Transatlantic Model for HealthIT Workforce Development through the European Union and the United States eHealth Cooperation Initiative Jamie Parker Associate Director, Health IT – Contractor to ONC S&I Framework ESAC Inc. jamie.parker@esacinc.com

Agenda Background on the EU-US Workforce Development Project Step-by-step Methodology for Achieving Project Goals How to Get Involved

Background: It Started with a Memorandum of Understanding The Memorandum of Understanding In December 2010, the European Commission and the US Dept. 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 Support global cooperation in the area of health related information and communication technologies. Interoperability of EHRs

Background: Vision & Roadmap Sets the Framework for Progress “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.” Roadmap From the Memorandum of Understanding, a roadmap was created to help guide the work of both the Interoperability of EHR’s and Workforce Development work streams

Background: Strategy to Achieve Goals of the MOU To reach this vision two high priority work streams were established eHealth/Health IT Interoperability – to accelerate progress towards the widespread deployment and routine use of internationally recognized standards that would support transnational interoperability of electronic health information and communication technology eHealth/Health IT Workforce Development – to identify approaches to achieving our common goals for achieving a robust supply of highly proficient eHealth/Health IT professionals and assuring health care, public health, and allied professional workforces have the eSkills needed to make optimum use of their available eHealth/Health IT

Workforce Development – Work Plan The work stream’s responsibility is three-fold Competency Analysis Identifying a curriculum based on competency analysis Definition and agreement on common standards of competence and professionalisms 1. Outline scope statement and goals/ objectives 2. Identify setting (Acute Care selected) 3. Identify Roles in Acute Care and map EU- US roles 4. Categoriz e skills from existing competen cy silos 5. Map skills to profess- ional roles 1. Examine curricula that support these skills 2. Curricula Gap analysis 3. Final recommendations

Step 1: Outline Scope Statement, Goals and Objectives… Using the MOU and the roadmap, we developed the foundation of our work through a Scope Statement, goals and objectives Scope Statement: Working to create strategies for the development of a proficient health IT workforce and assuring healthcare, public health and allied professional work forces have the technology skills needed to enhance their professional experience and performance with eHealth/HealthIT http://wiki.siframework.org/Workforce+Development+Work+Group 1. Outline scope statement and goals/ objectives 2. Identify setting (Acute Care selected) 3. Identify Roles in Acute Care and map EU-US roles 4. Categorize skills from existing competency silos 5. Map skills to profession al roles

Step 1: Outline Scope Statement, Goals and Objectives continued Assessment of the scope, scale and characteristics of the healthcare workforce in the US and EU – current status and future trends in terms of eHealth capabilities. Assessment of healthcare settings in the US and EU – current status and future trends. Role based competencies, curricula for chosen scenarios in the US and EU. Perform analysis of competencies required by the diverse care workforce that include: professionals in the field; academic track for new professionals (pre-service) and those transitioning from other health disciplines and from mainstream ICT into the health sector; all staff in healthcare delivery, management, administration and support. allied healthcare teams; and health IT professionals. Identify or align learning resources that promote competencies identified in the US and EU. Identify or align educational needs and learning resources (including baseline competencies). Create a needs analysis that examines the current curricula and training which exists, identify the gaps, and develop solutions to bridge the gap (e.g. plan to develop new curricula) Definition and agreement of common eHealth standards of competence and professionalism.

Step 2: Identifying the Setting… Solicited several settings where we could evaluate roles against HealthIT competencies. Acute Care was selected by community: stable setting setting that does not vary too much with the scale of the facility in which it is provided setting that is delivered similarly in both the US and EU setting with relatively common definitions on both sides of the Pond Acute Care is 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.” For example, influenza, allergies, bronchiolitis. *Definition of acute care taken from Hospitals Today: http://www.ct.gov/dph/lib/dph/ohca/hospitalstudy/HospToday.pdf 1. Outline scope statement and goals/ objectives 2. Identify setting (Acute Care selected) 3. Identify Roles in Acute Care and map EU-US roles 4. Categorize skills from existing competency silos 5. Map skills to profess- ional roles

Step 2: Identifying a Setting continued Acute Care Setting was selected by the community stable setting setting that does not vary too much with the scale of the facility in which it is provided setting that is delivered similarly in both the US and EU setting with relatively common definitions on both sides of the Pond Acute Care is 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.” For example, influenza, allergies, bronchiolitis. *Definition of acute care taken from Hospitals Today: http://www.ct.gov/dph/lib/dph/ohca/hospitalstudy/HospToday.pdf

