HITECH Career Development Panel Presentation

1. HITECH Career Development HITECH Career Development Panel Presentation Facilitated by: Linda Renn, RHIT, CCS, CPC, CPC-H Vice President Education and Communications STAT Solutions, Inc. HITECH Trainer Graduate FHIMA Annual Conference July 12, 2011 Orlando, Florida

2. HITECH Career Development YouTube - Exponential Times

3. Moving From Paper to Paperless

4. From Being Isolated to Connected

5. Vision for HIM Today To create qualified workers who will help establish, adapt and maintain EHR systems in health care facilities to facilitate data sharing and improve patient care!

6. Job Proof Your Skills Today • Prepare yourself today to play an integral role in the implementation of electronic health records within your healthcare organization or for your healthcare provider. • The education being provided is designed to be completed in 6 months or less and allows you to focus on one of the following workforce roles: • Practice workflow and information management redesign specialist • Clinician/practitioner Consultant • Implementation Support Specialist • Implementation Manager • Technical/Software Support Staff • Trainer

7. Non-degree Health Information Technology Training programs are available - began September 30, 2010 All training programs are online. Programs will be completed in six months or less. After successful completion of a training program, you will receive a certificate of completion and, You’ll be eligible to take the national HIT-PRO competency certification exam. Job placement assistance will be available. Students may qualify for a stipend. HITECH Training & Certification

8. HITECH Career Development COMMUNITY COLLEGE CONSORTIA Purpose: To Educate Health Information Technology Professionals through all online, non‐degree health IT training programs that students can complete in six months or less. Goal: To train more than 10,500 new health IT professionals annually by 2012 and provide US with increased workforce of skilled health IT specialists to support providers as they transition to electronic health records. • More than 70 community colleges in all 50 states • Nationally developed curriculum • Received $36 million in grants from the Office of the National Coordinator

9. HITECH Career Development • Your Panel Members this Morning are: • Santa Fe College: • Julie A. Shay, RHIA • Health Information Technology Management Program Director • HITECH Workforce Training Program Co-Director • julie.shay@sfcollege.edu • Indian River State College: • DeVonica “DeDe” Vaught, RHIA • Health Information Technology Management Program Director • HITECH Workforce Training Program Director • dvaught@irsc.edu • Broward College: • Charline “Charlee” Bumgardner, RHIT • Health Information Management Program Manager • HITECH Workforce Training Program Advisor • cbumgard@broward.edu

10. HITECH Careers – Santa Fe College Introducing… Julie A. Shay, RHIA Health Information Technology Management Programs Program Director Presenting: HIM Team of Now and Future and Process Re-Engineering

11. HITECH Careers – Santa Fe College • HIM Team of Now and Future • ARRA’s emphasis on electronic medical records will create shift in workforce. • Estimates based on data from the Bureau of Labor Statistics, Department of Education, and independent studies indicate a shortfall of approximately 50,000 qualified health IT workers required to meet the needs of hospitals and physicians as they move to adopt electronic health care systems by 2015.

12. HITECH Careers – Santa Fe College • Workforce Shift within HIM Profession, as we shift from manual processes to automated processes, will create the need for the following: • Need for advanced credentials such as Certified Health Data Analyst(CHDA) and Healthcare Privacy and Security Certification(CHPS) • Health IT Advanced Training/HIT Pro Competency Exam • Experience with multiple electronic medical record software systems.

13. HITECH Careers – Santa Fe College What jobs will look like as we move from HIM to HITM • Certified Health Data Analyst • Project Management such as E H R Implementation Managers • Electronic Record Analyst • Practice Workflow Redesign Specialists

14. HITECH Careers – Santa Fe College Workflow Process Analysis and Redesign Procedure, like dance, resists description. -Tom DeMarco 1978 Note: Concepts are taken from HIT10 component curriculum.

15. HITECH Careers – Santa Fe College Objectives What is it and why do we do it? Is Process Analysis and Redesign related to meaningful use? Let’s put it all together. Analyze a healthcare scenario Clinical workflow components Review Angel HITComp10

16. HITECH Careers – Santa Fe College • Why is Health Care Process Analysis and redesign important? • 98,000 or more people die annually in the US due to medical errors. (Crossing the Quality Chasm) • Lack of information and care fragmentation • Meaningful use of Health IT will decrease this number. • HOW do we get there and WHAT do we need to do?

