1. Survey Results of the CIOs, HIM Directors and HIM/HIT Educators in Northern Virginia Spring 2013 1

2. 2

3. Who are you? Government Institutions Federal Military State Clinical Providers Inpatient facilities Outpatient facilities Group Practices HMOs Associations Accreditation organizations Regional Health Information Organizations Regional/State Health Information Management Organizations Medical Society Educators Community Colleges Four year institutions 3

4. Is your organization more closely associated with HIM, HIT, or both? 4

5. In the LAST 12 months, has your organization increased the size of its HIM workforce, decreased the size, or stayed the same? 5

6. In the NEXT 12 months, does your organization plan to increase the size of its HIM workforce, decrease the size, or does it plan to make no change? 6

7. How easy or difficult is it for your organization to hire qualified employees to fill open HIM positions? 7

8. If you answered somewhat or very difficult, why do you believe this is true? “Finding resources with strong understanding of healthcare analytics and ability to align data to produce outcome measures is difficult” “Not enough HIM applicants” “Hard to find qualified HIM staff” “Matching skills to contract requirements is hard to balance; experience is the key” “Applicants do not meet minimum requirements” “Education and experience in the field as well as understanding of HIM vs. HIT” 8

9. Regarding the hiring process, do you tend to? 9

10. What are the top skills that you look for when considering hiring in Health Information Management? – “Coding competency (ICD-9 and 10)” – “Practical experience with data” – “EMR experience” – “Experience across domains: MMIS, PBM, EHR, HIX” – “Specific ICD-10” – “Record analysis knowledge” – “Education/credentials” – “Analytical skills” 10

11. What percentage of your workers are required to possess at least some skills in HIT? 11

12. What necessary skills are your HIM staff lacking? “Analytical skills for data presentation for educating physicians and customer service skills” = Clinicians trained in HIM/HIT “Understanding national standards, IT messaging standards and security standards” = HIT Skills “Knowledge of ICD-10” “Experience” “Education/credentials” 12

13. Which do you consider more of a priority, refining skills of incumbent workers or developing those of new workers? 13

14. Would you like to see more certificate program(s) for incumbent workers? 14 Examples ● “ Coding” ● “Certification in HIM Analytics” ● “Health Information Standards/ Meaningful Use” ● “EMR” ● “Advanced computer skills” =HIT ● “Clinical Informatics Certificate”

15. Does your organization have difficulty addressing the following workforce issues? IssueNo difficulty Some difficulty Great difficulty Providing training programs to keep incumbents current on changing Health IT/Management technologies and healthcare requirements 20%67%13% Providing training opportunities for incumbents to grow and advance 14%57%21% Recruiting employees with appropriate education/skills 13%67%20% 15 Other Issues: “Staff retention and eagerness to improve themselves” “Finding senior, experienced persons in these information domains” “Having staff interested in acquiring more skills”

16. Do HIM and HIT overlap in your organization? Describe how Overwhelmingly “Yes” – “Individuals are cross trained” – “Sometimes use them interchangeably” – “Will use HIT if we cannot attract HIM” – “Work together on projects” – “Our new EMR has caused these two areas to join together to support the EMR” – “Not understanding the difference between HIT & HIM causes various layers of confusion” – “Collaborate on many projects: *Point of service scanning *Forms on Demand *Remote coding” 16

17. Are you aware of academic or technical schools in the northern Virginia region to educate and train in HIM? 17

18. Do you have knowledge of certifications that these schools have? Do you understand what specific skills these programs develop and how they can benefit you? 18

19. Do you have knowledge of certifications that these schools have? Do you understand what specific skills these programs develop and how they can benefit you? 19

20. Do you have knowledge of certifications that these schools have? Do you understand what specific skills these programs develop and how they can benefit you? 20

21. Do you provide externship opportunities to new workers/students? 21 Yes: ○ “Offer several yearly” ○ “Have hired from unpaid clinicals” No ○ “Company policy makes it difficult” ○ “Work too sensitive” ○ “Work requires experience”

22. If “no” are you open to providing opportunities? 22 Comments: “Work/study environment such that they can tie experience to education”

23. What post-graduation certifications would benefit your organization? “Clinical documentation specialist” “Health Informatics” “Coding certificates” “EHR implementation certificate” “EHR is finally becoming a reality. Start with that” “Clinical internal controls” 23

24. What/who is missing from your current workforce that would make the management of health information more useful to your organization? “Clinical documentation improvement specialists” “Leaders able to use HIM data to define an action plan” “Operations manager of HIM” “Preparation for clinical coding transitions and fiscal coding for billing, fraud detection and OHI processes” “Understanding the role of clearinghouses and most common commercial tools” “Awareness of health information management and technology standards” “Engaged workforce familiar with current and new legislation impacting the electronic health record....HITECH, HIPAA, etc.” 24

25. HIT Survey Results 25 respondents 25

26. Who are you? Government Institutions Consulting firms HIT outsourcing Not for profit organizations Clinical Providers Community health centers Inpatient facilities Associations National Professional Educators Community Colleges Four year institutions 26

27. What skills would you like to see your HIT workers possess? “Analytical skills” = HIM “Increased medical terminology” = HIM “Coding knowledge” = HIM “MMIS, PBM, EHR and/or HBE systems” “Meaningful use, HIPAA” = HIM “ICD-10” =HIM “Information security, information messaging standards” “Basic skills” 27

