Summary Report: Development of a Standard Occupational Classification in Health Informatics

1. Summary Report:Development of a Standard Occupational Classification in Health Informatics HIT Policy Committee’s Certification & Adoption WG Workforce Subgroup Michelle Dougherty, MA, RHIA, CHP; AHIMA Foundation May 2, 2014

2. Purpose of the Summary Report • In absence of the Federal Register Notice and related proposal development, the workgroup will instead: • Develop a summary report of background analysis, findings and recommendations related to an SOC proposal • The purpose is to: • Document our recommendation for a new SOC • Provide background and rationale • Summarize our work defining work performed, skills, education, etc. • Today we will: • Confirm the structure for a summary report on SOC findings • Determine a plan for completion

3. Overall Summary Report Outline • Recommendation for SOC for Health Informatics • Rationale • Background • Description of health IT workforce • Gaps in SOC for health IT workforce occupations • Workforce data • Definition – Health Informatics • Work/Tasks Performed • Work Activities • Knowledge • Summary of Job Titles • Education • Wages and Employment • Professional Organizations and Continuing Education • References/Resources

4. Recommendation: • Addition of a SOC Major Group in Health Informatics • To Do: Need to finalize a recommendation on location in classification system. Options discussed include: • Request New Detailed Occupations to the 15-0000 Computer and Mathematical Occupations (O*NET Classified Nurse Informatics in the Computer and Mathematical Occupations) • Request new minor categories in Healthcare under 29-XXXX (such as 29-3000 Health Informatics) • Build into existing through major classification • Major Group: 29-0000 Healthcare Practitioners and Technical Occupations • Includes 29-2070 Medical Records and Health Information Technicians (Broad Group) • Creates an infrastructure for new subcode (Minor Groups) such as: • Informatics Nurse • Informatics Specialist • Public Health Informatics Specialist • Etc.

5. Rationale and Background • Overview of health IT workforce: • Our broad categorization into buckets: • Clinical • Informatics/Analytics • Information Systems • FYI: NHS UK Matrix of Health Informatics: (https://www.hicf.org.uk/) • Clinical informatics • Information and communication technology • Information management staff • Knowledge management staff • Project and programme management • Education and training • Health records and patient administrators • Analysis of health IT Occupations and Mapping to existing SOCs to identify the gaps • What we learned through our exploration (e.g. how occupations have healthcare designations that are reported) • Identify existing SOCs • Identify Gaps • Identify those that should be updated

6. Rationale and Background (Cont.) • Workforce Data: • Potential sources of information to gather data on the existing workforce

7. Definitions: • We didn’t identify an official definition: • What sources for a definition can be used? • Example from Nursing Informatics Proposal: • Nursing Informatics: Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. The specialty facilitates integration of data, information, and knowledge to support patients, nurses, and other providers in their decision making in all roles and settings through information structures, information processes, and information technology (Staggers & Thompson, 2002). • Informatics Nurse: An informatics nurse is a registered nurse practicing within the specialty of Nursing Informatics. • AMIA: Definition of Biomedical Informatics: • A formal definition of biomedical informatics was developed by AMIA's Academic Forum between 2008 and 2011. The resulting paper, which includes a discussion of the field as well as a delineation of the core competencies for graduate studies in biomedical informatics, was published in JAMIA in 2012 (click here external link). A summary of the definition and competencies is also available elsewhere on the AMIA web site (click here). (http://www.amia.org/about-amia/science-informatics) • Definition from AHIMA’s Health Information Careers: • Health Informatics (HI) is a science that defines how health information is technically captured, transmitted and utilized. Health informatics focuses on information systems, informatics principles, and information technology as it is applied to the continuum of healthcare delivery. It is an integrated discipline with specialty domains that include management science, management engineering principles, healthcare delivery and public health, patient safety, information science and computer technology. Health Informatics programs demonstrate uniqueness by offering varied options for practice or research focus. (http://www.ahima.org/careers/healthinfo?tabid=what) • NHS (UK) Definition of Health Informatics: • Health informatics is defined as "the knowledge, skills and tools which enable information to be collected, managed, used and shared to support the delivery of healthcare and promote health.“ (http://www.connectingforhealth.nhs.uk/systemsandservices/icd/informspec/careerplan/phi/about/hid)

8. Work/Tasks Performed: Summary of previous discussion – editing is still needed (not final): • Design, develop, select, test, implement, support, maintain, and evaluate new or modified informatics solutions, approaches to data management and analysis, and decision-support mechanisms to support patients, public health, health care professionals, and their information management and human-computer and human-technology interactions within health system contexts. • Analyze and interpret patient and organizational, data to improve health systems and services. • Apply knowledge of computer science, information science, decision-science, cognitive-science, organizational theory and management, clinical science, and informatics theory to health-related practice, education (learning), administration, or research. • Liaison between clinicians, public health, and systems engineers, analysts, or designers using object-oriented models or other techniques. • Translate practice information between clinicians, public health, and systems engineers, analysts, or designers using object-oriented models or other techniques.