17. HITECH Careers – Santa Fe College • Process Analysis involves: • Understanding process elements and the relationships between them AND • Identifying OPPORTUNITIES for improvement • 6 Quality Aims for the redesign: • Safe Timely • Effective Patient Centered • Efficient Equitable

18. HITECH Careers – Santa Fe College • Meaningful use Requirement Examples • >= 80% of all orders directly entered by authorizing provider • >=75% of all permissible medication orders are electronically prescribed

19. HITECH Careers – Santa Fe College • 5 National Health Priorities • Improve quality, safety and efficiency and reduce health disparities • Engage patients and families • Improve care coordination • Improve population and public health • Ensure adequate privacy and security protections for PHI

20. HITECH Careers – Santa Fe College

21. HITECH Careers – Santa Fe College

22. HITECH Careers – Santa Fe College

23. HITECH Careers – Indian River State College Introducing… DeVonica “DeDe” Vaught, RHIA Health Information Technology Management Program Director • HITECH Workforce Training Program Director Presenting HIM Hot Topics: Legal Electronic Health Records and Electronic Health Record Data Integrity & Quality

24. HITECH Careers – Indian River State College What is a Legal Electronic Health Record? Legal Health Record: Business record that is generated at or for a healthcare organization that documents the clinical care of a patient. Electronic Health Record: Health information that is recorded on any type of digital medium that documents transactions that have a legal or business value

25. HITECH Careers – Indian River State College • What should be included • Information that would be disclosed • Advanced Directives • History & Physical • Consultation Reports • Progress Notes • Provider Orders • Anesthesia Records • Discharge Summaries

26. HITECH Careers – Indian River State College • What should be included • Information that is maintained for governmental, licensing or accrediting requirements • JCAHO • Medicare COP • FDA • State Licensing Boards • State Pharmacy Requirements • Information that is required for third party payors

27. HITECH Careers – Indian River State College • What should NOT be included • Administrative Data • Audit Trails • Insurance Forms • Indices • Logs • Worksheets • Abbreviation Lists • Derived Data • Statistical Reports • Best Practice Guidelines • Accreditation Reports

28. HITECH Careers – Indian River State College Issues with Electronic Health Records • Data Integrity • Pay for Performance • More visible to patients • Meaningful use • Solutions • Training • Analyze situations appropriately • Clinician adoption

29. HITECH Careers – Indian River State College Issues with Electronic Health Records • Quality Issues • Errors • Adverse Effects • Increased Costs • Solutions • Standardized Documentation Procedures • Data Standards • Access Permissions

30. HITECH Careers – Indian River State College HITECH Workforce Program

31. HITECH Careers – Broward College Introducing… Charline “Charlee” Bumgardner, RHIT Health Information Management Program Manager HITECH Workforce Training Program Advisor Presenting HIM Hot Topics: HITECH SECURITY Health Information Technology Security

32. HITECH Careers – Broward College • What is HITECH Security? • Technology • Methodology • What is not HITECH Security? • Soft skills • Personnel background screening • How does it impact HIM? • Need to advance knowledge and skill sets • Become the leaders and content experts in this area

33. HITECH Careers – Broward College Confidentiality: Network security protocols, Network authentication services and data encryption services CIA TRIAD* Integrity: Firewall, communication and intrusion detection services Availability: Back-ups, redundant disk systems, acceptable logins and operating process performance * National Institute of Standards and Technology (NIST) An Introduction to Computer Security: The NIST Handbook • What is HITECH Security? • Securing by technology and methodology to prevent breach of confidentiality, integrity and availability * of ePHI (electronic protected health information)

34. HITECH Careers – Broward College • What is HITECH Security? (continued) • Access Control • Identification - Who are you? • Authentication – Prove it • Authorization – Permission • Accounting – What are you doing? • Complex password • Wall Street Journal did a survey of passwords and found that the 2 top passwords were 123456 and password.

