1. EU-US eHealth Cooperation Initiative Workforce Development Panel Discussion eHealth Forum 2014 Athens, Greece May 12-14, 2014

2. Agenda Introduction and Background : Doug Fridsma, MD, PhD - Chief Science Officer & Director, Office of Science & Technology – Office of the National Coordinator Workforce Development Strategy, Plans and Methodology: Rachelle Blake, PA, MHA, CEO and President - Omni Micro and Omni Med Solutions, Physician Assistant, Clinical Informatics and Healthcare Technology Specialist Connecting Competencies to Curriculum: Bill Rudman PhD, RHIA, Executive Director AHIMA Foundation and Vice President of Education Visioning for the American Health Information Management Association (AHIMA) 1

3. Interoperability of EHRs Background: EU-US eHealth Collaboration Project Memorandum of Understanding It started with a 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; and Support global cooperation in the area of health related information and communication technologies. 2

4. Background: EU-US eHealth Collaboration Project Project Vision and Roadmap 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.” 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 3

5. Background: EU-US eHealth Collaboration Project Work Plan Both the United States and the European Union are currently working to encourage broader and more effective use of Information and Communications Technology (ICT). This includes working towards: – Improvements in delivery of health services – Disease prevention – Health promotion To this end, the Transatlantic Economic Council is making a critical contribution to this development by: 1.Promoting interoperability of health related information and communication technology (eHealth/health IT) products and services, and 2.Gaining improved mobility and consistent proficiency recognition for a professional workforce 4

6. Background: EU-US eHealth Collaboration Project Strategy To ensure we could operationalize and achieve the Vision and the artifacts outlined in the roadmap, two high priority work streams were established: eHealth/Health IT Interoperability eHealth/Health IT Workforce Development 5

7. The global community that has been working alongside our efforts include: Community Participating and Supporting Workforce Activities – American Health Information Management Association (AHIMA) – Coordination Actions in scientific area of Medical Education Informatics (CAMEI) – National Health Service – UK (NHS) – United Kingdom Council for Health Informatics Professionals (UKCHIP) – Community Colleges – Federal Partners (United States) – Government Ministries (EU) – Consultants – Curriculum Development Organizations – Health Educators – Clinicians – Health Administrators – European Health Telematics Association (EHTEL) 6

8. 7 Workforce Development Community Members represent 13 countries Canada England Finland France Germany Greece Ireland Israel Italy Mexico Norway Scotland United States

9. Workforce Development Vision The Workforce Development work stream aims to develop a skilled Health IT workforce in the EU and US Goal of the Workforce Development: – “Achieving 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” 8

10. Workforce Development Methodology Rachelle Blake 9

11. Workforce Development Proposed Project Timeline Kick-off eHealth Cooperation Initiative (6/20) September May 10 June 2013 Launch Workforce Developme nt Sub Workgroup (8/20) January 2014 Group reaches agreement on Health IT Setting (9/12) Group reaches agreement on Classification Schema for Competencies and Roles (11/12) Group finalize mapping Roles to Classification Scheme Setting (01/02) March Finalized applying Classifications to Competencies( 03/31) Finalized first Role to Competency Mapping (4/24) Present work at eHealth Week in Athens (5/14) Finalize all Direct Patient Care and Research Domain mapping (7/10) Finalize all Role to Competency Mapping (9/18) Present at eHealth Week in Boston(ear ly Oct) Begin Work on needs/gap analysis, and develop solutions to bridge the gap Begin to Draft White Paper for Peer Review and potential publication on Methodology and Process(9/4) Begin Curriculum to Competency Analysis (11/30) November July 2014 September January 2015 March 2015

12. 11 Assessment of the scope, scale and characteristics of the healthcare workforce in the US and EU Assessment of healthcare settings in the US and EU Identify Health Care Settings and Roles in the EU and US Collect Competencies from various EU and US Sources to evaluate and map to roles Identify or align learning resources that promote competencies identified in the US and EU. Includes identifying/aligning educational needs and learning resources (with baseline competencies) Create a needs analysis that looks at what current curricula and training exist, 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 Ongoing Completed November 2014 March 2015 Ongoing Workforce Development Road Map

13. Overarching Work Plan To successfully complete our activities the work group is breaking down the work into three phases Competency Analysis Identifying a curriculum based on competency analysis Identifying a curriculum based on competency analysis Definition and agreement on common standards of competence and professionalisms Definition and agreement on common standards of competence and professionalisms 12

