on February 17, Included into this law is $32 billion for HIT investments, which is intended to be used to increase the use of EHRs by physicians and hospitals. This portion of the bill is called the Health Information Technology for Economic and Clinical Health Act, or HITECH Act. The government firmly believes in the benefits of using EHRs and is ready to invest federal resources to proliferate its use. Of the $32 billion, $2 billion is to be used to prepare and train the HIT workforce needed to support EHR adoption. The HITECH Act solicits applicants from academic institutions or consortia the opportunity to apply for this $2 billion pool of funds. The California Health Information Technology (IT) Initiative Workforce Workgroup asserts that: California Community Colleges are an important asset in this effort [meet the market s need for HIT workers] given their broad distribution and access, affordability, relevant course content, and high quality faculty. These community colleges offer 2-year associate degrees, but also a great deal of continuing education for professionals. Despite its importance to California s healthcare system, the HIT labor market has not been adequately studied. According to the California Health IT Workforce Workgroup, the factors that contribute to the lack of accurate data include: U.S. Bureau of Labor statistics not defining HIT professions with much granularity, making it difficult to get reliable current workforce numbers and projections of increased demand. Few research reports have been done to define the HIT workforce and project needs. 1 AHIMA, Building the Work Force for Health Information Transformation, February 2006 Real-time data to advance California Community Colleges 4

5 The Center of Excellence will take a multifaceted approach in studying this important sector of Orange County. This phase one report provides an overview of the HIT industry, its workforce, and the challenges and opportunities facing the sector. A phase two report will include analysis of the size and scope of the HIT sector in Orange County and its potential for growth. Phase three reports will include a series of regional in-depth labor market occupational studies including detailed wage information, growth forecasts, and recommendations for community college program development. Introduction The California Community Colleges Economic and Workforce Development (EWD) Program has charged the Centers of Excellence with identifying industries and occupations that have unmet employee development needs and partnering potential for the colleges programs. The Orange County Center of Excellence conducted an examination on the health information technology (HIT) workforce, with specific focus and determined that it met the criteria for further research. Appendix A contains information on how to use this environmental scan report. HIT was selected because: HIT is a profession that can be easily served by community college-level education and training programs. Yet, only one community college currently provides HIT training programs in Orange County. HIT is projected to be Orange County s seventh fastest growing healthcare practitioner and technical occupation group requiring an associate s degree or less from (see Appendix B). Forecasts may be understated due to the tremendous workforce ramp-up expected during the next several years to support the nationwide initiative to accelerate the transition from paper to EHRs. Thus, HIT should see increasing job opportunities that exceed the current labor market projection over the next five years. The field offers career pathway opportunities for workers. The literature asserts that Clearly more research is needed to better understand the HIT workforce and its optimal organization and training. 2 A three phase approach was most suitable in completing an environmental scan report. This approach was adopted to address an important aspect of the field: despite the growing interest by leaders, policy makers, and others, the HIT sector is inconsistently defined and poorly understood, even among the academics and professionals in the field. Therefore, the goal of this Phase I report is to inform California Community Colleges and other stakeholders about the nature and issues facing the HIT workforce. The report includes an overview of the HIT industry and a description of occupations. Also included are workforce challenges, needs, and opportunities, limitations of current HIT labor market data, college programs and response, recommendations for community colleges, and a conclusion. 2 Hersh, W., A Stimulus to Define Informatics and Health Information Technology, 2009 Real-time data to advance California Community Colleges 5

