The Health Information Technology Workforce

Summary

Background: There is increasing recognition that a competent and well-trained workforce is required for successful implementation of health information technology.

Methods: New and previous research was gathered through literature and Web searching as well as domain experts. Overall themes were extracted and specific data collated within each.

Results: There is still a paucity of research concerning the health information technology workforce. What research has been done can be classified into five categories: quantities and staffing ratios, job roles, gaps and growth, leadership qualifications, and education and competencies. From several countries it can be seen that substantial numbers of individuals are needed with diverse backgrounds and competencies.

Conclusions: Additional research is necessary to determine the optimal organization and education of the health information technology workforce.

Citation: Hersh W. : The health information technology workforce: Estimations of demands and a framework for requirements. Appl Clin Inf 2010; 1: 197–212 http://dx.doi.org/10.4338/ACI-2009-11-R-0011

Keywords

Health information technology - biomedical and health informatics - clinical informatics - workforce

• References

• 1 Eardley T. NHS Informatics Workforce Survey. 2006. ASSIST; London, England.: http://www.bcs.org/upload/pdf/finalreport_20061120102537.pdf
• 2 Legg M and Lovelock B. A Review of the Australian Health Informatics Workforce. 2009. Health Informatics Society of Australia; Melbourne, Australia.: http://www.hisa.org.au/files/File/Australian_Health_Informatics_Workforce_Review_v1_1.pdf
• 3 O’Grady J. Health Informatics and Health Information Management: Human Resources Report. 2009. Prism Economics and Analysis; Toronto, Ontario.: http://www.ictc-ctic.ca/uploadedFiles/Labour_Market_Intelligence/E-Health/HIHIM_report_E_web.pdf
• 4 Monegain B. Health IT effort to create thousands of new jobs, says Blumenthal, Healthcare IT News. October 6, 2009. http://www.healthcareitnews.com/news/health-it-effort-create-thousands-new-jobs-says-blumenthal
• 5 Hersh W, Margolis A, Quirós F, and Otero P. Building a health informatics workforce in developing countries. Health Affairs 2010; 29: 274-277.
• 6 Hersh W. Health and Biomedical Informatics: Opportunities and Challenges for a Twenty-First Century Profession and its Education. in: IMIA Yearbook of Medical Informatics 2008. Geissbuhler A and Kulikowski C. editors. 2008: 138-145. Schattauer; Stuttgart, Germany.:
• 7 Han YY, Carcillo JA, Venkataraman ST, Clark RS, Watson RS, Nguyen TC. et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics 2005; 116: 1506-1512.
• 8 Phibbs CS, Milstein A, Delbanco SD, and Bates D. No proven link between CPOE and mortality. Pediatrics. 2005 http://pediatrics.aappublications.org/cgi/eletters/116/6/1506
• 9 Sittig DF, Ash JS, Zhang J, Osheroff JA, and Shabot MM. Lessons from "unexpected increased mortality after implementation of a commercially sold computerized physician order entry system". Pediatrics 2006; 118: 797-801.
• 10 DelBeccaro MA, Jeffries HE, Eisenberg MA, and Harry ED. Computerized provider order entry implementation: no association with increased mortality rates in an intensive care unit. Pediatrics 2006; 118: 290-295.
• 11 Longhurst C, Sharek P, Hahn J, Sullivan J, and Classen D. Perceived increase in mortality after process and policy changes implemented with computerized physician order entry. Pediatrics 2006; 117: 1450-1451.
• 12 Jacobs BR, Brilli RJ, and Hart KW. Perceived increase in mortality after process and policy changes implemented with computerized physician order entry. Pediatrics 2006; 117: 1451-1452.
• 13 Rosenbloom ST, Harrell FE, Lehmann CU, Schneider JH, Spooner SA, and Johnson KB. Perceived increase in mortality after process and policy changes implemented with computerized physician order entry. Pediatrics 2006; 117: 1452-1455.
