Health Workforce Minimum Data Set: Asking the Right Questions Webinar sponsored by The Health Workforce Technical Assistance Center November 19, 2014 Jean Moore, DrPH, Director New York Center for Health Workforce Studies Elizabeth Carter, Director Justin Crow, Deputy Director Virginia Department of Health Professionals Healthcare Workforce Data Center
Today s Presentation Overview of HRSA s health professions Minimum Data Set (MDS) State example: Virginia Department of Health Professions, Healthcare Workforce Data Center Developing a health workforce monitoring system Using health workforce data to inform state policy decisions 2
Key Workforce Issues: What Do Planners and Policy Makers Need to Know? Supply and distribution: How many, where, what do they do, when will they retire Educational Pipeline: graduates per year, instate retention Demand: what jobs, how many, where, current & future unmet demand 3
Effective Health Workforce Monitoring Basic health workforce supply data can be used to: Describe supply and distribution Build better supply and demand forecast models Inform the development of health workforce programs and policies and evaluate their effectiveness 4
Many Groups Collect Health Workforce Supply Data Federal agencies State agencies Health professions associations Health professional board associations Health professions certification organizations 5
Concerns About Quality of Current Health Workforce Supply Data Differences in fundamental questions asked in surveys of health professionals Lack of standardized variables or definitions limit comparability Substantial variation in the data being collected Issues of timeliness, completeness, and accuracy of data 6
National Center for Health Workforce Analysis Prioritized Need for MDS NCHWA recognized the value of Identifying a small number of key questions that are critical for effective workforce planning Recommending standard approaches to asking these questions Built on work of other groups engaged in health workforce data collection, including State Nursing Workforce Centers and health workforce researchers across the country 7
What Is the Health Professions Minimum Dataset? A minimum set of standard questions that are recommended for use by all groups who collect data on the supply of health workers Questions focus on characteristics in three key areas: demographics education practice Provides basic information on health workers that can inform planning efforts 8
Demographic Questions Core Questions Birth date Gender Race/Ethnicity Optional Questions State or Country of Birth Languages Spoken Fluently 9
Education Questions Core Questions Professional education, entry level, including degree, year, and state/country Professional education, highest level, including degree, year, and state/country (includes residency training) Licensure type, initial year, and state Certifications (as applicable) Specialty (as applicable) Optional Questions Name and location of educational institution(s) 10
Practice Questions Core Questions Employment status Number of positions Hours by activity o Patient care o Research o Teaching o Administration Practice setting Practice location o Clinical hours by location Title Optional Questions Patients served (e.g., Medicaid, Medicare, etc.) Practice capacity Retirement plans 11
Uses of Data from Health Professions Minimum Dataset Describe the supply and distribution of health professionals by setting and location Assess primary care provider capacity Assess the racial/ethnic diversity of a health profession in relation to the diversity of the population served Complete profession-specific research studies on characteristics of health professionals who practice in underserved communities 12
Make Your Workforce Analysis Plan the Starting Point Design data collection instruments with a workforce analysis plan in mind Identify key research questions that will be answered using these data More detailed data may be needed to answer some research questions A primary care capacity assessment requires more detailed information on physicians, NPs, PAs, and CNMs o o o Specialty of practitioner, of supervising physician (as applicable) and of the practice Practice address including street, city and zip Hours worked by practice location A public health workforce enumeration o Occupation, public health specialization area, and job tasks 13
Useful Links HRSA MDS webpage http://bhpr.hrsa.gov/healthworkforce/data/minimumdataset/index.html Boulton, Matthew L., et al. "Public health workforce taxonomy." American Journal of Preventive Medicine 47.5 (2014): S314-S323. http://www.ajpmonline.org/article/s0749-3797(14)00382-1/pdf 2013 Statistical Profile of Certified Physician Assistants, An Annual Report of the National Commission on Certification of Physician Assistants http://www.nccpa.net/upload/pdfs/2013statisticalprofileofcertifiedphysician Assistants-AnAnnualReportoftheNCCPA.pdf 14
Healthcare Workforce Data Center Health Workforce Technical Assistance Center Health Workforce Minimum Data Set: Asking the Right Questions Elizabeth Carter, PhD Director Justin Crow, MPA Deputy Director Nov. 19, 2014
Healthcare Workforce Data Center Need to Know More Now Driving forces for a perfect storm: Unprecedented demand increase with supply decrease. Insurance coverage through the Patient Protection and Affordable Care Act should add to the demand at the same time that a large bulk of practitioners will want to reduce hours or retire. A large portion of Virginia s providers are Baby Boomers and older, and the trend is expected to continue into the next decade. By 2020, Virginia is estimated to have 1 million more people than in 2008 and a greater proportion age 65+. Used by permission of HWDC
Healthcare Workforce Data Center Background DHP is the natural data repository for over 80 professions and 300K+ licensees and has online licensure renewal and application capability. In 2007, a Governor s commission on healthcare recommended the HWDC s creation within DHP. In 2008 and 2009 WIA Grant funding enabled its establishment. Used by permission of HWDC
Other Outcomes Legislation Section 54.1-2506.1(A) Code of Virginia Authorizes data collection Protects confidentiality (FOIA) Allows sharing with Qualified Researchers Mission The Department of Health Professions Healthcare Workforce Data Center works to improve the data collection and measurement of Virginia s healthcare workforce through regular assessment of workforce supply and demand issues among the 80 professions and 350,000 practitioners licensed in Virginia by DHP. DHP healthcare workforce data is provided online to ensure accessibility of the findings among healthcare decision makers, hospital systems, academic institutions and constituents statewide.