6 Industry Overview HIT s growing role within healthcare organizations has created the need to deepen and widen the pool of workers. Organizations seek workers who can help them maximize the ongoing effectiveness of their investment in HIT, and in so doing maximize impact on equity, safety, patient-centeredness, timeliness, effectiveness and efficiency of care. According to the October 2008 Joint Work Force Task Force by the American Health Information Management Association (AHIMA) and the American Medical Informatics Association (AMIA), New graduates in any healthcare profession need a skill set adaptable to computer technologies and electronic health records to support work processes and information access experienced in the course of daily workflow. Employees at all levels and job types within today s healthcare workplace need a new set of skills and knowledge to embrace and effectively utilize computer technologies and electronic information. Part of the challenge is ensuring these workers function in a broad continuum of care and effective use of health information and electronic information systems. In addition, it is anticipated that these workers are likely to have different responsibilities due to the use and application of electronic health records. Industry Trends HIT s growth and significance is attributed to its evolution, which is influenced by the adoption of new technology and other changes impacting the healthcare system. 3 New uses and new users for health information. Health information specialist professionals are already addressing many factors influencing the healthcare industry. For example, changes in technology and its impact on delivery of patient care; consumer-driven healthcare and the movement for patient-centered care; and the value placed on health information for functions in healthcare organizations outside of medical records (i.e., quality improvement and other administrative functions, revenue cycle management and financial and strategic planning). Impact of evolving technology on health information and the healthcare field. The HIT field is in the midst of a business cycle often referred to as creative destruction. This is when existing technologies, processes or roles are destroyed as new technologies and processes are created. The role that health information specialists play is evolving and many of the paper forms of data are being eliminated as healthcare organizations convert to EHRs. The influence of this growing shift toward technology is already being felt across the industry. It will continue as many of the past roles of health information specialist centered on paper medical records are eliminated and replaced by new roles focused on patients EHRs. Translation of paper files to electronic health records. HIT s unique perspective and role in the healthcare field has resulted in health information specialists serving as key players in the implementation of EHRs and in the translation of patient 3 Source for entire section: AHIMA, Embracing the Future: New Times, New Opportunities for Health Information Manager, 2005 Real-time data to advance California Community Colleges 6

7 information from paper to electronic records. In fact, eight in ten health information specialist professionals in the AHIMA 2002 workforce study reported being in some phase of the EHR implementation process. In January 2008, the California Health Care Foundation surveyed HIT- EHR adoption and its use in the state. The survey found that compared to national rates, California has a slightly higher rate of HIT-EHR implementation. See Appendix C for the findings from the California Health Care Foundation Survey. Changing responsibilities for health information professionals. Thirty years ago the health information profession was focused on paper medical records that were used primarily by clinicians in hospitals. Although health information specialists are still responsible for the collection, storage, coding, processing, analysis, interpretation, application, privacy and sharing of information for a wide range of purposes in healthcare settings, the method by which these duties are carried out today has changed dramatically. Health information specialists are increasingly performing these tasks using emerging technology. They are helping people access information to support clinical decision-making, research, financial management, and personal health management. The health information specialist profession has earned a prominent leadership role in ensuring the quality, privacy, and efficiency of clinical information as the healthcare industry moves toward an increasingly electronic and global environment. Rapid HIT growth. As the information needs of the healthcare field advance, health information specialists are playing an increasingly pivotal role. Employers responding to AHIMA s workforce study reinforced that health information specialists are highly valued, and believe that they will be even more highly valued in the future. This value is due to a number of factors. For example, the escalating speed of transition from paper and manual entry to electronic entry and storage of data is resulting in an increasingly complex field. Thus, a significantly larger number of qualified health information specialists are required. Technological advancements used by health information specialists to manage patient information and healthcare data are assisting healthcare organizations in becoming more efficient and improving quality. This is accomplished through access to data for evidence-based care, access to clinical expertise, increased information to patients and supportive information systems. A shortage of qualified health information specialist professionals. The Bureau of Labor Statistics (BLS) projects a 49% growth in the number of health information specialist workers by 2010, making it one of the nation s fastest-growing health occupations. Demands on HIT education programs. New HIT graduates are entering a changing workplace, and their training and credentialing must reflect all the emerging needs and demands of healthcare organizations. Geographically dispersed degree programs and qualified educators with advanced degrees are needed at all levels of HIT education. This ensures that academic programs proactively reflect the changing demands of the healthcare industry and address the continuing needs of health information specialist professionals. AHIMA is assisting currently accredited academic programs and educators with the resources necessary to prepare future industry leaders. Diverging professional identities are driving curriculum development. While HIT has traditionally been viewed as a single profession, the roles performed by health information specialist professionals now impact a variety of areas throughout healthcare organizations and across the entire health system. This increasing diversity within HIT is resulting in a growing number of educational programs with specialized areas of emphasis. Education programs are also using an increasing number of problem-based modules, technologies, and practical Real-time data to advance California Community Colleges 7

