0 EU-US eHealth/Health IT Cooperation Initiative Workforce Development Work Group September 25, 2014

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Meeting Times 3 Washington, DC 10:00 am (EDT ) Eastern Daylight Time Washington, DC 10:00 am (EDT ) Eastern Daylight Time London 15:00 (BST) British Summer Time London 15:00 (BST) British Summer Time Berlin 16:00 (CEST) Central European Summer Time Berlin 16:00 (CEST) Central European Summer Time Athens 17:00 (EEST) Eastern European Summer Time Athens 17:00 (EEST) Eastern European Summer Time Workforce Development WG meets every Thursday

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Agenda TopicTime Allotted 5th EU-US eHealth Business Marketplace & Conference Update 10 minutes Community Review of Terminology and Classification Schemes 25 minutes Continue Reviewing EU-US Workforce Development Marketing Presentation 10 minutes Updates to New HITCOMP Interactive Tool10 minutes Next Steps5 minutes 5

6 5th EU-US eHealth Marketplace & Conference The 5th EU-US eHealth Marketplace & Conference will be taking place in Boston, Massachusetts, USA, from October 21-22, 2014 This event will provide information on new and exciting connected health and healthcare technologies and bring together international leaders from various healthcare disciplines and organizations, from across the United States and Europe The Workforce Development WG will be providing an overview of progress and update on project activity, including a new focus on “Learning Economies” To register for this event and to review the latest agenda, please visit:

Terminology and Classification: Community Review 7

EU-US eHealth/Health IT Cooperation Initiative Workforce Development Work Group Creating New Pathways in HIT Workforce Development 8 DRAFT

CURRENT WORK STREAMS EU-US eHealth/Health IT Cooperation Initiative Workforce Development Work Group 9

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: 10 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

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.” 11 Current Work Streams: Classification (cont’d) (DRAFT)

Classification Schema: Roles – Roles: Next, we mapped a variety of roles in acute care, across the European Union and the United States. 12 Current Work Streams: Classification (cont’d) (DRAFT)

Classification Schema: Roles We 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. 13 Current Work Streams: Classification (cont’d) (DRAFT) Direct Patient Care - Clinical

Current Work Streams: Classification (cont’d) (DRAFT) 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*. 14 AHIMA/AMIA IMIA DOL NHS-UK Additional UK Resources/Scottish Government American Academy of Nurses Cuyahoga 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."

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

After several months of careful examination, reworking and revision, in some cases, the competencies were finalized after subject matter expert review and group consensus 16 AHIMA/AMIA Differentiate data versus information Describe the differences between health data and health information (EB01) Identify classification and systematic health- related terminologies for coding and information retrieval. Understand terminologies used in electronic health records and health information technology pertinent to your role (EB02) Current Work Streams: Classification (cont’d) (DRAFT)

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 17 HIT Domains Direct Patient Care Admin/ Finance/ Law/Mgmt Engineering / Info Sys Health Informatics Research Current Work Streams: Classification (cont’d) (DRAFT)

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. 18 Clinical/ Non-Clinical Clinical/ Non-Clinical Professional/ Operational/ Management HIT Domains Direct Patient Care Admin/ Finance/ Law/Mgmt Engineering / Info Sys Health Informatics Research Current Work Streams: Classification (cont’d) (DRAFT)

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. 19 Competency Levels BaselineBasicIntermediateAdvancedExpert Current Work Streams: Classification (cont’d) (DRAFT)

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

21 Classification Schema: Levels – After deciding the competency levels, we applied Bloom’s taxonomy to the competencies, with each level corresponding to a Bloom’s level Synthesizing Evaluating Analyzing Applying Understanding Knowing ExpertAdvancedIntermediateBasicBaseline Bloom’s Taxonomy Competency Level Current Work Streams: Classification (cont’d) (DRAFT)

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. 22 Health Data Access to Information Data Compiling, Analysis and Reporting General HIT Knowledge Policies and Procedures Privacy and Security Clinical Clinical Decision Support Clinical Practice and Workflows Documentation Process Medications and Allergies Order Entry Patient Care Coordination Patient Access and Engagement Population Mgmt/Public Health Protected Health Information/Pati ent ID Quality and Safety Communications Coding and Terminologies Communications and Change Mgmt eHealth/mHealth /Telehealth Issue Management HIE/Interoperabil ity/Interfaces Current Work Streams: Classification (cont’d) (DRAFT)

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

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 24

Updates: HITCOMP Interactive Tool 25 Definitions have been added Roles have been updated and now can be filtered in five EU languages There is a cross-link reference to levels between the two tabs

Next Steps 26 Join us next Thursday, October 2 nd, 2014 – Continue Prep for Boston – Finalize Marketing Materials – Timeline / Next Steps

Workforce Development Project Support Team 27 US Point of Contacts – Mera Choi, – Jamie Parker, – Gayathri Jayawardena, – Christina Nguyen, – Amanda Merrill, – John Feikema, EU Point of Contacts – Mary Cleary, – Benoit Abeloos, – Frank Cunningham, US/EU Point of Contact – Rachelle Blake,

Initiative Resources EU-US Wiki Homepage – US+eHealth+Cooperation+Initiative US+eHealth+Cooperation+Initiative Join the Initiative – US+MOU+Roadmap+Project+Sign+Up US+MOU+Roadmap+Project+Sign+Up EU-US Initiative Reference Materials – US+MOU+Roadmap+Project+Reference+Materials US+MOU+Roadmap+Project+Reference+Materials Workforce Development Homepage – rk+Group rk+Group 28