35. HITECH Careers – Broward College • What is HITECH Security? (continued) • Physical Security • Business Continuity Planning and Disaster Recovery Planning • Law, Investigations and Ethics • Putting systems in place and training • And much more……

36. HITECH Careers – Broward College HITECH Security As of March 17, 2011, OCR had posted on its Web site 249 breaches that had impacted 8,289,236 individuals reported by covered entities (09/22/09— 01/12/11). Forty-eight cases reported by covered entities—19.3%–were breaches that involved a business associate.  Approximately 75% (177) of the total involved electronic protected health information (PHI) and 25% (58) hard copy formatted PHI.  Several reported breaches involved electronic and hard copy formatted PHI.

37. HITECH Careers – Broward College HITECH Security 3/14/2011 Health Net Inc.* has launched an investigation into a security breach that may have compromised personal data for 1.9 million current and former members. The investigation follows notification by IBM, Health Net’s information technology vendor, that it could not locate several server drives. *Health Net Inc. insurance carrier out of CA

38. HITECH Careers – Broward College HITECH Security • 2010 Massachusetts General Hospital settled with the DHHS to a pay a $1 million fine for a patient data security breach that was not caused by a hacker breaking into its system. Instead, HHS said, it was caused by an employee who inadvertently left a stack of paper files on a subway train on the way to work.

39. HITECH Careers – Broward College 2010 AvMed Health Insurance Company has been hit with a class action lawsuit for allowing millions of its customers’ personal medical data to be exposed to theft. Approximately 1.2 million AvMed Health Plan members are estimated to have had their health records exposed in what is being called one of the largest medical record breaches in history.

40. HITECH Careers – Broward College HITECH Security Kaufman, Rossin & Co., an accounting firm in South Florida, analyzed 166 breaches affecting 500 or more patients that were reported to HHS' Office for Civil Rights from September 2009 to September 2010 and found that theft and loss were the leading causes.

41. HITECH Careers – Broward College Not including the costs of Health Insurance Portability and Accountability Act (HIPAA) enforcement and the negative publicity involved with data breaches, the cost of a health care data breach is rising.

42. HITECH Careers – Broward College • How much? • according to a recent survey commissioned by Experian and conducted by security research experts at the *Ponemon Institute • $20,663 to resolve a case of medical identity theft • * Ponemon Institute conducts independent research on privacy, data protection and information security policy

43. HITECH Careers – Broward College • February 2010, survey conducted • 98% of survey respondents have a policy in place to limit the disclosure of PHI • 52% employ encryption technologies to render data unreadable or unusable in case of unauthorized access • 40% reported there is clear and broad awareness of new civil and criminal penalties under ARRA

44. HITECH Careers – Broward College • What is not HITECH Security? • Soft skills • Training • Communication • Awareness of security • Policy and Procedures • Enforcement

45. HITECH Careers – Broward College • 2008 AHIMA & American Medical Informatics Association (AMIA) published core competencies expected of healthcare workforce that use EHRs • Health information literacy and skills • Health informatics skills using EHR • Privacy and confidentiality of health information • Health information/data technical security • Basic computer literacy skills

46. HITECH Careers – Broward College • How does it impact HIM? • Where will we be? • Focus is on HIM as a key player • Educators • HOW DOES HITECH IMPACT… YOU?

47. HITECH Careers – Broward College One of the courses in the program series • HCT0005 HISTORY H.I.T. IN US • Traces the development of IT systems in health care and public health, beginning with the experiments of the 1950s and 1960s and culminating in the HITECH Act and concludes with the introduction of the concept of meaningful use with Phase I.

48. HITECH Careers – Broward College HITECH Security History of Health Information Technology in the United States Course is essential and is part of all 6 workforce role training

49. HITECH Careers – Broward College • HITECH Security • History of Health Information Technology in the United States • This course addresses essential knowledge issues related • Health Information Security, Privacy and Confidentiality • HITECH Act impact on HIPAA • 2009 Changes • HITECH Security Breach Notification Requirements • Breaches impacting < 500 individual • Breaches impacting > 500 individuals

50. HITECH Careers – Broward College • HITECH Security • History of Health Information Technology in the United States • This course addresses essential knowledge issues related - continued • HIPAA Security Rule • Access control • Audit Trails • Disaster Recovery • Encryption and Viral Protection • Encoded Authentication • Sanctions