Spe­cial Re­port: The rush to train health­care IT work­ers

Along with the push to ramp up the use of health in­for­ma­tion technology in hos­pi­tals and doc­tors’ of­fices comes the need for a highly skilled la­bor force to get the job done

Modern Healthcare - - Front Page -

T he Amer­i­can Re­cov­ery and Rein­vest­ment Act of 2009, com­monly known as the stim­u­lus law, has a host of tight dead­lines for its myr­iad health in­for­ma­tion technology sub­sidy and IT net­work devel­op­ment ini­tia­tives.

Nearly all of them are timed to help ful­fill the am­bi­tious goal set by for­mer Pres­i­dent Ge­orge W. Bush in 2004 and adopted by Pres­i­dent Barack Obama last year to make elec­tronic health records avail­able to most Amer­i­cans by 2014.

Not sur­pris­ingly, a fed­er­ally funded health IT work­force train­ing ef­fort is both part of the over­all pro­gram and caught up in its mad rush.

“We are mov­ing fast,” says Pa­tri­cia Dom­browski, di­rec­tor of the Life Sci­ence In­for­mat­ics Cen­ter at Belle­vue (Wash.) Col­lege, which is lead­ing a con­sor­tium of com­mu­nity col­leges that ap­plied for and won $3.4 mil­lion in work­force train­ing grants funded by the stim­u­lus law—cov­er­ing ca­reer paths from in­for­ma­tion man­age­ment to IT hard­ware in­stal­la­tion.

Prepa­ra­tions at the col­lege are mov­ing so fast, “We were talk­ing about us­ing roller skates this morn­ing, but we raised our hands,” Dom­browski says. “We knew the time line, so I re­ally feel con­fi­dent mov­ing for­ward.”

Last month, HHS’ Of­fice of the Na­tional Co­or­di­na­tor for Health In­for­ma­tion Technology awarded $112 mil­lion of stim­u­lus funds to dozens of uni­ver­si­ties and com­mu­nity col­leges such as Belle­vue for var­i­ous IT work­force train­ing and ad­vanced-ed­u­ca­tion pro­grams rang­ing from six-month cer­tifi­cates through post-grad­u­ate de­grees.

The fac­ul­ties and ad­min­is­tra­tors at those schools will be pre­par­ing fever­ishly for the fall se­mes­ter and the first in­flux of what they hope will be thou­sands of new health IT stu­dents and job seekers.

Feel­ing the need

Boost­ing em­ploy­ment na­tion­wide was a ma­jor goal of the stim­u­lus law, and there is lit­tle doubt, ac­cord­ing to the govern­ment and in­dus­try lead­ers, that tens of thou­sands of new jobs will be needed if the fed­eral ef­fort to push provider adop­tion of EHRs is to be suc­cess­ful.

Un­der the stim­u­lus law, both physi­cians and hos­pi­tals seek­ing sub­sidy pay­ments for their IT pur­chases must use cer­ti­fied EHRs in a mean­ing­ful man­ner. Last De­cem­ber, the ONC and CMS is­sued rules for cer­ti­fi­ca­tion and mean­ing­ful use. In re­sponse to thou­sands of sub­se­quent pub­lic com­ments, both rules are likely to be mod­i­fied some­time this spring.

The Na­tional Cen­ter for Health Statis­tics, part of the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, es­ti­mates there are 308,900 of­fice­based physi­cians who are not fed­eral em­ploy­ees, Dom­browski: “We are mov­ing fast” to get pro­grams ready. who are not work­ing for a hos­pi­tal’s am­bu­la­tory-care pro­gram, and who are not ra­di­ol­o­gists, anes­the­si­ol­o­gists or pathol­o­gists.

Al­most half of these doc­tors are ei­ther in solo prac­tice or work in part­ner­ship with just one other physi­cian. Ac­cord­ing to the lat­est NCHS data avail­able—the 2009 es­ti­mates from its Na­tional Am­bu­la­tory Med­i­cal Care Sur­vey— only 21% of these of­fice-based physi­cians have a “ba­sic” EHR.

By NCHS def­i­ni­tion, a ba­sic sys­tem has rudi­men­tary ca­pa­bil­i­ties, in­clud­ing the abil­ity to cre­ate pa­tient prob­lem lists and clin­i­cal notes and do elec­tronic pre­scrib­ing. Al­though it’s not part of the def­i­ni­tion, a ba­sic sys­tem most likely lacks suf­fi­cient func­tion­al­ity to be cer­ti­fied un­der ONC rules and thus be con­sid­ered to be an EHR sys­tem wor­thy of re­im­burse­ment un­der the multi­bil­lion-dol­lar stim­u­lus technology sub­sidy pro­gram that is dom­i­nat­ing the health IT land­scape.

Just 6% of all of­fice-based physi­cians use what the NCHS de­fines as a “fully func­tional” EHR. Such a sys­tem might have enough bells and whis­tles—such as au­to­matic warn­ings of drug in­ter­ac­tions and out-of-range test lev­els— that a physi­cian us­ing one might rea­son­ably ex­pect to qual­ify for fed­eral EHR sub­sidy pay­ments un­der the stim­u­lus law, based on cur­rent drafts of ONC and CMS rules.

But even these ad­vanced EHR sys­tems are likely to re­quire ven­dor up­grades to meet pro­posed ONC cer­ti­fi­ca­tion cri­te­ria, while many clin­i­cians will still be ex­pected to change their work­flows and re­port­ing re­quire­ments to fully qual­ify for EHR sub­sidy pay­ments un­der pro­posed CMS mean­ing­ful-use stan­dards.

On av­er­age, hos­pi­tals are a bit higher up the IT adop­tion curve than physi­cian of­fices, but most hos­pi­tals are still a long way from where they’ll need to be to achieve mean­ing­ful use un­der the pro­posed CMS cri­te­ria.

Com­put­er­ized physi­cian or­der en­try is an ad­vanced EHR func­tion in hos­pi­tals. Ac­cord­ing to the CMS pro­posed rule, to qual­ify for fed­eral EHR sub­sidy pay­ments un­der the Medi­care por­tion of the stim­u­lus law, hos­pi­tals must run 10% of their or­ders through a CPOE sys­tem for a 90-day pe­riod some­time dur­ing the first year of the pro­gram, which starts this fall.

Ja­son Hess, gen­eral man­ager of clin­i­cal re­search at KLAS En­ter­prises, Orem, Utah, a

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.