Workshop #5 Building a Workforce to meet the needs of a Learning Health System 2015 Minnesota e-health Summit Wednesday, June 17 9:30 11:30 am 1
Building a Workforce to Meet the Needs of a Learning Health System Bonnie L. Westra, PhD, RN, FAAN, FACMI Karen A. Monsen, PhD, RN, FAAN Douglas Wholey, PhD David S. Pieczkiewicz, PhD Sunny Ainley, Associate Dean Ryan Sandefer, PhD-C
What are your needs and interests related to informatics and health information technology workforce education?
Purpose of Workshop Relate informatics health information technology (HIT) workforce needs and opportunities to the learning health system Understand current informatics and HIT workforce skills-development options Learn about innovate strategies to prepare for the future informatics and HIT workforce Appreciate the diversity of informatics programs
University of Minnesota School of Nursing Offering doctoral degrees in nursing informatics preparing qualified applicants to improve information technology in health care and conduct big data research, leading to better health for all U of M School of Nursing at nursing.umn.edu Contact: Karen A. Monsen, PhD, RN, FAAN, Specialty Coordinator 612-624-0490 mons0122@umn.edu
UMN School of Nursing Programs Leadership in Health Information Technology Certificate (LHIT) Nursing and interprofessional informatics specialty roles in health systems and industry Doctor of Nursing Practice (DNP) System leader (CNIO, CEO) Educator and collaborator across systems Doctor of Philosophy (PhD) Researcher and educator Advanced analytics methods for big data
Public Health Informatics Certificate-PHI Certificate-PHI MPH-PHI
Public Health Informatics Goals Teach you to improve population health by conceiving, designing, developing, implementing, and evaluating public health information systems Prepare you for a career in implementing and operating public health information systems in NGOs and local, state, federal, and global public health organizations Offered by the School of Public Health at the University of Minnesota Programs Certificate in Public Health Informatics Requirements: a bachelor s degree or higher from an accredited college or university 13 credits, residential and distance http://sph.umn.edu/programs/certificate/informatics/ Masters of Public Health in Public Health Informatics Requirements: a bachelor s degree or higher from an accredited college or university; GRE scores or equivalent. 43 credit, residential and distance http://sph.umn.edu/programs/mph_phi/ Key focus: Integrate education with practice Contact Daniel Chan, chan0876@umn.edu, (612) 626-8871
Institute for Health Informatics University of Minnesota Three degree programs, emphasizing clinical informatics, data management and analysis, and research in using information technology to solve health care problems: Master of Health Informatics (MHI) 30-credit, coursework-oriented degree Most popular option for working students Master of Science (MS) 36-credit degree, with thesis and project options More traditional, research-oriented degree Doctor of Philosophy (PhD) 70-credit degree (46 coursework, 24 dissertation) Advanced research and training for academia and industry MHI/MS courses are completely online, or taught in a classroom with live streaming and recording The majority of MHI/MS students are distance learners, and/or working professionals for whom this has been an attractive learning option Contact: Jessica Whitcomb-Trance, jwhitcom@umn.edu, 612-626-3348
Health Informatics Coursework Topics History and trajectory of the US health care system Health care terminologies and ontologies Health information exchange Electronic health records Ethics and information security Systems analysis Process and data modeling Workflows Human-computer interaction and usability Data visualization Information retrieval and literature review Translational research Clinical research informatics Clinical decision making Clinical decision support systems Natural language processing Data mining Pharmacy informatics Patient safety Programming and software engineering Database design and SQL Biostatistics Data analytics Reproducible research Big Data Consumer health informatics Population health informatics and elective coursework, tailored to the student s interests Emphasis is on transforming data for human use via information technology
Associate Degree Healthcare Systems Technology AAS Degree Possible Work Roles upon completion: Applications Software Developer Computer and Information Scientist Information Technologist Health Data Specialist Systems Analyst Technology Support Specialist Professional Training Programs MN Health IT Certificate Programs Contact Tracy Mastel for program information tracy.mastel@normandale.edu 952-358-8035 Possible Work Roles upon completion: Health Business Analyst Clinical Systems Liaison Health IT Project Manager Systems Analyst Implementation Specialist Practice Workflow Specialist MENTOR Health IT Workforce Training (Rural) Possible Work Roles upon completion: Health IT Informatics Professional Health IT Support Professional Health IT Training Professional Health IT Analyst