• 14 Ash JS, Stavri PZ, Dykstra R, and Fournier L. Implementing computerized physician order entry: the importance of special people. International Journal of Medical Informatics 2003; 69: 235-250.
• 15 Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E. et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine 2006; 144: 742-752.
• 16 Goldzweig CL, Towfigh A, Maglione M, and Shekelle PG. Costs and benefits of health information technology: new trends from the literature. Health Affairs 2009; 28: w282-w293.
• 17 Monegain B. Healthcare IT: is it a breed apart? Healthcare IT News. September 2004: 4. http://www.healthcareitnews.com/story.cms?id=1522
• 18 Sable JH, Hales JW, and Bopp KD. Medical informatics in healthcare organizations: a survey of healthcare information managers. Proceedings of the AMIA 2000 Annual Symposium 2000; 745-748. Los Angeles, CA: Hanley & Belfus.
• 19 Detmer DE, Lumpkin JR, and Williamson JJ. Defining the medical subspecialty of clinical informatics. Journal of the American Medical Informatics Association 2009; 16: 167-168.
• 20 Anonymous.. Standard Occupational Classification (SOC) User Guide. 2004. US Department of Labor -Bureau of Labor Statistics; Washington, DC.: http://www.bls.gov/soc/socguide.htm
• 21 DalPoz MR, Kinfu Y, Dräger S, and Kunjumen T. Counting health workers: definitions, data, methods and global results, in Background Paper for the World Health Report 2006. 2006. World Health Organization; Geneva, Switzerland.: http://www.who.int/hrh/documents/counting_health_workers.pdf
• 22 Wing P, Langelier M, Continelli T, and Armstrong D. Data for Decisions: the HIM Workforce and Workplace - 2002 Member Survey. 2003. American Health Information Management Association; Chicago, IL.: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_018947.pdf
• 23 Leviss J, Kremsdorf R, and Mohaideen MF. The CMIO - a new leader for health systems. Journal of the American Medical Informatics Association 2006; 13: 573-578.
• 24 Anonymous.. Nationwide Health Information Network (NHIN) Workforce Study. 2007. Altarum Institute; Ann Arbor, MI.: http://aspe.hhs.gov/sp/reports/2007/NHIN/NHINReport.pdf
• 25 Shaffer V.U.S. Integrated Delivery System IT Budget and Staffing Survey, 2008. 2008. Gartner; Stamford, CT.:
• 26 Hersh WR and Wright A. What workforce is needed to implement the health information technology agenda? An analysis from the HIMSS Analytics™ Database. AMIA Annual Symposium Proceedings. 2008; 303-307. Washington, DC: American Medical Informatics Association.
• 27 Shaffer V and Lovelock JD. Results of the Gartner-AMDIS Survey of Chief Medical Informatics Officers. 2009. Gartner; Stamford, CT.:
• 28 Anonymous.. Medical Records and Health Information Technicians, in Occupational Outlook Handbook, 2010-11 Edition. 2009. Bureau of Labor Statistics; Washington, DC.: http://www.bls.gov/oco/ocoS103.htm
• 29 Covvey HD, Zitner D, and Bernstein R. Pointing the Way: Competencies and Curricula in Health Informatics. 2001. University of Waterloo; Waterloo, Ontario, Canada.: http://www.cs.uwaterloo.ca/health_info/health_docs/CurriculaMASTERDocumentVersion1Final.zip
• 30 Hersh W. A stimulus to define informatics and health information technology. BMC Medical Informatics & Decision Making 2009; 9: 24. http://www.biomedcentral.com/1472-6947/9/24
• 31 Hersh WR. Who are the informaticians? What we know and should know. Journal of the American Medical Informatics Association 2006; 13: 166-170.
• 32 Joyub R. The Professionalisation of Health Informatics in the United Kingdom, UK Health Informatics Today. Spring; 2004. 42 1-2 4. http://www.bmis.org/ebmit/2004_42_spring.pdf
• 33 Anonymous.. Making information count: a human resources strategy for health professionals. 2002. UK Department of Health; London, England.: http://www.dh.gov.uk/assetRoot/04/07/30/84/04073084.pdf
• 34 Anonymous.. Scope and Standards of Nursing Informatics Practice. 2008. Washington, DC: American Nurses Association.;
