1. EU-US eHealth/Health IT Cooperation Initiative Workforce Development Work Group September 5, 2013 0

2. Using the Web Meeting Tool Participants automatically enter the webinar in “listen only” mode. The organizer will then unmute all participants. We ask if you are not speaking to manually mute yourself NOTE: VoIP participants have the ability to “Mute” themselves by clicking on the green microphone. However, if you would like to speak, only you can unmute yourself. If you are dialing in using a telephone and NOT using the VoIP you MUST dial the audio pin in order for the organizer to unmute you – if you do not use the audio pin and just push # when prompted the Organizer cannot unmute you

3. Using the Web Meeting Tool If you are calling from a telephone, please do not put your phone on hold. If you need to take a call, hang up and dial in again when you have completed your other call This meeting is being recorded Another reason to keep your phone or your VoIP on mute when not speaking Use the “Chat” or “Question” feature for questions, comments and items you would like the moderator or other panelists to know. 2

4. New Webinar Information We have switched over to GoToMeetings that allows participants to stream audio directly from their electronic device (VoIP), which provides a more cost-effective telephone/audio service. Participants have the option to join using EITHER VoIP or Telephone but NOT both. Participants will need to register for every meeting. Visit our Wiki homepage for the latest webinar information: http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative. http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative After you “Register,” you will immediately be prompted to “Run” the “Citrix Online Launcher.exe.” By double-clicking this it will automatically “Install” GoToWebinar. If your electronic device does not detect the automatic download, please check your e-mail for a link for manual download instructions. System Requirements: – PC-based attendees require Windows® 8, 7, Vista, XP or 2003 Server – Mac®-based attendees require Mac OS® X 10.6 or newer – Mobile attendees require iPhone®, iPad®, Android™ phone or Android tablet 3

5. Agenda TopicTime Allotted General Announcements5 minutes Review the Workforce Development Wiki5 minutes Defining and Refining Our Work5 minutes Defining Settings20 minutes Defining Competencies and Skills20 minutes Next Steps/Questions5 minutes 4

6. General Announcements The Workforce Development Workgroup meets every Thursday from 10:00am – 11:00am ET or 4:00pm-5:00pm CEST – To participate please see the “Weekly Meetings” Section of the EU-US eHealth Collaboration Wiki Homepage: http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative 5 Note: Please check the meeting schedule weekly to get the most up-to-date meeting information

7. Join the EU-US eHealth/Health IT Cooperation Initiative 6 We encourage all members to “sign up” for the initiative. By joining this ensures you stay up-to-date with the work being done, communications and any initiative activities Simply complete the EU-US MOU Project Signup Form on the Wiki Page: http://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Sign+U p http://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Sign+U p

8. Visit the EU-US eHealth/Health IT Cooperation Initiative Wiki Page 7 For the latest meetings announcements, meeting details and initiative contacts visit our homepage at http://wiki.siframework.org/EU- US+eHealth+Cooperation+Initiative.http://wiki.siframework.org/EU- US+eHealth+Cooperation+Initiative

9. Locating the Workforce Work Group Wiki Page http://wiki.siframework.org/Workforce+Develo pment+Work+Group http://wiki.siframework.org/Workforce+Develo pment+Work+Group 8

10. Meeting Materials 9 For all meeting minutes, presentations, reference materials and recordings please visit the Materials tab and select “Past Meetings” from the drop down menu http://wiki.siframework.org/Project+Meeting+Artifacts. http://wiki.siframework.org/Project+Meeting+Artifacts

11. Defining and Refining Our Work Phase 1: – Proposed Approach Define settings – Select one small setting such as pharmacy, primary care, etc. and then repeat process for other settings to help them run a bit smoother and perhaps faster. Define skills needed to support these settings – as related to HealthIT Map skills to professional roles/titles (should we examine skills then roles or roles and then skills)? Phase 2: Examine what exists to support these roles Phase 3: Gap Analysis Phase 4: Final Recommendations 10

12. Defining Settings Healthcare Setting: The surrounding or environment in which healthcare happens Few examples include long-term care, ambulatory care, rehabilitation, pharmacy, health record banks, diagnostics facilities, public health agencies etc. Task is to brainstorm settings and find one in common and select it as our starting point in order to begin outlining the appropriate skills sets needed to perform the desired tasks in that setting 11

