A TIGER-based Model for Interprofessional Informatics Competencies: The Nutrition Informatics Delphi Study

Transcription

1 A TIGER-based Model for Interprofessional Informatics Competencies: The Nutrition Informatics Delphi Study DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2 Conflict of Interest Peggy Turner, MS, RD/LD None Margaret Dittloff, MS, RD None 2013 HIMSS 2

3 Learning Objectives Describe the background and events that lead to incorporation of informatics into the profession of dietetics Explain the need for as well as the steps taken to conduct a Delphi study to establish informatics competencies for the profession of dietetics State 3 strategies to move forward based on the results of the study. 3

4 The Academy of Nutrition and Dietetics 4% Males 47 Years of Age 45% Masters Degree 16 Years of Service 73,000 Members Compensation and Benefits Survey

5 Education and Research 7% 6% Consultation and Business 12% 8% Food/Nutrition Management 13% 12% Community 11% 12% Clinical 56% 57% Clinical Nutrition Acute Care 30% 31% Ambulatory Ambulatory 17% 16% Long Term Care Care 10% 9% Compensation & Benefits Survey

6 Educational Pathways Dietetics Education Program in Nutrition and Dietetics (DE) Didactic Program in Nutrition and Dietetics (DP) Internship Program in Nutrition and Dietetics (IP) Registered Dietitian (RD) 6

7 Academy s Dietetics Career Development Guide 7

8 Institute Of Medicine 8

9 Institute of Medicine Health Professions Education: A Bridge to Quality, Ann C Greiner, Elisa Knebel, eds. Washington, DC: National Academies Press (p 46) 9

10 TIGER VISION... making information technology the stethoscope for the 21st century 10

11 Informatics Background Within the Academy Informatics Workgroup Nutrition Informatics Committee Delphi Study Nutrition Informatics Surveys (2008 & 2011) 11

12 The Intersection of Information, Nutrition and Technology Nutrition Informatics Committee

13 Establish the first compilation of informatics competencies for RDs, DTRs, and students, based on the Academy s Dietetics Career Development Guide s six levels of practice: Novice Beginner Competent Proficient Advanced practice (Informatics specialist) Expert (Informatics Expert) 13

14 What Other Practitioners Were Doing Staggers N. and colleagues A Delphi Study to determine informatics competencies for Nurses at four levels of practice Nurs Res. 2002;51(6): Eldredge JD, and colleagues Library and informatics competencies statements from major health professional associations Med Ref Serv Q. 2012:31(1):34:44 14

15 Experts to achieve consensus Anonymity of responders Delphi Method Iterative rounds to make revision Agreement by the group as a whole 15

16 Study Endpoints Define informatics competencies for the field of nutrition and dietetics Determine the assignment of each competency to the appropriate level of practice based on the Academy s definitions 16

17 Informatics Knowledge Computer Skills Informatics Skills Began with 229 Competencies 17

18 Participants Cohort Cohort Size Educators 30 Clinical/Community 30 Practice Informatics 30 Food Service Management 30 Academy Staff 10 18

19 Round One Round 1 Survey Question 19

20 Round 2Survey Question 20

21 Round 3 Survey Question 21

22 Summary of all 3 rounds Round 1 Round 2 Round 3 Nov 16 30, 2011 Dec 6 20, 2011 Jan 12 26, 2012 Determine Inclusion or Exclusion (229) 20 Excluded 8 Added 95% Completion Rate 5 Cohort Groups Assign a level of practice to each comp (217) 156 Agreement 61 Variation 84% Completion Rate 4 Cohort Groups Achieve consensus on variations(61) 54 Achieved consensus 7 Others but 1 duplicate 216 Total 69% Completion Rate 4 Cohorts Groups 22

23 Age Range of Participants Demographics under 25 years years years years years >65 years 23

24 Years of Professional Practice Demographics < 2 years 2 5 years 6 10 years years years > 30 years 24

25 Summary of Competencies Informatics Specialist Informatics Expert Novice Beginner Competent Proficient TOTAL Computer Skills Informatics Knowledge Informatics Skills TOTAL Competencies by category and level of practice at the completion of the study. 25

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28 TIGER Informatics Competencies Collaborative (TICC) 1000 informatics competencies Basic Computer Competencies Information Literacy Information Management (incl. using EHR) 28

29 Comparing Models TIGER Basic Computer Competency Information Literacy Information Management Nutrition & Dietetics Computer Skills Informatics Knowledge Informatics Skills Resources & Examples ICDL: International Computer Driving License American Library Assoc. AMIA 10 x 10 HIMSS AND: Evidence Analysis Library HL7: EHR System Functional Model DPRC: Digital Patient Record Certification 29