College of St. Scholastica Department of Health Informatics and Information Management Four degree programs and two certificate programs Programs focus on the intersection of clinical practice, leadership, and technology application Program is celebrating 80 th anniversary of educating health information professionals Contact: Kris Carlson at (218) 723-7062 or kcarlson@css.edu
Department of Health Informatics and Information Management BS Health Information Management 128 earned semester credits Traditional offering 100% online offering RHIA eligibility MS Health Information Management 40 earned semester credits 100% online RHIA eligibility MS Health Informatics 42 earned semester credits 100% online MS HIM/Information Technology Leadership Joint Degree 100% online Graduate Certificates in Health Informatics and HIM & Exchange
LINKING THE LEARNING HEALTH SYSTEM AND ONC STRATEGIC PLAN TO PREPARING THE FUTURE WORKFORCE
Continuous Learning, Best Care, Lower Cost The Vision of the Learning Health System (LHS) Sept 2012 iom.edu/bestcare
7 Characteristics of Continuously Learning Healthcare System 1. Real-time access to knowledge 2. Digital capture of the care experience 3. Engaged, empowered patients 4. Incentives aligned for value 5. Full transparency 6. Leadership-instilled culture of learning 7. Supportive system competencies
ONC 10-Year Vision to Achieve an Interoperable Health IT System 2004 2014 2024 ONC Framework 10 year Vision to achieve Interoperable Health IT Infrastructure 2014
Douglas Wholey, University of Minnesota, School of Public Health
The Learning Health System: Implementation in Public Health What are public health information systems? Population health Prevention Surveillance Community
Examples of Student Work Improving data quality and entry for gonorrhea/chlamydia surveillance Work with stakeholders and end users to identify improvements Create question wizard within MEDSS (Minnesota Electronic Disease Surveillance System) An information system to reduce underage substance abuse in schools Systems analysis of current system, business processes to develop a propose system for GIS Integration of Law Enforcement and Healthcare utilization data An information system to implement behavioral health home certification Systems analysis of current system in a clinic serving disadvantaged individuals to evaluate whether the system had the data necessary to meet the Behavioral Health Home Core Measurement Set standards and recommend improvement alternatives
Educational Objectives Integrate public health informatics and public health Integrate academics and practice to develop knowledge and skills Systems Analysis and Capstone Masters Project apply academic material (use cases, data modeling, business process modeling) in practice settings using computer aided design tools Contribute to practice from the start of the program Focus on public health goals using use cases How will stakeholders use the information system to improve population health Integrate students in public health informatics networks
Sunny Ainley, Normandale Community College
Electronic Quality Measures e-measure Development for Epilepsy A Student Practicum Project with the American Academy of Neurology Problem Identified: Many areas of neurology did not have e-measures which were compatible with or readable by EHR systems, necessary to gather and publicly report performance information, support Meaningful Use, value-based purchasing, and reimbursement requirements, all aimed at improving care, population health management, and research. Solution: Organized a team of MNHIT students to research and develop e- measures for Epilepsy for AAN and to develop a scalable on-going process. Project supported the LHS (Learning Health System s) by identifying a gap, innovating a synergistic learning solution and responding to the environment s needs. And developed non-existing e-measures for epilepsy and documented the process and workflow of these activities that would later be scaled and re-used for other quality measurements that required e-specifications. Contact Tracy Mastel for program information tracy.mastel@normandale.edu 952-358-8035
