EU-US eHealth/Health IT Cooperation Initiative Workforce Development Work Group

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EU-US eHealth/Health IT Cooperation Initiative

Workforce DevelopmentWork Group

Creating New Pathways in HIT Workforce Development

DRAFT

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BACKGROUND AND INTRODUCTION

EU-US eHealth/Health IT Cooperation InitiativeWorkforce DevelopmentWork Group

HIT Workforce Development

Background: EU-US eHealth Collaboration Initiative Memorandum of Understanding (DRAFT)

It started with a Memorandum of Understanding• In December 2010, the European Commission and the US

Department of Health and Human Services signed a Memorandum of Understanding (MOU) to:

– Help facilitate more effective uses of eHealth/Health IT;

– Strengthen their international relationship; and

– Support global cooperation in the area of health related information

and communication technologies

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Genesis of the EU-US eHealth Collaborative Initiative (DRAFT)

• In June 2013, an key stakeholders and interested parties were invited to participate in the EU-US eHealth Collaborative Initiative

• In August 2013, two work groups were launched, from the two initiative work streams of Interoperability and Workforce Development

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Workforce Development Community (DRAFT)

Work Group Members represent 13 countries

• Canada• England• Finland• France• Germany• Greece• Ireland• Israel• Italy• Mexico• Norway• Scotland• United States

EU-US eHealth Collaborative Initiative Vision (DRAFT)The vision and roadmap set the framework for progress• Vision

– “To support an innovative collaborative community of public- and private-sector entities working toward the shared objective of developing, deploying, and using eHealth science and technology to empower individuals, support care, improve clinical outcomes, enhance patient safety and improve the health of populations.”

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Workforce Development Vision (DRAFT)

The Workforce Development work group aims to develop a skilled Health IT workforce in the EU and US• Goal of the Workforce Development Work Group:

– “To achieve a robust supply of health professionals highly

proficient in the use of health IT, assuring healthcare, public

health and allied professional work forces have the technology

skills needed to enhance their professional experience and

performance with eHealth/Health IT”

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ROADMAP AND TIMELINE


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Workforce Development Roadmap (DRAFT)

• Roadmap– From the Memorandum of Understanding, a roadmap was created to

help guide the work of the Workforce Development Work Group

• The Roadmap contains these major tasks:– Identify Project Champions– Complete analysis of competencies required by the diverse healthcare

and eHealth/IT workforce– Identify and map curricula that addresses the competencies identified in

the US and EU– Explore new models of education/employer collaboration– Pilot innovative ways to develop a healthcare IT workforce

• These tasks were broken down into the following key milestones:

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Assessment of the scope, scale and characteristics of the healthcare workforce in the US and EU, and assessment of healthcare settings

Categorize Health Care Settings into domains, and map to HIT-related roles in the EU and US

Collect Competencies from various EU and US Sources to evaluate and map to roles; launch interactive competencies tool (HIT COMP)

Define HIT Competencies for domains, assign levels, and integrate Bloom’s Taxonomy (completed for Direct Patient Care – Clinical bucket)

Identify and map learning resources that promote competencies identified in the US and EU; develop white paper

Create a needs analysis that looks at what current formal and informal curricula and training exist, identify the gaps, and develop solutions to bridge the gap

Define and agree upon common eHealth standards of competence and professionalism

Ongoing

Completed

Ongoing

Completed

November 2014

March 2015

Ongoing

Roadmap Milestones (DRAFT)

Workforce Development

Proposed Project Timeline(all dates are tentative) (DRAFT)

Kick-off eHealth Cooperation Initiative (6/20)

September May

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June 2013

Launch of Workforce Development Sub Workgroup (8/20)

January 2014

Group reached agreement on Health IT Setting (9/12)

Group reached agreement on Classification Schema for Competencies and Roles (11/12)

Finalized mapping Roles to Classification Scheme Setting (01/02)

March

Finalized applying Classifications to Competencies; defined domains, levels and buckets (03/31)