13. Defining Settings CONTINUED Aim for using an area of HI/HIT that is: – stable – does not vary too much with the scale of the facility in which it is provided – is delivered similarly in US and EU – has a relatively common definition on both sides of the Pond Community Comments: – “primary care (family physicians’ health centers etc.) are sufficiently different in EU/US to cloud the HI similarities with differences in the model of care delivery so I suggest these too may not be common bases to start from.” 12

14. Potential Settings Long-term care Ambulatory care Rehabilitation center Pharmacy Acute Care Clinics (Flu, HIV, etc.) Health record banks Diagnostics facilities (e.g. facility that only performs MRIs) Public health agencies Patient Centered Medical Home 13 Mobile Medical Care (healthcare delivered via vehicle transport) – Blood banks buses, vaccinations on wheels, etc. Personal Health Care – Mobile phones etc. – Tele-health (health and social care) Home Health Care Consumer Health – engaging the consumers Primary Care

15. Identified Setting(s) Begin with… 14

16. Now that we have a setting… Look at Competencies from various sources and Map them to the Roles – Use the AMHIA competency list to start Select which competencies map to the setting – Use the spreadsheet provided (slide 20) to plug in competencies to roles as Identified by the EU and US 15

17. Need for Competencies/Skills Several health professionals—from physicians to administrators utilize health IT in their day-to-day activities. This, in turn, has an impact on the broad range of training needed, from basic computer literacy to more sophisticated computer applications and health information management skills; the range of environments in which training will take place, from professional education programs to the workplace itself; and the important role of vendors in the training process. *AHIMA and AMIA. (2008). Joint Work Force Task Force: Health Information Management and Informatics Core Competencies for Individuals Working With Electronic Health Records. (2008). Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_040723.pdf. http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_040723.pdf 16

18. Defining Competencies/Skills As a result a core set of skills will need to be identified for those professionals that will employ eHealth/Health IT in their everyday role Sample core competencies include: – health information literacy and skills; – health informatics skills using the electronic health record (EHR); – privacy and confidentiality of health information; – health information/data technical security; and – basic computer literacy skills. *AHIMA and AMIA. (2008). Joint Work Force Task Force: Health Information Management and Informatics Core Competencies for Individuals Working With Electronic Health Records. (2008). Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_040723.pdf. http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_040723.pdf 17

19. Thoughts on Competencies/ Skills Community Comments: – “There are current activities, for example, to define clinical informatics formally so that it can be recognized by the medical royal colleges – for a medical informatician who operates as a clinical practitioner with some HI responsibilities / activities as well and has embedded skills and competences gained through the medical qualification process, from and additional HI qualification (such as a Masters in HI or higher) or experientially through their work.” – “The above being said, I still think it legitimate that we recognize the differences in regulatory stances US/EU and concentrate on looking at the common skills and competences however they are demonstrated or validated.” – “pharmacy informatics is a very small constituency in the EU, so could I suggest we could start with a more generic one such as a Team Leader or Director of ICT (HIT) or the lead person on a HI Help Desk in a hospital?” 18

20. Review Competencies/Skills Proposed by AMHIA Review AMHIA competencies; see if any map to our identified setting(s); and add any additional competencies. View this spreadsheet on our Wiki: http://wiki.siframework.org/file/detail/AHIMA-AMIA_Matrix_Tool.pdf http://wiki.siframework.org/file/detail/AHIMA-AMIA_Matrix_Tool.pdf *Developed by the American Health Information Management Association (AHIMA) and American Medical Informatics Association (AMIA) 19

21. Mapping EU and US Roles/Titles Found on our Wiki: http://wiki.siframework.org/file/detail/Comparison%20of%20Healthcare%20Worker%20Roles%20in%20US%20a nd%20EU.xlsx http://wiki.siframework.org/file/detail/Comparison%20of%20Healthcare%20Worker%20Roles%20in%20US%20a nd%20EU.xlsx EU Healthcare Worker: http://ec.europa.eu/internal_market/qualifications/regprof/index.cfm?action=professions&quid=1&m ode=asc&pagenum=1&maxrows=15#top http://ec.europa.eu/internal_market/qualifications/regprof/index.cfm?action=professions&quid=1&m ode=asc&pagenum=1&maxrows=15#top US Healthcare Worker: http://library.thinkquest.org/15569/car1a.htmlhttp://library.thinkquest.org/15569/car1a.html 20