2010 HWDC merged with Board of Health Professions Combined research elements in DHP Virginia Health Workforce Development Initiative Grant $1.93 million HWDC provided research support Full-time Staff Director Research Analyst Operations Manager
Current Surveys Every March: Assisted Living Facility Administrators Dental Hygienists Dentists Nursing Home Administrators Every June: Clinical Psychologists Licensed Professional Counselors June, Odd Years Licensed Clinical Social Workers Every December Audiologists Pharmacists Pharmacy Technicians Speech-Language Pathologists December, Odd Years Physician Assistants December, Even Years Doctors of Osteopathic Medicine Medical Doctors Physical Therapists Physical Therapy Assistants Every August* Certified Nurse Aides Licensed Practical Nurses Nurse Practitioners** Registered Nurses New This Winter Optometrists Respiratory Therapists Radiological Technologists
Governor Kaine s Health Reform Commission
Without Healthcare Workforce Data Center
Healthcare Workforce Data Center http://vahwdc.tumblr.com/regiondetail
Strategy Focus on Core Mission Create Research Quality Data Standardization Apples to apples comparisons Link to Federal/State Data Sets CareForce Indicators Standardized Reporting Products Allows for Automation 2012 2014
Standards: Questionnaire How much do you work? Time period Currently? Average over last month/year? Unit of measure Full-time or part-time? Part-time = (less than) 30, 32, 35 hours per week (or less) Hours per week? Number of weeks? Overall, or by location 1,2,3 or more locations...? Hours per week 1 9 1 10 1 4 10 19 11 20 5 9 20 29 21 30 10 14 30 39 31 40 15 19 40 hours or more...more than 60 hours... 80 hours or more HWDC uses 5 hour increments, and weeks worked over past 12 months, at up to two locations. 1 FTE = 2,000 hrs (40 hrs, 50wks)
US Census Standards: Other Data Sources Race & Ethnicity (Separate questions) North American Industrial Classification System (NAICS) Administrative Regions in your State (County) Health Education Workforce Planning Dartmouth Atlas of Health Care (Zip Code) Patient Data
OUTPUT ACTIVATE Valid0402DentHyg2012. *Validation Tables for Location Variables. Standards: Automation COMPUTE PriNVALID=NVALID(PriLocNum,PriDuration,PriWeeks,PriHours,PriAdmin,PriSector,PriEst,PriComp). COMPUTE SecNVALID=NVALID(SecLocNum,SecDuration,SecWeeks,SecHours,SecAdmin,SecSector,SecEst). EXECUTE. CTABLES /VLABELS VARIABLES=PriNVALID Working DISPLAY=DEFAULT /TABLE PriNVALID [C] BY Working [COUNT F40.0, ROWPCT.COUNT PCT40.1] Tools: SPSS Syntax Python Excel & Word Templates ArcGIS Models Embedded Decisions Standard Methodology Standard Definitions Embedded documentation /CATEGORIES VARIABLES=PriNVALID ORDER=A KEY=VALUE EMPTY=EXCLUDE TOTAL=YES POSITION=AFTER /CATEGORIES VARIABLES=Working ORDER=A KEY=VALUE EMPTY=INCLUDE TOTAL=YES POSITION=AFTER MISSING=EXCLUDE. CTABLES /VLABELS VARIABLES=SecNVALID Working DISPLAY=DEFAULT /TABLE SecNVALID [C] BY Working [COUNT F40.0, ROWPCT.COUNT PCT40.1] /CATEGORIES VARIABLES=SecNVALID ORDER=A KEY=VALUE EMPTY=EXCLUDE to weeks. TOTAL=YES POSITION=AFTER /CATEGORIES VARIABLES=Working ORDER=A KEY=VALUE EMPTY=INCLUDE TOTAL=YES POSITION=AFTER MISSING=EXCLUDE. Shortens processing time from months DELETE VARIABLES PriNVALID SecNVALID.