Step 3: Identify Roles in Acute Care in EU and US… We needed to identify Acute Care Roles in EU and US Resources: http://ec.europa.eu/internal_market/qual ifications/regprof/index.cfm?action=prof essions&quid=1&mode=asc&pagenum =1&maxrows=15#top http://www.ahima.org/ http://www.nhscareers.nhs.uk/a-to-z/ 1. Outline scope statement and goals/ objectives 2. Identify setting (Acute Care selected) 3. Identify Roles in Acute Care and map EU- US roles 4. Categorize skills from existing competency silos 5. Map skills to profess- ional roles 11

Step 3: Identify Roles in Acute Care in EU and US continued We needed to identify Acute Care Roles in EU and US and categorize them Domain (5) Direct Patient Care Administration, Management, Legal Engineering and Information Systems Informatics Research Settings (2) Clinical Non Clinical Skill Level (4) Basic Intermediate Advanced Expert

Step 4: Categorize Skills from Competencies… We collected competencies from 10 different sources resulting in categorizing more than 2050 HealthIT competencies AHIMA-AMIA IMIA Department of Labor National Health Service UK Scottish Government HealthIT.gov Cuyahoga County Community College Texas HealthIT European eCompetency Framework National Occupational Standards 1. Outline scope statement and goals/ objectives 2. Identify setting (Acute Care selected) 3. Identify Roles in Acute Care and map EU-US roles 4. Categorize skills from existing competency silos 5. Map skills to profess- ional roles 13 13

Step 4: Categorize Skills from Competencies continued To facilitate the Competency Analysis phase, a model was created; it included the same 5 domains, 2 settings, and 4 skill levels as applied to categorizing roles A baseline: broad IT skills and competencies needed for every occupation 5 domains: Direct Patient Care, Administration/Finance/Law/Management, Engineering/Information Systems, Informatics, and Research 2 settings: Clinical and Non-Clinical. 4 levels of skills: Basic, Intermediate, Advanced, and Expert Total groups of skills 4*5*2= 40 buckets + 1 baseline Description 14

Step 5: Map Skills to Roles… This enabled mapping of Skills to Roles in Acute Care After selecting the Acute Care setting, we identified roles in Acute Care and placed them into 40 buckets We then looked at 10 silos of competencies, and assigned each competency to its respective bucket We identified a need to identify baseline skills – those skills that apply to ALL roles in HealthIT The community is working on refining the Skills-Role map for the Direct Patient Care/Intermediate/Clinical bucket; This will be done for all 40 buckets http://wiki.siframework.org/Workforce+Development+ Work+Group Categorizing Roles Mapping Roles to Competencies based on categorization Categorizing Competencies 1. Outline scope statement and goals/ objectives 2. Identify setting (Acute Care selected) 3. Identify Roles in Acute Care and map EU-US roles 4. Categorize skills from existing competency silos 5. Map skills to profess- ional roles 15 15 15

Step 5: Map Skills to Roles continued Sample Mapping: For a complete listing of the mapping of the Direct Patient Care, Clinical, Intermediate, Competencies please review the excel spreadsheet listed on our wiki page: http://wiki.siframework.org/Workforce+Development+Work+Group

Recap of the EU-US Workforce Development Activities The Workforce Development work stream continues to progress towards the MOU vision COMPLETED Selected Acute Care setting Identified EU and US Roles in the Acute Care setting Defined competency buckets Assigned Roles to competency buckets Assigned Skills to competency buckets FUTURE WORK Research existing HIT curricula Create curricula gap analysis Draft recommendations to address significant gaps IN PROGRESS Refining Skills to Role map

How to get Involved? Link to EU initiative: http://wiki.siframework.org (EU-US eHealth Cooperation initiative link on the left hand side) Project Charter, Meeting Schedules, Minutes, Reference Materials, Use Case, and all Announcements are posted on the Wiki page Join the project and the project mailing list: http://wiki.siframework.org/EU-US+MOU+Roadmap+Project+Sign+Up

Questions

Contacts For more information on the EU-US Workforce Development work ONC Contacts: Mera Choi: Mera.Choi@hhs.gov Chitra Mohla: chitra.mohla@hhs.gov Project Management Team: Jamie Parker: jamie.parker@esacinc.com Gayathri Jayawardena: gayathri.jayawardena@esacinc.com Amanda Merrill: amanda.merrill@accenturefederal.com Kareem Malek: kareem.malek@accenturefederal.com Christina Nguyen: christina.nguyen@esacinc.com