14. Phase 1: Competency Analysis The Competency Analysis consists of 5 tasks: 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 professional roles (Competency Matrix) Competency Analysis Identifying a curriculum based on competency analysis Identifying a curriculum based on competency analysis Definition and agreement on common standards of competence and professionalisms Definition and agreement on common standards of competence and professionalisms 13

15. Competency Analysis Step 1: Outline Scope Statement Using the MOU and the roadmap, the workgroup developed the foundation of our work through a Scope Statement …. 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 http://wiki.siframework.org/Workforce+Development+Work+Group 14 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 professional roles (Competency Matrix)

16. 15 Competency Analysis Goals and Objectives… The Scope Statement established the framework for creating achievable Goals and Objectives Assessment of the scope, scale and characteristics of the healthcare workforce in the US and EU in terms of eHealth capabilities. Assessment of healthcare settings in the US and EU. Develop 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. 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 professional roles (Competency Matrix)

17. 16 The Objectives of the Workforce Development Workgroup: 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) Define and agree upon common eHealth standards of competence and professionalism. Competency Analysis Goals and Objectives continued

18. Competency Analysis Step 2: Identify the Setting… We solicited several Settings where we could evaluate roles against Health IT competencies. Selection Criteria 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; and setting with relatively common definitions on both sides of the Atlantic. 17 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 professional roles (Competency Matrix)

19. Competency Analysis Step 2: Identify the Setting… The community suggested several Settings where we could evaluate roles against Health IT competencies. – long-term care – ambulatory care – Rehabilitation center – Pharmacy – Acute Care – Clinics (Flu, HIV etc.) – Health record banks 18 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 professional roles (Competency Matrix) – Diagnostics facilities (Facility that only performs MRIs) – Public health agencies – Mobile Health Care (blood banks, vaccinations ) Short list of options (as proposed and discussed by the community) included:

20. Competency Analysis Step 2: Identify the Setting continued Acute Care Setting was selected by the community 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 19 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 professional roles (Competency Matrix)

21. Competency Analysis Step 3: Identify Roles in Acute Care We identified roles in EU and US roles in Acute care, and mapped them to their corresponding counterparts US RolesEU Roles Administrative Assistant Administrator Admissions Director Anesthesiologist AudiologistHearing Aid Dispenser / Audiometric Technician Behavioral Medicine TechnicianPsychiatric Rehabilitation Technician Bereavement CoordinatorFuneral Director / Undertaker / Bereavement specialist Biomedical TechnicianBiomedical Technician / Technologist Resources: European Commission AHIMA NHS 20 Example taken from actual US –EU role mapping work: http://wiki.siframework.org/Workforce+Development+Work+Grouphttp://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 professional roles (Competency Matrix)

22. Competency Analysis Step 3: Classify Roles in Acute Care We categorized the roles into three classifications: Domain (5) – 1. Direct Patient Care – 2. Administration, Management, Legal – 3. Engineering and Information Systems - 4. Informatics - 5. Research Settings (2) – 1. Clinical - 2. Non Clinical Skill Level (4) – 1. Basic - 2. Intermediate - 3. Advanced - 4. Expert Example taken from actual US –EU role mapping and classification work: http://wiki.siframework.org/Workforce+Development+Work+Grouphttp://wiki.siframework.org/Workforce+Development+Work+Group

23. Competency Analysis Step 3: Classify Roles into Buckets Applying the classifications: 5 domains, 2 Settings and 4 Skill levels we have 40 separate buckets plus a “Baseline Skills” bucket in which to categorize roles 22 Expert Direct Patient Care Advanced Direct Patient Care Intermediate Direct Patient Care Basic Direct Patient Care Expert Admin, Fin, Law, Mgmt Advanced Admin, Fin, Law, Mgmt Intermediate Admin, Fin, Law, Mgmt Basic Admin, Fin, Law, Mgmt Expert Engineer, Information Systems Advanced Engineer, Information Systems Intermediate Engineer, Information Systems Basic Engineer, Information Systems Expert Informatics Advanced Informatics Intermediate Informatics Basic Informatics Expert Research Advanced Research Intermediate Research Basic Research CLINICAL Expert Direct Patient Care Advanced Direct Patient Care Intermediate Direct Patient Care Basic Direct Patient Care Expert Admin, Fin, Law, Mgmt Advanced Admin, Fin, Law, Mgmt Intermediate Admin, Fin, Law, Mgmt Basic Admin, Fin, Law, Mgmt Expert Engineer, Information Systems Advanced Engineer, Information Systems Intermediate Engineer, Information Systems Basic Engineer, Information Systems Expert Informatics Advanced Informatics Intermediate Informatics Basic Informatics Expert Research Advanced Research Intermediate Research Basic Research NON CLINICAL IT Baseline Skills