Data Presentation
2012 2012 Standards: Reporting HWDC CareForce Indicators 2014
Standards: Reporting HWDC CareForce Indicators
Policy Research
Dental Hygienist Scope of Practice Review Primary Dental Workplace Hygienist Dentist Solo Practice 53% 51% Group Practice 39% 38% Hospital 1% 3% Public Health 1% 3% Dental School 2% 2% Community Clinic 1% 1% Long term Care 0% 0% K 12 School 0% 0% Other 3% 2% Dentists Dental Hygienists
Oral Health Workforce Median Age Dentists: 55 Dental Hygienists: 43 10 Year Growth Rate Dentists: 39% Dental Hygienists: 60%
Medicaid Expansion: Medicaid Workforce Map Packet
Pathways to BSN
Pathways to BSN
Some Other Projects Old Dominion University 2015 State of the Region Report Comparison of Nursing Workforce by Virginia MSA Virginia Health Workforce Development Authority Virginia Community Health Impact Portal (VCHIP) http://atlasva.org/vchip/ Regional Supply/Demand Analysis Virginia Department of Health Shortage Designations NoVa HealthForce/Jobs for the Future The State of the Health Care Workforce in Northern Virginia
Department of Health Professions Healthcare Workforce Data Center www.dhp.virginia.gov/hwdc/ Tumblr: www.vahwdc.tumblr.com Twitter: @DHP_HWDC Data Products Profession Reports (www.dhp.virginia.gov/hwdc/findings.htm) The HWDC Profession Reports are the mainstay of the HWDC s data products. They provide a statewide look at the healthcare workforce on a profession by profession basis. Profession reports are published following the end of the data collection period. Profession reports include HWDC CareForce Indicators as well as more detailed information pertaining to the professions. Virginia CareForce Snapshots (vahwdc.tumblr.com/vacareforcesnapshot) The Virginia CareForce Snapshot is a compilation of the CareForce indicators for all professions, statewide, in a given HWDC survey year. The Careforce Snapshot, updated annually in spring, provide an interactive guide to compare CareForce Indicators across professions.
Regional CareForce Snapshot (www.vahwdc.tumblr.com/regionalcareforce) Produced in collaboration with the Virginia Healthcare Workforce Development Authority, (VHWDA) our Regional CareForce Products provide an interactive guide to the CareForce in each of Virginia s eight AHEC regions. Regional Reports are updated each spring. Student Choice (www.vahwdc.tumblr.com/studentchoice) Our interactive Student Choice page uses HWDC data and data from the Bureau of Labor Statistics to help students begin thinking about health careers and education. This tool highlights the interoperability of HWDC data and how it can be used in analysis and decision making. Virginia Health Workforce Briefs (www.dhp.virginia.gov/hwdc/briefs.htm) The Healthcare Workforce Data Center s Virginia Healthcare Workforce Briefs provide timely indicators of the strength of Virginia s healthcare labor market in an accessible format. Information in these briefs is based on data provided by the US Department of Labor, Bureau of Labor Statistics and the US Department of Commerce, Bureau of Economic Analysis. The briefs consist of three series: Series 1: State & National Employment (Monthly) Series 2: Virginia Regional & Sectoral Employment (Monthly) Series 3: Income & Compensation (Quarterly)
Thank You! Director Elizabeth Carter, Ph.D. Deputy Director Justin Crow, MPA Operations Manager Laura Jackson Research Assistant Christopher Coyle Healthcare Workforce Data Center www.dhp.virginia.gov/hwdc/