9. Work/Tasks Performed (Cont.) • Develop strategies, policies or procedures for introducing, evaluating, supporting, maintaining, or modifying information technology applied to health-related practice, administration, education, or research. • Develop or implement policies or practices to ensure the privacy, confidentiality, or security of health information and other health system data. • Identify, collect, record or analyze health-related data used for health system improvement. • Read (and apply) current literature, talk with colleagues, and participate in professional organizations or conferences to maintain competencies and keep abreast of developments in informatics and disciplines. • Provide consultation regarding health information systems use and configuration appropriate to the setting and workflows, i.e., the usability of the technology. • Disseminate information about the science and practice of informatics to the profession, other health care professions, students, policy-makers and the public.

10. Work Activities: Summary of previous discussion – editing is still needed (not final): • Interacting With Computers - Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information. • Communicating with Supervisors, Peers, or Subordinates • Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources. • Organizing, Planning, and Prioritizing Work — Developing specific goals and plans to prioritize, organize, and accomplish your work. • Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job. • Evaluating Information to Determine Compliance with Standards — Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards. • Establishing and Maintaining Interpersonal Relationships • Making Decisions and Solving Problems Analyzing information and evaluating results to choose the best solution and solve problems. • Training and Teaching Others • Analyzing Data or Information — Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts.

11. Knowledge: Summary of previous discussion – editing is still needed (not final): • (Broaden to health related knowledge and broader than) Bio-medical and Health Sciences (public/population health) — Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures. • Customer and Personal Service — Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction. • Computers and Electronics — Macro-Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming. • Education and Training — Knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects. • Administration and Management — Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources. • Communications and Media — Knowledge of media production, communication, and dissemination techniques and methods. This includes alternative ways to inform and entertain via written, oral, and visual media. • Design — Knowledge of design techniques, tools, and principles involved in production of precision technical plans, blueprints, drawings, and models. • Mathematics — Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.

12. Summary of Job Titles Preliminary List – recommended that the titles be categorize into levels: • Business Consultant • Clinical Informatics • Clinical Applications Specialist • Clinical Coordinator • Clinical Informatics Director • Clinical Informatics Specialist • Clinical Informatics Strategist • Clinical Information Systems Director • Consultant • Director Clinical Information Services • Nursing Information Systems Coordinator • Data analyst • Others? • Also investigate: and include information from: • O*NET Public Health Informatician • Include AMIA’s additional job titles • Look at on-line job boards for: • HIMSS • AMIA • AHIMA • General workforce

13. Education: • Overview and Summary of Health Informatics Education Programs: • Summarize the development of informatics academic programs • Education Programs • Schools/Programs • Informatics Curriculum Standards • Accreditation programs • Certification/Credentials • Previously Discussed: • Most of these occupations require at least a four-year bachelor's degree, but some do not. (and many are at the graduate level) • Example Nursing Informatics Proposal: • Nursing Informatics was first recognized as a specialty for which a distinct education was needed in 1988. Since then, NI education has expanded to include twelve master’s programs, nine certificate programs, and four doctoral programs (Utah, Maryland, Arizona, and the Midwest Regional Clinical Nursing and Informatics Consortium, which involves the Universities of Iowa, Wisconsin, Indiana, and Michigan). For details, see the AMIA NIWG website at: http://www.amia.org/working/ni/education/education.html. The American Nurses’ Association Scope and Standards of Nursing Informatics Practice includes competencies for informatics nurse specialists. Staggers et al (2001) defined competencies for informatics nurses at four levels of practice.

14. Summary of Wages and Employment • Employer types • Overview of Wage Information

15. Professional Organizations and Continuing Education • Identify professional organizations • Continuing Education requirements • Examples of Related Professional Conferences • Professional Journals

16. References and Research • Include references on health informatics workforce • Specific recommendations from sub workgroup?

17. Next Steps in Report Development: • Volunteers to assist with development report needed • Divide sections and writing responsibilities • Schedule milestone and meetings for report development • Meetings open to full group to participate • Share drafts for comments • Target Completion Date: • End of June 2014