24. Competency Analysis Step 4: Categorize Skills We collected competencies from 12 different sources resulting in categorizing more than 2700 Health IT competencies 1.AHIMA-AMIA 2.IMIA 3.Department of Labor 4.National Health Service UK 5.Additional UK Resources 1.Academy of Royal Medical Colleges 2.National Health Service 24 6.HealthIT.gov 7.Cuyahoga County Community College 23 8.Texas HealthIT 9.European eCompetency Framework 10.UK National Occupational Standards 11.Virtual Career Network 12.American Association of Community Colleges/ONC 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 professional roles (Competency Matrix)

25. Competency Analysis Step 4: Categorize Skills As we did with roles, we applied the same categorization schema to the competencies 24 Domain (5) Direct Patient Care, Administration, Management, Legal, Engineering and Information Systems, Informatics, Research Settings (2) Clinical and Non Clinical Skill Level (4) – Basic – Intermediate – Advanced – Expert Example taken from actual competency mapping document: http://wiki.siframework.org/Workforce+Development+Wor k+Group http://wiki.siframework.org/Workforce+Development+Wor k+Group

26. Competency Analysis Step 4: Classify Competencies into Buckets Applying the classifications: 5 domains, 2 Settings and 4 Skill levels we have 40 separate buckets plus a “Baseline Skills” bucket in which to categorize competencies 25 Expert Direct Patient Care Advanced Direct Patient Care Intermediate Direct Patient Care Basic Direct Patient Care Expert Admin, Fin, Law, Mgmt Advanced Admin, Fin, Law, Mgmt Intermediate Admin, Fin, Law, Mgmt Basic Admin, Fin, Law, Mgmt Expert Engineer, Information Systems Advanced Engineer, Information Systems Intermediate Engineer, Information Systems Basic Engineer, Information Systems Expert Informatics Advanced Informatics Intermediate Informatics Basic Informatics Expert Research Advanced Research Intermediate Research Basic Research CLINICAL Expert Direct Patient Care Advanced Direct Patient Care Intermediate Direct Patient Care Basic Direct Patient Care Expert Admin, Fin, Law, Mgmt Advanced Admin, Fin, Law, Mgmt Intermediate Admin, Fin, Law, Mgmt Basic Admin, Fin, Law, Mgmt Expert Engineer, Information Systems Advanced Engineer, Information Systems Intermediate Engineer, Information Systems Basic Engineer, Information Systems Expert Informatics Advanced Informatics Intermediate Informatics Basic Informatics Expert Research Advanced Research Intermediate Research Basic Research NON CLINICAL IT Baseline Skills

27. 26 Competency Analysis Step 5: Mapping Skills to Roles Once we classified Role and Skills we were able to match one to the other Because we use the same classification for Skills and Roles we are able map roles to skills – Once skills are mapped Roles are reviewed (to ensure the competencies reflect the roles) Duplicates are removed Wording of the competencies is fixed Gaps in Competencies are identified 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 professional roles (Competency Matrix) Role to Category Map Skill to Category Map Role to Skill Map

28. Competency Analysis Step 5: Map Skills to Roles 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 http://wiki.siframework.org/Workforce+Development+Work+Group 27 Roles for Direct Patient Care, Clinical, Intermediate Competencies for Direct Patient Care, Clinical, Intermediate

29. Doing this mapping work we realized a need to identify baseline skills – those skills that apply to ALL roles in HealthIT Competency Analysis Step 5: Map Skills to Roles - Baseline Skills 28 Example taken from actual US –EU Baseline Competency Bucket: http://wiki.siframework.org/Workforce+Development+Work+Grouphttp://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 professional roles (Competency Matrix)

