Health Information Management Systems Technology and Analysis (HIMSTA) Domains, Competencies and Modules Introduction: The Curriculum The outline below frames the 14 modules of this curriculum within their knowledge domains and the competencies that students are meant to achieve in completion of the modules. The entire curriculum is comprised of 14 modules which may be used to design a full semester or which may be used as an adjunct to a curriculum that the instructor has already designed. 1. Domain: Information Management Competency: 1.A. Understand the major features of the information revolution; the role of knowledge workers; the differences between data, information and knowledge; data analysis and reporting; and major trends in IT; particularly as they relate to HIT. Module 1.a: Introduction Introduction and overview of health information environment (e.g. EHR, HIE, Federal Policy, meaningful use of HIS). Management of clinical and administrative information Role of knowledge workers History and major trends in the evolution of computing and healthcare information systems, including broad changes. Introduction to: e.g. Module 1.b: Data and Information Differences between data, information and knowledge, and core concepts of measurement (e.g. validity, reliability, data integrity, accuracy) Different kinds of data that are used (e.g. clinical, administrative); source and origins of the data The patient medical record; the legal medical record Organization level metrics from both clinical and administrative areas (e.g. dashboards) Knowledge management; analytics/informatics; use of data and reporting Data as an asset; complexity of healthcare data; introduction to databases 2 Domain: Strategy & Planning Competency
2.A. Develop and align information systems strategy and plan with the organizational strategy and plan to support the achievement of organizational goals. Module 2.a: Strategy formulation Vision and mission Internal capabilities (strengths and weaknesses; IT as an Asset) External environment (opportunities and threats) Role of IS in patient-centered care (e.g. ACOs) IS planning and alignment Strategy implementation Exit strategy 3. Domain: Assessment, System Selection and Implementation Competencies 3.A. Understand the purpose, use, and key functions of various administrative and clinical information systems and the factors that may influence adoption. 3.B. Design and plan for the selection and acquisition of a new or upgraded health care information system. 3.C. Appreciate the necessary resources, processes and support needed to effectively manage the implementation of health care information systems projects. 3.D. Demonstrate ability to apply project management principles, tools, and techniques to health information technology implementation. Module 3.a: Purpose, adoption, and use of healthcare information systems Purpose, adoption (e.g. barriers to adoption, stages of adoption), use and key functions and features of administrative and clinical information systems applications. Types of healthcare information systems include: o Administrative e.g. financial, billing, revenue cycle, supply chain, registration, patient accounting, scheduling, human resource management, materials management, decision support, etc. o Clinical electronic health records; computerized provider order entry; barcoding medication administration; pharmacy, laboratory, and radiology information systems; telemedicine and telehealth; clinical documentation, decision support, etc. (Could include opportunity for students to see system demos; vendor demos) Module 3.b: Organizational Commitment Process/Linkage with organizational strategic plan and developing the project proposal or business plan Essentials of project management; e.g. Scope of project, defining resource, budget, timelines, interdependencies, risk points Project governance and leadership Assessment and initial project planning and approval Goals of project Getting to consensus on needs/wants
Determining needs of organization Business plan making the case for the HIT investment Gaining Board approval Assess and define the user needs for information technology Project Steering Committee (role, functions, scope, deliverables) Module 3.c: Selection System selection methodologies, e.g. system development life cycle; object oriented approaches to systems analysis and design Convene selection team Selection strategy: e.g. Best of breed, best of suite, hybrid Solicitation of vendor proposals and evaluation Sourcing: Various approaches and options build in house, purchase from HIT vendor, lease, contract through ASP, outsourcing, etc. Scan of HIT marketplace and vendor profiles/products; site visits Request for Proposal RFP (purpose, use, content, pros/cons) & Evaluation of Proposals/Products Identification and Prioritization of System Requirements Cost-benefit analysis of options Role of leadership in the selection process Contract negotiations; basic legal aspects of contracts Role of consultants Module 3.d:Implementation Project team selection Vendor relations and management Workflow and process analysis Preparation for system installation, build, testing Training Data/System Conversion Communications Plan Strategies for implementation (4 Ps: parallel, pilot, piecemeal, plunge ) Downtime Procedures/Policies on Use Management of Organizational Aspects 4. Domain: Management of Information Systems and Resources Competencies: 4.A. Manage information systems assets and functions to reach organizational goals. 4.B. Promote and manage the change that is necessary to reach the organization s information systems goals. Modules and content include at least: Module 4.a: Change Management