Electronic Quality Measures e-measure Development for Epilepsy Practicum with the American Academy of Neurology How did this project help develop a workforce that both supported the operationalization of a LHS and the ability to perform activities within the lifecycle of the system? What did the student s learn? By doing the skills and knowledge to develop e-measures (data acumen), how to use and design tools to manage and analyze quality data/information (learn, do, adjust). How to bring (apply) competencies in the MNHIT program and how to work as a team, project manage, research unknowns and problem-solve. To document learning process and work activities by Creating re-usable resources and guides and by sharing lessons learned for the next iteration of e-measures (continuous process improvement). Contact Tracy Mastel for program information tracy.mastel@normandale.edu 952-358-8035
Electronic Quality Measures e-measure Development for Epilepsy A Student Practicum Project with the American Academy of Neurology The E-Team Contact Tracy Mastel for program information tracy.mastel@normandale.edu 952-358-8035
Ryan Sandefer, College of St. Scholastica
Enhancing Product Use CareLogic use in the classroom MS Health Informatics Human Factors and Usability Assessment Course Video tutorials for teaching purposes Incorporate numerous usability testing techniques Student-driven usability assessments (e.g., scheduling the first appointment for a patient)
Example of Student Work Identify current and past diagnoses for the client Bob Smith* Two methods of evaluation Heuristic Evaluation & Think-aloud method * Bob Smith is an entirely fabricated client
Benefits of Classroom Use Offers students a hands-on learning experience The information derived from the student s work may inform the local agency and the vendor about possible alternative work flows Students are better prepared to evaluate the usability of health information technology The focus on behavioral and mental health is highly desired as this sector is often underserved by health informatics professionals
Dave Pieczkiewicz, University of Minnesota, Institute of Public Health
When Spreadsheets Aren t Enough HINF 5510 (Applied Health Care Databases) Course provides units on relational database design, Structured Query Language (SQL), and databases in health care Emphasis on using open-source tools when possible (MySQL), but knowledge will carry over to any database vendor s products
When Spreadsheets Aren t Enough A guiding principle for the course is that while simple, flat databases in spreadsheets are often used in health care, they can be problematic as the data become larger and more complex Course project asks student groups to design a relational database in a setting of their choice, including table structure, attributes, data dictionary, etc.
Pediatric Rheumatology Database (actual Fall 2014 course project)
When Spreadsheets Aren t Enough Emphasis is on design and documentation, rather than implementation Still, a surprising number of students and groups redesign databases in their own fields and areas of work (nurse scheduling, vaccinations, appointments, lab specimens) Some projects have grown into actual production databases and/or degree projects! Students spend as much time gathering (human) requirements for databases as they do coding them This course and other HINF courses emphasize that humans are the most important component of health information technology Human communication and collaboration are stressed in the programs as a whole
Karen Monsen, University of Minnesota, School of Nursing
Social Determinants of Health in the EHR: State of the Science Project completed at the request of the Minnesota Department of Health by Fall 2014 Population Health Informatics Practicum students (Faculty K. A. Monsen) Nicole Kapinos, BSN, RN Joyce M. Rudenick, MA, BSN, RN Kathy Warmbold, BSN, RN
Survey of 10 key informants How 23 SDH were reported in 9 EHRs Affinity (SDH = 4) CareFacts (SDH=76) Centricity GE (SDH=27) Epic (SDH=59) McKesson Paragon (SDH=27) Meditech (SDH=23) Nightingale Notes (SDH=20) PH-Doc (SDH=75) QCPR (QuadraMed) (SDH=23)
Dissemination Emphasis on publication of DNP and PhD scholarship Topics included Knowledge representation issues and solutions Methods development for EHR analytics Multi-disciplinary perspectives within the EHR Strengths-based care and terminology Outcomes measurement methods and metrics Data mining methods and clinical findings
Interactive Discussion Describe challenges in education encountered and an innovative strategy developed to prepare students for careers that will further the LHS
Support from the Community What can the community do to support learning experiences for students?
Summary The LHS and ONC strategic plan provide a vision of workforce competencies to be addressed Need for multiple educational programs to address the informatics and HIT competencies in a LHS Only 1 example provided of how the LHS is addressed in each program For more information Handouts available Contact information
THANK YOU! QUESTIONS?