Finalized first Role to Competency Mapping (4/24)

Presented work at eHealth Week in Athens (5/14)

Finalized all Direct Patient Care Domain mapping (7/10)

Finalize second domain Competency Mapping (Administration) (11/30)

Present at eHealth Week in Boston (Oct 21-22); Begin to Draft White Paper for Peer Review and potential publication on Methodology and Process (10/30)

Develop solutions to bridge gaps; create interactive tools; devise pilot(s) (3/5 onward)

Develop Marketing Materials; Launch online interactive competency tools (HIT COMP); Communicate Progress to Stakeholders (9/4)

Begin Curriculum to Competency Gap Analysis and Mapping (8/6)

NovemberJuly 2014 September January 2015 March 2015OctoberAugust

Finalize work on curriculum needs/gap analysis (1/29)

Key: Completed In Progress Future

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BRIDGING HIT GAPS


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Bridging the Gaps Between HealthcareIT and Health Information Management(DRAFT)

• The EU-US Workforce Development Workgroup, in Creating New Pathways in Health Information Technology, is helping to bridge the gaps between traditional healthcare roles, information technology roles and healthcare information management roles, as well as building bridges between previously disconnected HIT skills and roles

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• One of the ways in which the WDW does this is by mapping areas where information technology “touches” traditional healthcare roles (in addition to mapping roles and skills usually associated with healthcare IT, such as HIM, clinical informatics, administration, etc.)

• These HIT competencies supplement the core skills in many areas of healthcare delivery not commonly associated with information technology

Examples:

Bridging the Gaps Between HealthcareIT and Health Information Management(cont’d) (DRAFT)

Nurse Core Skills:• Patient Care• Clinical

Interventions• Care Protocols• Medication Delivery• Triaging• Vital Sign

Assessments• Wound Care• …

Nurse HIT Skills:• Clinical Decision

Support• Orders

Management• Electronic

Documentation• Bar Code

Administration• Medication

Reconciliation• …

Pharmacist Core Skills:• Drug Compounding• Drug Distribution• Intravenous

Preparations• Prescription

Processing• Prescription

Packaging• …

Pharmacist HIT Skills:• Order Processing and

Management• Clinical Decision

Support Build• Electronic

Distribution Systems Management

• Medication Systems Implementation

• …

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MAPPING A COMPETENCY FRAMEWORK


The Skills Mapping Forms a Competency Framework (DRAFT)

BaselineBasic

IntermediateAdvanced

Expert

A competency framework is based on skill sets used as building blocks. It could be shown in a progression such as this…

However, a competency level needs to be able to accommodate a variety of roles and job types

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Competency FrameworkProgress to Date (DRAFT)

• To date, we have accomplished the following tasks and subtasks in the mapping of skill areas:– Developed classification schema for HIT areas, roles, competencies and levels

– Classified over 3000 competencies, with comprehensive mapping across 14 silos

– Categorized healthcare roles into domains, levels and buckets

– Created proof of concept competency mapping, including developing competencies,

assigning levels, codifying and integrating Bloom’s taxonomy for over 250 Direct Patient Care

– Clinical competencies

– Begun an HIT curriculum requirement and gap analysis, identifying and mapping both

formal and informal educational resources and needs

– Created an interactive tool (HIT COMP) that can be used to search, aggregate and filter roles

and competencies based on a variety of categories and levels

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CURRENT WORK STREAMS


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Current Work Streams: Classification(DRAFT)

• Classification Schema: Settings, Roles, Silos, Domains, Subdomains/Buckets, Levels, Quadrants and Competency Areas – Settings: First we looked at settings for health care. Our task was to

select one as our starting point in order to begin outlining the appropriate skills sets needed to perform the desired tasks in that setting

– We looked at the following list of health care settings:

• Long-term care• Ambulatory care• Rehabilitation center• Pharmacy• Acute Care• Clinics (Flu, HIV, etc.)• Health record banks• Diagnostics facilities (e.g. facility

that only performs MRIs)