30. Phase 2: Identifying Curriculum The Curriculum Identification Consists of 3 Tasks: Competency Analysis Identifying a curriculum based on competency analysis Identifying a curriculum based on competency analysis Definition and agreement on common standards of competence and professionalisms Definition and agreement on common standards of competence and professionalisms 29 1. Examine curricula that support these skills 2. Curricula Gap analysis 3. Final recommendations

31. Curriculum and Competencies Bill Rudman 30

32. Equipping the Health Information Management & Technology Workforce through Establishment of Educational Curricula Competencies to Meet Future Needs: Development of the Global Health Workforce Council U.S. Department of Commerce (DoC) - International Trade Association (ITA) Market Development Cooperator Program (MDCP) award #IT13MAS1120001

33. About AHIMA: – Leading professional association of health information management (HIM) professionals – Serving 52 affiliated component state associations (CSAs) and more than 71,000 members - recognized as the leading source of "HIM knowledge," a respected authority for rigorous professional education and training – Founded in 1928 to improve health record quality, AHIMA has played a leadership role in the effective management of health data and medical records needed to deliver quality healthcare to the public Member of the International Federation of Health Information Management Associations (IFHIMA) AHIMA’s Affiliate: – AHIMA Foundation: Establishes the academic curricula competencies for Health Informatics and Information Management profession – Commission on Accreditation of Health Informatics and Information Management Education (CAHIIM): Accrediting organization that enforces Accreditation Standards for Health Informatics and Health Information Management (HIIM) educational programs – Commission on Certification for Health Informatics and Information Management (CCHIIM) Commission assuring the competency of professionals practicing HIIM and oversees AHIMA’s certification program Identifying Curriculum – Phase 2 About the American Health Information Management Association (AHIMA)

34. Identifying Curriculum – Phase 2 Importance of a Trained Health Information Workforce There is global expansion of e-health technologies Human resources are the most critical prerequisite for the implementation Healthcare systems need well-trained and highly- skilled workers to implement systems A comprehensive healthcare education and workforce strategy is needed

35. Identifying Curriculum – Phase 2 Specific Goals of the Grant: Develop and train a Health Information workforce globally Launch a Global Health Workforce Council that will develop an internationally applicable curriculum and set Health Information education and workforce training competencies and skills Help create an educated and trained international workforce. These efforts will specifically target new students, those already working in the HIM/HI/HIT field, and those working in other areas and wanting to change professions. Expand educational resources to a global market to support country specific HIM/HI/HIT educational needs in order to develop an internal HIM/HI/HIT workforce. A major emphasis will be placed on recruiting international students to U.S. universities and colleges. Increase access to educational products and services including educational offerings, webinars and seminars for training.

36. Identifying Curriculum – Phase 2 Global Health Workforce Council 35 Marci MacDonald, Halton Healthcare Services Bill Rudman, AHIMA Foundation Lincoln Moura, IMIA President José del Río Mata, MD, Andalusian Health Services Adio Rasaq Adetona, National Hospital Abuja Angelika Handel, IFHIMA President, Country Level Outreach Hussein Ali Y AlBishi, Saudi Arabia Ministry of Health Rachelle Blake, Omni Micro Systems/Omni Med Solutions Sabu K M, Namipal University Sue Walker, Queensland University of Technology Yukiko Yokobori, Japan Healthcare Association GHWC: 13 members to be appointed

37. Identifying Curriculum – Phase 2 Advancing a Trained Global eHealth Workforce Deliverable: Develop global curricula competency model for HIM/HI/HIM – Evaluate curricula and competency standards and models from countries across the globe – Develop a publicly available global resource developed in an open and transparent manner Once developed countries/academic programs may: – Review and refine against their existing requirements – Build new requirements and academic programs AHIMA’s Grant Partner:

38. Identifying Curriculum – Phase 2 Example: Curricula Competency Model 37

39. Identifying Curriculum – Phase 2 Building on the EU-US Workforce Workgroup Leveraging EU-US Workgroup Deliverables – Environmental scan and curricula/competency models collected to inform draft – Use the competency buckets as a foundation for curricula competencies – Use the Map of Skills to Roles to map curricula competencies to different roles Create Curricula Competencies – Add other global curricula/competency resources – Establish domains and sub-domains for Health Information – Determine educational taxonomy (e.g. Bloom’s Taxonomy) – Identify curricula competencies for multiple educational levels (e.g. entry- level, intermediate and advanced levels) Map Global Academic Curricula Competencies to Various Workforce Roles Support development of a global health information career map resource 38