• 35 Gardner RM, Overhage JM, Steen E, Munger BS, Holmes JH, Williamson JJ. et al. Core content for the subspecialty of clinical informatics. Journal of the American Medical Informatics Association 2009; 16: 153-157.
• 36 Safran C, Shabot MM, Munger BS, Holmes JH, Steen EB, Lumpkin JR. et al. ACGME program requirements for fellowship education in the subspecialty of clinical informatics. Journal of the American Medical Informatics Association 2009; 16: 158-166.
• 37 Detmer DE, Munger BS, and Lehmann CU. Medical informatics board certification: history, current status, and predicted impact on the medical informatics workforce. Applied Clinical Informatics 2010; 1: 11-18. doi: 10.4338/ACI-2009-11-R-0016.
• 38 Safran C and Detmer DE. Computerized physician order entry systems and medication errors. Journal of the American Medical Association 2005; 294: 179.
• 39 Friedman CP. Building the Health Informatics Workforce. 2008. University of California Davis Invited Presentation; Sacramento, CA.:
• 40 Anonymous.. The EHR Adoption Model. 2007. Healthcare Information Management and Systems Society; Chicago, IL: http://www.himssanalytics.org/docs/EMRAM_att_corrected.pdf
• 41 Davis MW. The State of U. S. Hospitals Relative to Achieving Meaningful Use Measurements. 2009. HIMSS Analytics; Chicago, IL: http://www.himssanalytics.org/docs/HA_ARRA_100509.pdf
• 42 Conn J. In IT it pays to think big –survey puts metrics to medical informatics. Modern Physician 7: 18-19.
• 43 Stevens M. CMIO 2010 Compensation Survey: The Results Are In!. CMIO Magazine. February, 2010. 4-7. http://www.cmio.net/index.php?option=com_articles&view=article&id=20446
• 44 Anonymous.. Building the Work Force for Health Information Transformation. 2006. American Health Information Management Association and American Medical Informatics Association; Chicago, IL and Bethesda, MD.: http://www.ahima.org/emerging_issues/Workforce_web.pdf.
• 45 Anonymous.. Crossing the Quality Chasm: A New Health System for the 21st Century. 2001. Washington, DC: National Academies Press.;
• 46 Huang QR. Competencies for graduate curricula in health, medical and biomedical informatics: a framework. Health Informatics Journal 2007; 13: 89-103.
• 47 Greiner AC and Knebel E. eds. Health Professions Education: A Bridge to Quality. 2003. National Academies Press; Washington, DC.:
• 48 Nemko M. Ahead-of-the-Curve Careers, US News & World Report. December 19, 2007. http://www.usnews.com/articles/business/best-careers/2007/12/19/ahead-of-the-curve-careers.html
• 49 Duncan KA, Austing RH, Katz S, Pengov RE, Pogue RE, and Wasserman AI. Health Computing: Curriculum for an emerging profession –report of the ACM curriculum committee on health computing education. Proceedings of the 1978 ACM Annual Conference/Annual Meeting. 1978; 277-285. Washington, DC: ACM Press. http://portal.acm.org/ft_gateway.cfm?id=804112&type=pdf&coll=GUIDE&dl=GUIDE&CFID=47975758&CFTOKEN=19987037
• 50 Haux R, Dudeck J, Gaus W, Leven FJ, Kunath H, Michaelis J. et al. Recommendations of the German Association for Medical Informatics, Biometry and Epidemiology for education and training in medical informatics. Methods of Information in Medicine 1992; 31: 60-70.
• 51 Anonymous.. Medical School Objectives Project: Medical Informatics Objectives. 1999. Association of American Medical Colleges; Washington, DC.: http://www.aamc.org/meded/msop/start.htm
• 52 Anonymous.. Recommendations of the International Medical Informatics Association (IMIA) on education in health and medical informatics. Methods of Information in Medicine 2000; 39: 267-277. http://www.imia.org/pubdocs/rec_english.pdf
• 53 Anonymous.. Health Informatics Competency Profiles for the NHS. 2001. National Health Service Information Authority; London, England.: http://www.nhsia.nhs.uk/nhid/pages/resource_informatics/hi_competencyprofiles.pdf
• 54 Staggers N, Gassert CA, and Curran C. A Delphi study to determine informatics competencies at four levels of practice. Nursing Research 2002; 51: 383-390.