• Public health agencies

• Patient Centered Medical Home• Mobile Medical Care (healthcare

delivered via vehicle transport)• Personal Health Care• Home Health Care• Consumer Health – engaging the

consumers • Primary Care

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• Finally, we decided upon Acute Care, In order to manage the immense task of assigning competencies to roles and domains, the acute care setting was chosen due to the relative consistency and commonalities in hospital settings between the US and EU

• Acute care was defined as:“A level of health care in which a patient is treated for a brief but severe episode of illness, for conditions that are the result of disease or trauma, and during recovery from surgery. Acute care is generally provided in a hospital by a variety of clinical personnel using technical equipment, pharmaceuticals, and medical supplies.”

Current Work Streams: Classification(cont’d) (DRAFT)

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• Classification Schema: Roles– Roles: Next, we mapped a variety of roles in acute care, across the European Union

and the United States.


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• Classification Schema: RolesWe first took a look at all roles in Acute Care, and began to narrow down the focus to the most common roles in this setting in the US and EU.


Direct Patient Care - Clinical

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• Classification Schema: Silos– Silos: We collated over 3000 competencies from 13 derivative areas for

competencies and curricula, including AHIMA-AMIA, IMIA, US Department of Labor, National Health Service UK (NHS-UK), Cuyahoga Community College, Texas HIT, HIMSS worldwide, and the European e-Competency Framework and others*.

AHIMA/AMIA IMIA DOL NHS-UKAdditional UK

Resources/Scottish Government

American Academy of

NursesCuyahoga CC

America’s Job Bank Texas HIT HealthIT.gov

European e-Competence Framework

NOS-UK HIMSS worldwide

Created Competencies

*Disclaimer: "Our final competencies have their basis in the Silo/Origin, but in many cases do not reflect the actual or original language due to our community development and consensus process."

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• From each silo, hundreds of competencies were categorized into domains and divisions, and assigned a preliminary level.

• We chose the Direct Patient Care domain, clinical division, as our first set of competencies to review.


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• After several months of careful examination, reworking and revision, in some cases, the competencies were finalized after subject matter expert review and group consensus

AHIMA/AMIA

Differentiate data

versus information

Describe th

e differences

between health

data and

health in

formation (E

B01)

Iden

tify c

lassifi

catio

n

and s

yste

mati

c hea

lth-

relat

ed te

rmino

logies

for c

oding

and

infor

mati

on re

triev

al.

Understand terminologies

used in electronic health

records and health

information technology

pertinent to your role

(EB02)


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• Classification Schema: Domains– Domains: We developed 5 domains of HIT settings, including Direct

Patient Care, Administration/Finance/Law/ Management, Engineering/Information Systems, Informatics and Research.

– Our first domain tackled was Direct Patient Care

HIT Domains

Direct Patient Care

Admin/ Finance/

Law/Mgmt

Engineering/ Info Sys

Health Informatic

s

Research


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• Classification Schema: Subdomains/Buckets– Buckets: We then broke the domains down, dividing them into

divisions of clinical and non-clinical, and subdomains such as Professional/Operational/Managerial, revenue/compliance, etc.

Clinical/Non-Clinical

Professional/ Operational/ Management

HIT Domains

Direct Patient

Care

Admin/ Finance/

Law/Mgmt

Engineering/ Info Sys

Health Informatic

s

Research


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• Classification Schema: Levels– Levels: We classified the competencies into five levels: Baseline (the

baseline set of skills for all healthcare workers), Basic, Intermediate, Advanced and Expert. To assist us in this effort, we incorporated Bloom’s taxonomy to help determine the appropriate level for a competency.

Competency Levels

Baseline Basic Intermediate

Advanced Expert


• Interoperability is the backbone of Health IT – it ensures interoperability of our work when we use existing standards

• Bloom's Taxonomy of Educational Objectives provides standard classifications for the many nebulous terms often encountered in competency/curriculum development and evaluation

• The interoperability of this process can be leveraged when mapping competencies and curriculum (using the Blooms Taxonomy), or when consolidating this work with similar initiatives, etc.