8 experience to train health information specialists, preparing them for the critical role they play across the healthcare spectrum. Expanding application of health information specialist roles in multiple settings. There is a growing diversification of needs as health information specialist professionals work in settings other than the traditional hospital setting. The field currently offers nearly 40 different working settings, including: Hospitals Managed care organizations Long-term care facilities Behavioral health facilities Consulting and law firms Information system vendors Ambulatory care facilities Rehabilitation centers Skilled nursing facilities Home care providers Government agencies Pharmaceutical companies Physician practices Insurance companies Within this variety of settings, health information specialists fulfill a wide range of job positions, and increasingly work in critical and influential positions. Common job titles held by associate degree health information specialists (mostly Health Information Management professionals) in today s job market include: Clinical coder Coding manager Clinical data collection and reporting specialist Cancer/other disease registrar Data integrity specialist Documentation specialist Imaging specialist Reimbursement specialist Financial services liaison Instructor/trainer Job titles and job functions will continue to change as employment settings increase their reliance on information systems and technology. Health information specialists have, and will continue to hold, positions that support health information in an electronic environment. See Appendix D for AHIMA 2007 job titles of members with associate degrees and RHIT credential. Real-time data to advance California Community Colleges 8

9 Changing roles of HIT professionals. Healthcare providers and HIT employers are increasingly utilizing health information for a variety of decisions and benchmarking measurements. As a result, they are increasing their reliance on health information specialist professionals to provide data management and analysis and ensure quality and security of information. This growing demand for HIT services in a variety of functions has resulted in the profession embracing a broader set of roles. As a result, health information specialists often specialize in a particular area of expertise, in addition to being trained in a core set of HIT skills. Occupational Overview One aspect of the HIT workforce is health information specialists. Health information specialists are composed of three broad categories: HIM professionals, clinical informaticians, and IT professionals. 4 HIM professionals. HIM is the discipline that historically focuses on the management of medical records. It is the study of principles and practices of acquiring, analyzing, and protecting digital and traditional medical information vital to providing quality patient care. HIM professionals are those who demonstrate leadership and management of health information, especially in areas of documentation (paper, scanned, or computerized), coding, and legal and compliance issues. As the medical record has become electronic, the HIM field has been in transition and increasingly overlaps with informatics. One major difference between HIM and informatics is the educational path of practitioners. HIM professionals have historically been educated at the associate or baccalaureate level whereas informaticians often come from clinical backgrounds, including those with doctoral degrees, such as M.D., Pharm. D., etc. Clinical informaticians. Clinical informatics focuses on computer applications that address medical data (collection, analysis, representation). It is a combination of information science, computer science, and health care. Clinical informatics is designed to assist in the management and processing of data, and information and knowledge to support the practice and delivery of clinical care. They are the individuals who bring expertise at the intersection of health care and IT to assure successful adoption and use of HIT and the information within it. These individuals also optimize the use of information though leadership of clinical staff, organizing and structuring information for its direct and secondary use. They serve as a bridge between IT and clinical personnel. IT professionals. IT is the term generally used to describe computers and related technologies in operational settings. IT professionals are those who install, maintain, and optimize the hardware and software. The health information specialist profession is suitable for individuals who: Want to work in healthcare, but not directly with patients. Have an aptitude for science, but also like management, law, and computers. Enjoy working professionals: physicians, nurses, lawyers, administrators and executives. Want a career that offers flexibility in work environment. Have a high level of organizational skills. 4 Hersh, W., A Stimulus to Define Informatics and Health Information Technology, 2009 Real-time data to advance California Community Colleges 9

10 Embrace change and welcome challenge. Feel that they have strong communication skills. Value honesty and integrity in all aspects of their life. 5 Limitations of Existing Data Existing labor market data and information at the state and federal level do not define or classify HIT professions accurately. This creates challenges in leveraging prior studies to create a more comprehensive report on HIT employment as a whole. Consequently, primary research is needed to gather new information on skills in demand, and HIT occupations needed by industry. This information is needed by employers, HIT professionals, students and education and training providers. 6 Traditional labor market analysis for HIT occupations is a complicated endeavor, for the following reasons: Job titles have little consistency across healthcare agencies, so reliable data collection based on job titles become difficult, if not impossible. Healthcare agencies allocate work differently, and many workers with non-health information specialists titles perform health information specialists job functions. It can be difficult to differentiate between health information specialists in an organization (the focus of Center of Excellence study) and medical personnel who provide service to patients that require the use of EHRs. Accessing individuals within a given organization who have broad knowledge of everyone performing health information specialists-related work can be difficult. In light of this reality, industry representatives have indicated that any research effort focused on specific job titles would be difficult to execute and may provide inaccurate or inadequate information. Industry representative indicate that: Workforce studies focused on health information specialists related job functions, instead of job titles, would be more valuable. Specific functions have unique components deserving of more in-depth study. For example, a study of health information management professionals is greatly enhanced by reviewing the various validated workforce training competencies (see Appendix E for a sample of AHIMA and AMIA s joint workforce taskforce core competency matrix for using electronic health information). 5 The California Community Colleges Allied Health Programs: Step Up to the Future with Health Information Technology 6 North Orange County Community College District (NOCCCD) Joint Advisory Committee for HIT Programs, May 6, 2009 Real-time data to advance California Community Colleges 10