28. Within the context of HIT, describe your workforce needs. Identify and list the specific skills that are required of your HIT workforce. Management Proficiency in EHR Business and requirement analysis Putting “H” in “IT” Modeling Management Proficiency in EHR Business and requirement analysis Putting “H” in “IT” Modeling Technical and Functional Desktop and application support Security and data management Networker and server knowledge Various HIT applications Technical and Functional Desktop and application support Security and data management Networker and server knowledge Various HIT applications 28

29. In the LAST 12 months, has your organization increased the size of its HIT workforce, decreased the size, or stayed the same? 29

30. In the NEXT 12 months, does your organization plan to increase the size of its HIT workforce, decrease the size, or does it plan to make no change. 30

31. How easy or difficult is it for your organization to hire qualified employees to fill open HIT positions? 31

32. If you answered very or somewhat difficult, why do you believe this is true? “Lack of experience with IT standards- HL/7, X12, HIPAA” “Salary and two years of experience causes some issues” “Skilled clinicians and IT resources to assist in EMR implementation” = Clinicians trained in HIM/HIT 32

33. Regarding the hiring process, do you tend to: 33

34. What are the top skills that you look for when considering hiring in Health Information Technology – “Level of computer skills- hardware & software” – “Previous experience in EMR” – “Program management training” 34

35. What necessary skills are your HIT staff lacking? “Clinical knowledge to supplement technology skills” = Clinician “POC specific to our organization” “ICD-10” = HIM “Documentation skills” 35 Why are those workers lacking certain skills? “Programs vary significantly among companies” “Much of HIT is locked in resources that are not familiar with modern tech” “Technology changes too fast”

36. Which is the greater priority- refining skills of incumbents or developing those of new workers? 36

37. Would you like to see more certificate program(s) for incumbent workers? 37 What kind? - “ICD-10” = HIM - “EMR support” - “HIT Career Studies Certificate”

38. Does your organization have difficulty addressing the following workforce issues? IssueNo difficulty Some difficulty Great difficulty Providing training programs to keep incumbents current on changing Health IT/Management technologies and healthcare requirements 13%75%13% Providing training opportunities for incumbents to grow and advance 25%63%13% Recruiting employees with appropriate education/skills 25%63%13% 38 Other Issues: “Students with poor English skills”

39. Do HIM and HIT overlap in your organization? Describe how Overwhelmingly “Yes” – “Individuals are cross trained” – “Sometimes use them interchangeably” – “Will use HIT if we cannot attract HIM” – “Work together on projects” 39

40. Are you aware of academic or technical schools in the northern Virginia region to educate and train in HIT? 40

41. Do you have knowledge of certifications that these schools have? Do you understand what specific skills these programs develop and how they can benefit you? 41

42. Do you have knowledge of certifications that these schools have? Do you understand what specific skills these programs develop and how they can benefit you? 42

43. Do you have knowledge of certifications that these schools have? Do you understand what specific skills these programs develop and how they can benefit you? 43

44. Is there a need for an HIT Associate Degree? (CAHIM MS Certification, cyber security, Health Information Exchanges, Internet exchanges) 44 Is there a need for a bachelor’s degree in HIT? ______________________________________________________________

45. Do you provide externship opportunities to new workers/students? 45 Yes: ○ “Offer several yearly” No ○ “Too busy” ○ “Students not aware of possibilities”

46. If “no” are you open to providing opportunities? 46 Comments: “Provide basic skills” “Print opportunities in bulletins”

47. What post-graduation certifications would benefit your organization? “Program Management Professional (PMP) Training for already degreed person” “Contract specific training” “Clinical Informatics Career Studies Certificate” = Clinicians 47

48. Are there any short, non-certificate, non-degree courses that are needed for incumbent workers? “Medical terminology” = HIM “Excel” “ICD-10” = HIM “Clinical Informatics Health Information Technology” = Clinicians 48

49. So What? There is a need for crossover of skills in HIM and HIT There is a great demand for Analytical Skills training There is a great demand for clinicians trained in informatics There is an overwhelming desire for experienced workers There is more emphasis placed on training incumbent workers than on training new workers. While there is a severe shortage of clinical training opportunities, there is unresponsiveness on the part of employers to provide clinical training opportunities There is a need for post-graduate certifications in both HIM and HIT There is a need for additional training in anatomy, physiology, and medical terminology HIPAA training should be a part of all HIT and HIM programs and refresher trainings for incumbent workers 49

50. 50 Curriculum Advisory Committees

51. Discussion Groups 51

52. 52  Promote collaboration between the HIM and HIT communities  Gain your collective wisdom on these critical questions Our Goals

53. Organizing the Dialogue 53 1.Is there a meaningful difference between the HIT and HIM fields? 2. What constitutes the skill set in Clinical Informatics? 3. What skill/certificates/degrees is industry looking for in new workers? Consider both EHR and NON-EHR related needs. a. www.hicareers.com b. Clinical rotation opportunities

54. Organizing the Dialogue 54 4.What internal workforce (incumbent workers) improvement needs are desirable? Be specific. A. Certificate programs B. EHR related needs C. NON-EHR related needs 5. How can we better prepare our students for the industry? A. What are current needs? B. What are emerging needs? C. EHR related needs? D. NON- EHR related needs? E. Clinical rotations?

55. Organizing the Dialogue 55 6. NoVaHealthFORCE Focus Group on HIT/HIM workforce needs in Northern Virginia A. Discussion with Boston –based Jobs for the Future study principals B. Focus group for 2013 HealthFORCE study update. C. Your input for the study will influence its outcome