Bloom’s Taxonomy Wheel


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• Classification Schema: Levels– After deciding the competency levels, we applied Bloom’s

taxonomy to the competencies, with each level corresponding to a Bloom’s levelS

ynthesizing

Evaluating

Analyzing

Applying

Understanding

Knowing

Expert

Advanced

Intermediate

Basic

Baseline

Bloom’s

Taxonomy

Com

pete

ncy L

evel


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• Classification Schema: Competency Quadrants – Competency Quadrants: So the competencies can be more effectively aligned with

other internal and external workforce development initiatives, we grouped them into four major areas of interactions, called Quadrants. These quadrants correspond to major areas of information technology related activities specific to health care. Each quadrant contains five key competency categories, described next.

Health Data

Access to Information

Data Compiling, Analysis and Reporting

General HIT Knowledge

Policies and Procedures

Privacy and Security


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• Classification Schema: Competency Categories– Competency Categories: Finally, we placed five

related competency areas in each of the four quadrants, resulting in 20 categories

– These categories can be further aligned to our and other initiatives’ eCompetence Proficiencies, such as “Can correctly access information”, “Follows security procedures”, etc., and followed or built upon through skill levels


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Understand that implementation of new

systems may require change to business processes or service

redesign to maximize achievement of benefit

Bringing it All Together: Tools (DRAFT)

• We have taken thousands of HIT competencies, hundreds of HIT roles, and many HIT areas and domains, and aggregated, catalogued and synthesized them into useful mappings and tools

Promote the need for good governance processes to ensure

systems developed or procured are able to provide the functionality required to deliver the greatest benefits to the patient, end user

and the organization

REWORDED COMPETENCY: Promote positive change

management techniques and good governance process in clinical

workflows

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Creating the Framework forInteractive Tools and Pilots (DRAFT)

Operational Roles

Direct Patient Care

Administration/Law/Management/Finance

Health Informatics

Engineering/Information Systems

Research

Basic Bereavement CounselorOrderlyNurse’s Aide

Intermediate

Advanced

Expert

Codes: AB01, AB02…EU Role Names: bereavement counsellor (UK), chargé decompagnement (FR), Trauerbegleiter (DE), consejero de duelo (ES), consigliere lutto (IT)Role Description: A bereavement counselor or coordinator monitors and manages the bereavement services for people dealing with terminal illness or death. They act as the main manager of the volunteers, medical staff, and others who are working with the bereaved. These professionals can work in a variety of settings including hospice, nursing homes, hospitals, and home health.Job duties for this position include offering counseling, assessing needs, and explaining the services available to the bereaved. Additional job duties include organizing and scheduling support groups, creating bereavement materials, documenting bereavement services given to clients, and training new staff.Competencies: • Be familiar with the concepts of primary and secondary health

data• Locate and retrieve information in the electronic health record,

according to your job role

Codes: AB01, AB02…EU Role Names: medical orderly/ward assistant (UK), aide-soignant(e) (FR), Krankenwärter(in) (DE), camillera del hospital (ES), attendente (IT)Role Description: Orderlies are often utilized in various hospital departments. Orderly duties can range in scope depending on the area of the health care facility they are employed. For that reason, duties can range from assisting in the physical restraint of combative patients, assisting physicians with the application of casts, transporting patients, shaving patients and providing other similar routine personal careCompetencies: • Be familiar with the concepts of primary and

secondary health data• Locate and retrieve information in the electronic

health record, according to your job role

Codes: AB01, AB02…EU Role Names:* nurse aide (UK), soigne l'aide (FR), Krankenpflegehelfer(in) (DE), cuida al asistente (ES), infermieri aiutante (IT)Role Description: Nurses' aides (NAs) work under the supervision of nurses or physicians to address the most fundamental elements of a patient’s care. They feed, dress, bathe and groom patients, contributing enormously to their sense of normalcy and well-being. NAs are sometimes given more medically-oriented duties such as measuring and recording temperature, blood pressure, and other vital signs. Nurses' aides also assist with the administrative duties and record-keeping that accompany patient care. Competencies: • Be familiar with the concepts of primary and