11 Workforce Challenges, Needs, and Opportunities Unlike the challenge to create a national health information infrastructure, workforce considerations receive very little attention. The California Health IT Initiative Workforce Workgroup has identified the following challenges and needs: There already exists a well-documented shortage of health workers in general, which will make it difficult to recruit new workers out of these roles to meet increased HIT demand. At the same time, some roles, such as medical records filing staff, may be rendered obsolete by EHRs, and these workers could be repurposed. The key challenge will be ramping up the workforce to meet the increase of EHR adoption over the next five years. As a newer profession and given its dynamic nature, HIT lacks clearly defined career tracks and educational requirements. Education programs are not clearly mapped to new HIT-related occupations. There are relatively few formal health information technology education programs. The California Health IT Initiative Workforce Workgroup believes that based on their broad distribution and access, affordability, relevant course content, and high quality faculty, California Community Colleges can properly train and augment the supply of HIT workers in California. This includes community colleges that do not have HIT programs but can integrate HIT competencies into their nurse or allied health training programs. Nurses and allied health professionals will need to have an understanding of and be comfortable using EHRs and other HIT upon completion of their studies. There is also an opportunity for community colleges to facilitate a crossover program that will help IT workers learn the necessary healthcare fundamentals so that they can be effective at implementing solutions in a provider environment. 7 College Programs and Response The Orange County Center of Excellence serves nine community colleges in the region. All nine colleges offer programs in healthcare fields. Only one, Cypress College, offers an HIT training program (associate degree and certificates). HIT associate degree programs are available at seven other California Community Colleges, while three additional community colleges offer only a coding certificate program. Seven private institutions in or near the Orange County region also offer an HIT associate degree program (see Appendix F). HIT associate degree programs include subjects of medicine, management, finance, information technology, and legal and ethical issues in one curriculum. HIT associate degree and certificate recipients mostly receive employment in the HIM field. 7 California Health & Human Services Agency, Health Information Technology Initiative, Health Workforce Workgroup Draft Report, July 2009 Real-time data to advance California Community Colleges 11

12 Recommendations for Community Colleges To meet the challenge of providing Orange County with a sufficient and well-trained HIT workforce, community colleges are encouraged to conduct a curriculum review to ensure that relevant programs adequately prepare students with HIT essentials. 8 As part of their review process, community colleges might want to consider the preliminary recommendations by the California Health IT Initiative: 1. Integrate HIT core competencies into training for all clinicians: The importance of HIT competencies for all clinicians has been extensively discussed by the Institute of Medicine in Crossing the Quality Chasm and Health Professions Education. ARRA further underlines the need to act now to put these recommendations into effect in clinical training programs. TIGER is a program that has made great strides in developing HIT guidelines for nursing education and can be used as an outreach model. 9 AHIMA and AMIA s joint workforce taskforce developed a core competency matrix which acts as an important guide for the HIT skills that clinical graduates should possess upon the completion of training. 2. Build the HIT workforce through crossover training programs: Short-term certificate programs can offer valuable training to those workers with a portion of the skill set necessary for a variety of HIT functions. IT workers can be trained in healthcare essentials and clinical workers can be trained in HIT. a. Build hands-on training into HIT programs. One key roadblock to training students on EHRs is the limited access these students and institutions have to computing and software resources. AHIMA has set up the Virtual Lab to try to address this problem, but it is under-resourced, leading to expensive access and insufficient functionality. Community colleges can seek partnerships with the HIT vendor community, to ensure students have broad-based, affordable access to EHRs in a functional and realistic environment. b. Evaluate and consider offering a new specialization around EHR training. Being able to bridge the gap between clinical and technical, and being able to teach these skills to others, will be a distinct, valuable, and highly demanded skill set that currently lacks a clear course of training. c. Recruitment and retention. Attaining and keeping students for these programs, particularly ahead of broadly recognized demand for these skills, will require effective promotion and communication of the opportunities that exist. It will also require the development of programs around the schedules and requirements of the workers likely to make use of them, and making them affordable through aid programs. Utilize the framework developed by the Connecting the Dots Initiative to guide workforce development efforts California Health & Human Services Agency, Health Information Technology Initiative, Health Workforce Workgroup Draft Report, July The TIGER initiative aims to enable practicing nurses and nursing students to fully engage in the unfolding digital electronic era in healthcare. For more information on the TIGER initiative, go to: 10 Connecting the Dots is a statewide initiative that focuses on increasing health professions workforce diversity in California. For more information on the Connecting the Dots initiative, go to: Real-time data to advance California Community Colleges 12