40. Identifying Curriculum – Phase 2 Inform Workforce Roles/Jobs for Health Information: AHIMA’s Health Information Career Map is Available at: http://hicareers.com/CareerMap/http://hicareers.com/CareerMap/ NHS has a similar resource at: https://www.hicf.org.uk/https://www.hicf.org.uk/

41. Identifying Curriculum – Phase 2 Global Curricula Competencies Development Timeline April 2014 – Appoint Council members May – June 2014 – Compile Health Information curriculum/ competency from stakeholders and countries July – August 2014 – Face to Face Council meeting to develop draft curricula competencies August – October 2014 – Input by Country-level workgroups October – December 2014 – Council reconciles comments and develops final draft of global health information curricula competency model – Releases final global curricula competency model 2015 – Outreach – Map Curricula Competencies to Different Roles 2016 (and on-going) Review/Modification Cycle 40 Leveraging EU-US Workgroup Leverage the research and work of the EU-US Workforce Workgroup Includes EU-US Workforce Workgroup Member Engage US and EU Countries to provide feedback Building on the work of the EU-US Workforce Workgroup Continued coordination on future work

42. THANK YOU Bill Rudman, PhD, RHIA AHIMA Foundation | Executive Director AHIMA | Vice President of Education Visioning Phone: +1 312-233-1131 bill.rudman@ahimafoundation.org

43. Putting it Together: Phase 3 Rachelle Blake 42

44. Methodology Phase 3 Finding Agreement on Common Standards of Competency consists of 3 tasks (future work): Competency Analysis Identifying a curriculum based on competency analysis Identifying a curriculum based on competency analysis Definition and agreement on common standards of competence and professionalisms Definition and agreement on common standards of competence and professionalisms 43 2. Develop Use Cases 3. Create Interactive Tool 1. Draft White Paper (Gap Analysis)

45. 44 Common Standards – Phase 3 Putting it Together Once we complete all of the mapping activities between roles, competencies, curriculum we need to put it together Create a “findings” white paper (including gap analysis, methodologies, etc.) Make recommendations for potential curriculum development – To include formal, informal and on-the job training or in house training Put together a set of use cases to help further the work and position the work for wider consumption Develop Use Cases to help further the work in a more visible way Create an interactive tool for matching EU-US roles with competencies, suggested curricula and measures of competence (idea for final deliverable)

46. 45 Sample of Final Competency Matrix Common Standards – Phase 3 Step 5: Map Skills to Roles

47. Questions 46

48. Resources EU-US eHealth Cooperation Homepage – http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative Join the Mailing List – http://wiki.siframework.org/EU-US+MOU+Roadmap+Project+Sign+Up 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 http://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Reference+Materials Workforce Development Homepage – http://wiki.siframework.org/Workforce+Development+Work+Group http://wiki.siframework.org/Workforce+Development+Work+Group 47

49. Contacts – US Department of Health/ONC Contacts Mera Choi: Mera.Choi@hhs.govMera.Choi@hhs.gov Chitra Mohla: chitra.mohla@hhs.govchitra.mohla@hhs.gov – EU Point of Contacts Benoit Abeloos, Benoit.ABELOOS@ec.europa.eu Benoit.ABELOOS@ec.europa.eu Frank Cunningham, frank.cunningham@ec.europa.eufrank.cunningham@ec.europa.eu – Project Management Team Jamie Parker: jamie.parker@esacinc.comjamie.parker@esacinc.com Gayathri Jayawardena: gayathri.jayawardena@esacinc.comgayathri.jayawardena@esacinc.com Amanda Merrill: amanda.merrill@accenturefederal.comamanda.merrill@accenturefederal.com Christina Nguyen: christina.nguyen@esacinc.comchristina.nguyen@esacinc.com – Subject Matter Experts Rachelle Blake: shelblake@omnimicro.comshelblake@omnimicro.com Nessa Barry: nessa.barry@nhs.netnessa.barry@nhs.net Jean Roberts: jeanhcjean@gmail.comjeanhcjean@gmail.com Michelle Dougherty: michelle.dougherty@ahimafoundation.orgmichelle.dougherty@ahimafoundation.org Susan Fenton: susan.h.fenton@uth.tmc.edususan.h.fenton@uth.tmc.edu 48