30 What is Unique to Nutrition? Computer Skills Nutritional analysis and menu software EHR & Food and Nutrition Management Systems Informatics Knowledge/Literacy Nutrition standardized language (IDNT) Informatics Skills/Management Nutrition Care Process applied to systems 30

31 NCP Model Dietetics Knowledge Skills & Competencies Critical Thinking Collaboration Communication 2013Academy of Nutrition and Dietetics. Reprinted with permission. 31

32 Barriers for Not Using IT What are the reasons/barriers (personal or work related) for not using information technology in your practice or for your education needs? N= 3342 No Barriers Training Issues 19% 55% Employer Issues Technology Equipment Issues Access Issues Personal Preference 15% 13% 9% 5% Academy Nutrition and Dietetics: Don't Know 3% 2011 Nutrition Informatics Survey 32 Other 6%

33 Member Requested Assistance Prof. Development on Nutrition Informatics Reference Materials on Nutrition Informatics Prof. Development on Using Technology Journal Articles EHR Training/Practice Application* Standards of Practice in Nutrition Certification in Nutrition Informatics 81% 84% 80% 84% 76% 77% 67% 71% 63% 56% 60% 63% 45% 45% Academy Nutrition and Dietetics: 2011 (N=3,342) 2008 (N=9,507) 2011 Nutrition Informatics Survey 33

34 Nutrition Informatics Advanced Practice Levels Nutrition Informatics Specialist Nutrition Informatics Experts Nutrition Informatics RDs NIRDS E. Ayres, #NIRD 34

35 Nutrition Informatics RD: Using Informatics to Enhance the Profession He s a NIRD! - Is an EHR System Analyst - Uses icloud to keep ipad and Laptop in sync keeping him on time - Learned to test software by paying attention to details just like calculating energy needs John Snyder, DTR, RD 35

36 Nutrition Informatics RD: Using Informatics to Enhance the Profession She s a NIRD! Cathy Welsh, MS, RD - Senior Clinical Analyst building orders and reports for EHR - Provide support for RD's on electronic processes & workflows - Website Manager for EatrightMemphis.org - AMIA and the Academy 10 x 10 course 36

37 IOM: 5 Core Competencies Deliver Patient-Centered Care Work in Interdisciplinary Teams Employ Evidenced-based Practice Focus on Quality Improvement Utilize Informatics Institute of Medicine Health Professions Education: A Bridge to Quality, Ann C Greiner, Elisa Knebel, eds. Washington, DC: National Academies Press 37

38 What About Other Disciplines? IOM Core Competencies in PharmD Curricula % Extent of Inclusion Zeind CS, Blagg JD Jr, Amato MG, Jacobson S. Incorporation of Institute of Medicine competency recommendations within doctor of pharmacy curricula. Am J Pharm Educ Jun 18;76(5):83. 38

39 When Included,... Informatics Competency Format - % Standalone Course 18% Topics Within Course(s) 40% Integrated Throughout the Curriculum 37% Not Offered 7% N= 102 Zeind CS, Blagg JD Jr, Amato MG, Jacobson S. Incorporation of Institute of Medicine competency recommendations within doctor of pharmacy curricula. Am J Pharm Educ Jun 18;76(5):83. 39

40 Following TIGER s Lead Phase II TIGER had 9 Collaborative Groups Standards & Interoperability National Health Information Technology (IT) Agenda Informatics Competencies Education & Faculty Development Usability and Clinical Application Design Virtual Demonstration Center Leadership Development Consumer Empowerment and Personal Health Records 40

41 TIGER Foundation - Phase III Implement Recommendations Virtual Learning Environment Interdisciplinary Collaborations Working together helps leverage existing resources to better prepare the interdisciplinary health care work force. 41

42 Future Competencies? Social Media Gaming for Health Biometrics & Feedback Food Industry Data Feeds 42

43 Strategies to Move Forward For Students Curriculum development Registration exam For Practitioners Academy/AMIA 10 x 10 courses HIMSS Webinars/Town Hall series Nutrition Informatics Certificate (coming) For Advanced Practice Levels Additional research needed Establish advanced degree programs 43

44 The Door is wide open.. Come be a NIRD! 44

45 Questions 45

46 Thank You! Peggy R. Turner, MS, RD/LD peggy Margaret K. Dittloff, MS RD