13 3. Engage key partners in curriculum design and identifying career pathways. Work with Health Jobs Start Here, California Hospital Association, and Workforce Investment Boards to undertake an initiative to promote HIT jobs in California and lay out career and educational pathways. 4. Pursue funding for HIT programs. The HITECH Act is a portion of ARRA and includes $2 billion to be used to prepare and train the HIT workforce needed to support EHR adoption. The Act stipulates that existing programs not more than six months in duration will be given priority for funding (see Appendix G). In addition, the ARRA includes $500 million through the Health Resources and Services Administration) to address health profession workforce shortages. $75 million of this amount will be available for the National Health Service Corps. Funds may be used to provide scholarships, loan repayment and grants to training programs for equipment as authorized in the Public Health Services Grant. Conclusion and Next Steps The dynamic HIT environment presents many training challenges for industry and significant educational opportunities for California s community colleges. Traditional health information job roles will require personnel with more specialized job skills and greater experience, which can be met by better training and certification. At the same time, emerging job roles outside of medical records such as quality improvement and other administrative functions, revenue cycle management and financial and strategic planning are becoming more crucial to the success of the healthcare industry. Thus, the healthcare industry will need to meet the challenges of an increasingly distributed and remote workforce. In this rapidly changing and vibrant working environment, HIT education programs are required to meet these challenges. And community colleges, which can provide short-term, focused, and practical training relevant to HIT, can be at the forefront of meeting these challenges. Based upon advice from industry, the Centers of Excellence will seek resources to continue an HIT workforce study focusing on health information specialists-related job functions. From these findings, subsequent reports will include more in-depth occupation-specific research such as detailed wage information, employment growth projections, and recommendations for new program development. Real-time data to advance California Community Colleges 13

14 References AHIMA, Joint Work Force Task Force, Health Information Management and Informatics Core Competencies for Individuals Working with Electronic Health Records, October 2008 AHIMA, Vision 2016: A Blueprint for Quality Education in Health Information Management, September 24, 2007 AHIMA, Building the Work Force for Health Information Transformation, February 2006 AHIMA, Embracing the Future: New Times, New Opportunities for Health Information Manager, 2005 California Health & Human Services Agency, Health Information Technology Initiative, Health Workforce Workgroup Draft Report, July 2009 EMSI Complete Employment, 2nd Quarter 2009, v. 2 Frohlich, Jonah, Health IT Overview: HITECH & Implications for California, California HealthCare Foundation, Senate Health Committee Hearing, March 13, 2009 Hersh, W., A Stimulus to Define Informatics and Health Information Technology, 2009 Monster for Employers, Economic Stimulus Dollars: Health Care Industry, 2009 The California Community Colleges Allied Health Programs: Step Up to the Future with Health Information Technology Real-time data to advance California Community Colleges 14