• 55 O’Carroll PW. Informatics Competencies for Public Health Professionals. 2002. Northwest Center for Public Health Practice; Seattle, WA.: http://www.cphi.washington.edu/resources/competencies-professionals.pdf
• 56 Curran CR. Informatics competencies for nurse practitioners. AACN Clinical Issues 2003; 14: 320-330.
• 57 Johnson LA. Biomedical informatics training for dental researchers. Advances in Dental Research 2003; 17: 29-33.
• 58 Friedman CP, Altman RB, Kohane IS, McCormick KA, Miller PL, Ozbolt JG. et al. Training the next generation of informaticians: the impact of ‘BISTI’ and bioinformatics; a report from the American College of Medical Informatics. Journal of the American Medical Informatics Association 2004; 11: 167-172.
• 59 Anonymous.. Standards for Health Information Management Education –Baccalaureate Degree Program Standards. 2005. Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM); Chicago, IL.: http://library.ahima.org/xpedio/groups/public/documents/accreditation/bok1_026307.pdf
• 60 Anonymous.. Standards for Health Information Management Education -–Associate Degree Program Standards. 2005. Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM); Chicago, IL.: http://library.ahima.org/xpedio/groups/public/documents/accreditation/bok1_026306.pdf
• 61 McNeil BJ, Elfrink VL, Pierce ST, Beyea SC, Bickford CJ, and Averill C. Nursing informatics knowledge and competencies: a national survey of nursing education programs in the United States. International Journal of Medical Informatics 2005; 74: 1021-1030.
• 62 Garde S and Hovenga E. Australian Health Informatics Educational Framework. 2006. Australian College of Health Informatics; Brunswick East, Australia.: http://www.achi.org.au/documents/publications/Health_Informatics_Educational_Framework_20060326.pdf
• 63 Ivanitskaya L, O’Boyle I, and Casey AM. Health information literacy and competencies of information age students: results from the interactive online Research Readiness Self-Assessment (RRSA). Journal of Medical Internet Research 2006; 8 (Suppl. 02) e6.
• 64 http://www.jmir.org/2006/2/e6
• 65 Anonymous.. Health Informatics National Occupational Standards. 2007. UK Council for Health Informatics Professions; London, England.: http://www.hinos.org.uk.
• 66 Anonymous.. Health Information Science Knowledge and Skills. 2007. Medical Library Association; Chicago, IL.: http://www.mlanet.org/education/platform/skills.html
• 67 Pigott K, deLusignan S, Rapley A, Robinson J, and Pritchard-Copley A. An informatics benchmarking statement. Methods of Information in Medicine 2007; 46: 394-398.
• 68 Anonymous.. Health Informatics Professional Core Competencies. 2007. COACH; Canada’s Health Informatics Association: Toronto, Ontario.: http://www.coachorg.com/opendoc.asp?docID=1179
• 69 Gassert CA. Technology and informatics competencies. Nursing Clinics of North America 2008; 43: 507-521.
• 70 Hersh W. AMIA-OHSU 10x10 Program –Logistics, Accessing Demo, Detailed Curriculum, Learning Objectives, and Additional Information. 2009. Oregon Health & Science University; Portland, OR.: http://www.billhersh.info/10x10.html
• 71 Gugerty B and Delaney C. TIGER Informatics Competencies Collaborative (TICC) Final Report. 2009 Technology Informatics Guiding Educational Reform (TIGER) Initiative. http://tigercompetencies.pbworks.com/f/TICC_Final.pdf
• 72 Anonymous. HIT Workforce Competencies by Role. 2009 Office of the National Coordinator for Health IT. Washington, DC.: http://healthit.hhs.gov/portal/server.pt?open=18&objID=888534&parentname=CommunityPage&parentid=15&mode=2&in_hi_userid=11113&cached=true
• 73 Anonymous.. Public Health Informatics Competencies. 2009. Centers for Disease Control and Prevention; Atlanta, GA.: http://www.cdc.gov/InformaticsCompetencies/downloads/PHI_Competencies.pdf
• 74 Mantas J, Ammenwerth E, Demiris G, Hasman A, Haux R, Hersh W. et al. Recommendations of the International Medical Informatics Association (IMIA) on education in biomedical and health informatics –1st revision. Methods of Information in Medicine 2010; 49: 105-120.