Transformational impact of IT, the way in which IT changes an organization, organizational readiness for change Leadership (e.g. role of organizational leadership in successful IT implementation; leadership styles Understanding organizational culture Models of change management Resistance to change; overcoming Clinician roles and responses to healthcare IT (e.g. resistance, understand how systems alter the nature of clinicians work, impact on interaction of clinicians with patients) Module 4.b: Management of IS Function Roles and responsibilities of the IS department Structure of the IS management function Organizational structures related to for example: Governance People/positions on the IS team Finance 5 Domain: Assessing emerging technologies Competency Statement: 5.A. Explore innovative uses of existing and emerging technologies to optimize healthcare delivery and improve efficiency. Module 5.a: Innovative uses of technology New technologies and how might they impact the organization s ability to meet its goals and fulfill its strategies Attitude/openness to new technologies Technology diffusion (e.g. models of technology diffusion) Process for assessment of new technologies and their usefulness to organization Forward thinking regarding emerging technologies and their applicability to the organization s direction 6 Domain: Assessment of the Value of IT Competency Statement: 6.A. Establish measurable goals and objectives, and assess the extent to which a health information technology implementation achieved those goals and objectives Module 6.a: Assessment of impact of IS on the organization Identify and establish appropriate measurable goals and objectives Use of IS as an intervention to improve value/processes in the future Selecting metrics for assessment, e.g. Role of IS in improving value and in quality improvement Identification of measurable objectives at the initiation of the project; measurement of outcomes after implementation
Tools available to measure the impact of health IS: CBA, Net present value, Internal rate of return, Return on investment Alignment of roles and accountability to perform assessment and accountability of achievement of outcomes Direct and indirect costs and opportunity costs recognizing the breadth and depth of impact on the organization; transformational potential Costs and Benefits Evaluations of other applications (Handheld devices, wearable, convergent, and virtual technologies) Value from IS to impact organizational change: Impact on people; workflows; etc. Economic and non-economic costs/benefits Value of new system Importance of defining metrics and measuring results over time. Assessment of the effectiveness of the IS function: 7. Domain: Security and Privacy Competency Statement: 7.A. Demonstrate knowledge of legal and ethical issues and principles for protecting patient privacy and the security of health data. 7. B. Assess and implement policies related to the security of systems to protect data integrity, validity, and privacy. Module 7.a: Security and Privacy Legal and regulatory requirements related to the use of personal health information. Possible consequences of inappropriate use of health information Health information exchange, e.g. Ethical issues related to use of healthcare IT data An understanding of federal law and regulations as they pertain to patient privacy (Individual instructor should develop content on the law of the relevant state) Administrative, physical, and technical safeguards, e.g. Policies, procedures, and training for health data security Managing a security breach Knowledge of the healthcare organizations policies and procedures regarding Disaster Planning and Management Risk mitigation and recovery 8. Domain: Systems and Standards Competency Statements: 8.a. Understand the role of standards and protocols in health information technology, the principle systems of protocols applicable to HIT and the policies and development bodies responsible for HIT standards 8.b. Assess the core elements of information systems and their networks in order to effectively manage both the systems and data assets.
Module 8.A: Information Systems Characteristics and components of systems Architecture Managing systems Databases Networks Module 8.B: Standards Policy regarding standards development and adoption Evaluation, adoption, and Implementation of standards Standards development bodies Major types and classification of data standards Standards development approaches Identification of the need, requirements for, and benefits of standardization Certification of EHRs