15 Appendix A: How to Utilize this Report This report is designed to provide current industry data to: Define potential strategic opportunities relative to an industry s emerging trends and workforce needs; Influence and inform local college program planning and resource development; Promote a future-oriented and market responsive way of thinking among stakeholders; and, Assist faculty, Economic Development and CTE administrators, and Community and Contract Education programs in connecting with industry partners. The information in this report has been validated by employers and also includes a listing of what programs are already being offered by colleges to address those workforce needs. In some instances, the labor market information and industry validation will suggest that colleges might not want to begin or add programs, thereby avoiding needless replication and low enrollments. About the Centers of Excellence The Centers of Excellence (COE), in partnership with business and industry, deliver regional workforce research customized for community college decision making and resource development. This information has proven valuable to colleges in beginning, revising, or updating economic development and Career Technical Education (CTE) programs, strengthening grant applications, assisting in the accreditation process, and in supporting strategic planning efforts. The Centers of Excellence Initiative is funded in part by the Chancellor s Office, California Community Colleges, Economic and Workforce Development Program. The total grant amount (grant number for $205,000) represents funding for multiple projects and written reports through the Center of Excellence. The Centers aspire to be the premier source of regional economic and workforce information and insight for California s community colleges. More information about the Centers of Excellence is available at Important Disclaimer All representations included in this report have been produced from primary research and/or secondary review of publicly and/or privately available data and/or research reports. Efforts have been made to qualify and validate the accuracy of the data and the reported findings; however, neither the Centers of Excellence, COE host District, nor California Community Colleges Chancellor s Office are responsible for applications or decisions made by recipient community colleges or their representatives based upon components or recommendations contained in this study. Real-time data to advance California Community Colleges 15

16 Appendix B: Fastest Growing Healthcare Practitioner and Technical Occupations This graph demonstrates the ten fastest growing healthcare occupations that require an associate s degree or less in Orange County from Medical records and health information technicians are 7th with a growth of 175 new jobs. Fastest Growing Healthcare Practitioner and Technical Occupations ,523 26,593 30,000 23,070 25, Number of Jobs 20,000 15,000 10,000 5, ,921 5,321 3,107 2, ,704 2, ,349 2,161 1,365 1,137 1,529 1,717 1,531 1,706 1,390 1,219 1,409 1,566 0 Registered nurses Licensed practical & licensed vocational nurses Pharmacy technicians Veterinary technologists & technicians Dental hygienists Emergency medical technicians & paramedics Medical records & health info. technicians Medical & clinical laboratory technicians Respiratory therapists Radiologic technologists & technicians Source: EMSI, 2 nd Quarter, 2009 v Short-term on-the-job training, moderate-term on-the-job training, long-term on-the-job training, work experience in a related field, and postsecondary vocational award. Real-time data to advance California Community Colleges 16

17 Appendix C: 2008 California HealthCare Foundation Survey Findings Source: Borrowed from the Health IT Overview: HITECH & Implications for California, Testimony of Jonah Frohlich, California HealthCare Foundation, Senate Health Committee Hearing, March 13, 2009 Real-time data to advance California Community Colleges 17

18 Source: Borrowed from the Health IT Overview: HITECH & Implications for California, Testimony of Jonah Frohlich, California HealthCare Foundation, Senate Health Committee Hearing, March 13, 2009 Real-time data to advance California Community Colleges 18

19 Appendix D: AHIMA 2007 Job Titles of Members The following table details the job titles of AHIMA members with HIM/HIT Associate degrees and RHIT credentials. Job Titles Number Percent Coding Professionals 3, % Director % Other % Manager % Supervisor % Consultant % Coordinator % Registrar % Medical Record Analyst % Transcriptionist % Administrator/CEO/COO % HIM Faculty % Data Quality Analyst % Assistant Director % Team Leader % Compliance Officer % Systems Analyst % DRG Coordinator % Customer/Client Representative % Nurse % Assistant Administrator/VP/AVP % Privacy Officer % Project Manager % Assistant Manager % Client Support Specialist % IS/MIS Director % Sales Representative 9 0.1% Chief Information Officer 8 0.1% Information Security Officer 6 0.1% Safety Officer 3 0.0% Case Mix Analyst 1 0.0% Chief Financial Officer 1 0.0% Health Information Management Total 9, % Source: AHIMA, Vision: 2016, A Blueprint for Quality Education in Health Information Management, September 24, 2007 Real-time data to advance California Community Colleges 19