secondary health data• Locate and retrieve information in the electronic

health record, according to your job role

*We are incorporating different naming conventions, and also different role definitions, for various EU member countries, so there is not just one definition for all of EU

http://education-portal.com/articles/Bereavement_Counseling_Training_and_Education_Program_Options.html

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Tools: Presenting The HIT COMP:Our HIT Competency Tool

HITComp: An Interactive Tool for Discovering “Health IT eSkills” in the United States and European Union The EU-US Workforce Development Workgroup’s Health Comp e-mapping tool is a searchable database that workforce developers, staffing experts and interested parties in healthcare and the healthcare information technology can use to compile information on skills and competencies needed for a variety of healthcare roles, levels and areas of knowledge. You can sort over 250 competencies in the Direct Patient Care – Clinical sector by level, quadrant (health data, clinical, communications or patient interactions), or 20 areas of competency.

Competencies e-Mapping Tool:

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Tools: Presenting The HIT COMP:Our HIT Competency Tool

HITComp: An Interactive Tool for Discovering “Health IT eSkills” in the United States and European Union Roles e-Mapping Tool (includes roles in five EU languages):

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PLANNING FOR THE FUTURE


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Supporting Concurrent Initiatives (DRAFT)

• In addition to developing a framework and tools for HIT workforce development, our work also aims to enhance and support other parallel and complementary initiatives, including:

– AHIMA - Global Health Workforce Council– AHIMA’s Career Tool– European e-Competence Framework– CAMEI– Technology Informatics Guiding Education Reform (TIGER Summit)– TransAtlantic Business Council– "NEW SKILLS AND NEW JOBS IN THE HEALTH CARE AND SOCIAL WORK

SECTOR “: a project developed by 13 partners of 5 Member States in response to a European Tender of the 2009 Progress Program

– Others

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Next Steps (DRAFT)

• Communicate Progress to Stakeholders and Leadership• Draft White Paper for Peer Review and potential publication

on Methodology and Process• Continue work on Formal and Informal Curriculum Mapping• Present at eHealth Week in Boston (Oct 21-22)• Finalize second domain Competency Mapping

(Administration/Finance/Legal/Management)

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ABOUT US…


Workforce Development Project Support Team (DRAFT)

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• US Point of Contacts– Mera Choi, [email protected]– Jamie Parker, [email protected]– Gayathri Jayawardena, [email protected]– Christina Nguyen, [email protected]– Amanda Merrill, [email protected]– John Feikema, [email protected]

• EU Point of Contacts – Mary Cleary, [email protected] – Benoit Abeloos, [email protected] – Frank Cunningham, [email protected]

• US/EU Point of Contact– Rachelle Blake, [email protected]

mailto:[email protected]










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Initiative Resources (DRAFT) • EU-US Wiki Homepage

– http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative

• Join the Initiative– http://

wiki.siframework.org/EU-US+MOU+Roadmap+Project+Sign+Up

• EU-US Initiative Reference Materials– http://

wiki.siframework.org/EU-US+MOU+Roadmap+Project+Reference+Materials

• Workforce Development Homepage– http://

wiki.siframework.org/Workforce+Development+Work+Group

• Workforce Development HITCOMP Tool– http://hitcomp.siframework.org/

http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative



http://wiki.siframework.org/EU-US+MOU+Roadmap+Project+Sign+Up



http://wiki.siframework.org/EU-US+MOU+Roadmap+Project+Reference+Materials



http://wiki.siframework.org/Workforce+Development+Work+Group



http://hitcomp.siframework.org/



EU-US eHealth/Health IT Cooperation Initiative Workforce Development Work Group

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