20 Appendix E: Electronic Health Record Core Competencies The table below represents a sample listing of the AHIMA s and AMIA s electronic health record core competencies. For complete matrix tool, visit: Domain Competency Cognitive Affective Psychomotor ROLE 1.1 Differentiate data versus information. C 1.2 Describe the principles of structure, design and use of health information (such as individual, comparative reports, trended data). C 1.3 Use health record data collection tools (such as input screens, document templates). C P 1.4 Apply standard data definitions, vocabularies, terminologies, and/or relevant healthcare data sets (such as OASIS, HEDIS, UHDDS) as used in the organization's health information systems C 1.5 Differentiate between the types of content of patient health records (such as paper-based, electronic health record, personal health record). C 1.6 Adhere to health record documentation requirements of external agencies and organizations (such as those specified by the Joint Commission, licensure, reimbursement, discipline-specific good practice ). C A 1.7 Adhere to internal organizational health record documentation requirements, policies and procedures. C A 1.8 Ensure that documentation in the health record reflects timeliness, completeness, accuracy, appropriateness, quality, integrity and authenticity C A 1.9 Adhere to information systems policies and procedures as required by national health information initiatives from national, state, local and organizational levels. C A 1.11 Identify incorrect data and take corrective action. C A 1.12 Identify methods and types of data collected in health care C 1.13 Maintain professional standards in all documentation activities C A Real-time data to advance California Community Colleges 20

21 Appendix F: HIT Training Programs The first table below details HIT training program offerings from the California Community Colleges across the state. The second table details training programs offered through private institutions in or around Orange County. California Community Colleges College Name Location Programs City College of San Francisco Consumnes River College Cypress College De Anza College* East Los Angeles College San Francisco, CA Sacramento, CA Cypress, CA Cupertino, CA Los Angeles, CA HIT (A.S. degree) Health Info. Clerk I & II (Cert.) Health Info. Coding Specialist (Cert.) Medical Biller (Cert.) HIT (A.S. degree) Health Info. Coding Specialist (Cert.) HIT (A.S. degree) Medical Staff Services Science (A.S. degree & Cert.) Health Info. Coding (Cert.) Medical Insurance Billing Specialist (Cert.) Medical Quality Review Assistant (Cert.) Medical Record Clerk (Cert.) Health Care Management & Supervision (Cert.) Health Care Marketing & Sales (Cert.) Insurance & Coding (Cert.) Medical Records Clerk (Cert.) HIT (A.S. degree) HIT (Cert.) Health Info. Coding Specialist (Cert.) Health Info. Coding & Statistics Clerk (Cert.) Fresno City College Fresno, CA HIT (A.S. degree) Hartnell College Salinas, CA Medical Coding (Cert.) Mendocino College Ukiah, CA HIT (A.S. degree) San Diego Mesa College San Diego, CA HIT (A.S. degree) Santa Barbara City College Santa Barbara, CA HIT (A.S. degree) Cancer Info. Management (A.S. degree & Cert.) Santa Rosa Junior College* Santa Rosa, CA Medical Assisting Coding & Reimbursement (Cert.) *Part of Medical Assisting program Private Institutions College Name Location Programs Charles Drew University Los Angeles, CA HIT (A.S. degree) Clinical Coding (cert.) DeVry University Long Beach, CA HIT (A.S. degree) DeVry University Pomona, CA HIT (A.S. degree) ITT Technical Institute Anaheim, CA HIT (A.S. degree) ITT Technical Institute San Bernardino, CA HIT (A.S. degree) ITT Technical Institute San Dimas, CA HIT (A.S. degree) ITT Technical Institute Oxnard, CA HIT (A.S. degree) Real-time data to advance California Community Colleges 21

22 Appendix G: HITECH Act SEC INFORMATION TECHNOLOGY PROFESSIONALS IN HEALTH CARE (P. 143) (a) IN GENERAL. The Secretary, in consultation with the Director of the National Science Foundation, shall provide assistance to institutions of higher education (or consortia thereof) to establish or expand medical health informatics education programs, including certification, undergraduate, and masters degree programs, for both health care and information technology students to ensure the rapid and effective utilization and development of health information technologies (in the United States health care infrastructure). (b) ACTIVITIES. Activities for which assistance may be provided under subsection (a) may include the following: (1) Developing and revising curricula in medical health informatics and related disciplines. (2) Recruiting and retaining students to the program involved. (3) Acquiring equipment necessary for student instruction in these programs, including the installation of testbed networks for student use. (4) Establishing or enhancing bridge programs in the health informatics fields between community colleges and universities. (c) PRIORITY. In providing assistance under subsection (a), the Secretary shall give preference to the following: (1) Existing education and training programs. (2) Programs designed to be completed in less than six months. Real-time data to advance California Community Colleges 22