22. Identifying Professional Roles/Titles It is important to create a common understanding of health IT titles and roles in order to create a common health IT workforce The UK Health Informatics Career Framework (HICF) describes “the profession in the same way that clinical and other professions in health and care are described and to establish career pathways and development opportunities.” – The HICF is not only designed to help individuals plan their own careers, but also to help managers with team and individual staff development; and to support workforce planning in this important area. – The approach is consistent with other Career Frameworks in health and owned by Skills for Health, the Sector Skills Council for the Health Sector. This means that individuals will be able to plan and develop their careers within and across the different frameworks. Its content is also equally applicable to individuals providing services to the NHS and other health and care organizations as well as those actually employed in health and care organizations – that is, the actual sector or nature of someone’s employment does not preclude them using this framework. *https://www.hicf.org.uk/Index.aspxhttps://www.hicf.org.uk/Index.aspx 21

23. Sample Professional Role/Title Community Suggestion: EU ICT Service Manager – Other indicative job titles: Clinical Systems Manager, Desktop Operations Manager, IT Manager, IT Operational Manager, Service Manager – Job description: An ICT Service Manager takes ownership of and provides a resilient, reliable and effective information communication and technology service so that all staff in an organization are able to rely upon the technology that helps them to do their work. This includes: ensuring that all aspects of the IT architecture and infrastructure are documented, understood and maintained; managing, directing, developing and implementing the IT technical strategy so that it evolves in line with national, regional and local requirements and the organization's corporate strategies and objectives; performance managing third party IT supplier contracts and interaction with all departments to ensure delivery against pre-defined criteria; building and sustaining relationships with IT users; managing software license's; and working closely with all IT users across the organization to ensure service satisfaction and appropriate levels of robustness for all IT applications. – Qualifications: – Degree in a relevant subject or equivalent (or equivalent experience) – Masters degree in a relevant subject or equivalent (or equivalent experience) – Vendor qualifications at Certified Professional and/or Specialist level (e.g. Microsoft Certified IT Professional (MCITP)) – IT Service Management (ITIL V3) Manager’s Bridge – ISEB Practitioner Certificates in IT Service Management – PRINCE2 Practitioner (or equivalent project management methodology) – Qualification at QCF level 4 in management or equivalent (or equivalent experience) *taken from NHs HI Career Framework 22

24. Sample EU Mapping Roles/Titles *https://www.hicf.org.uk/Index.aspx 23

25. Next Steps 24 Workforce Development Work Group will continue to meet every Thursday from 10:00am - 11:00am (ET)/4:00pm - 5:00 pm (CEST) Check the Workforce Development Wikipage regularly for updates: http://wiki.siframework.org/Workforce+Development+Work +Group http://wiki.siframework.org/Workforce+Development+Work +Group Don’t forget we have a new web meeting tool and you will have to REGISTER for each meeting before being supplied the link to access the meeting

26. Workforce Support Leads 25 US Point of Contacts – Mera Choi, Mera.Choi@hhs.govMera.Choi@hhs.gov – 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 – Emily Mitchell, emily.d.mitchell@accenturefederal.comemily.d.mitchell@accenturefederal.com EU Point of Contacts – Mary Cleary: mary@ics.ie mary@ics.ie – Benoit Abeloos, Benoit.ABELOOS@ec.europa.eu Benoit.ABELOOS@ec.europa.eu – Frank Cunningham, frank.cunningham@ec.europa.eufrank.cunningham@ec.europa.eu

27. Questions 26

28. Initiative Resources EU-US Wiki Homepage – http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative Join the Initiative – 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 27

29. Work Group Reference Materials 28 US Health IT Training Curriculum: http://www.onc-ntdc.org/ http://www.healthit.gov/providers- professionals/curriculum-development- centers http://www.onc-ntdc.org/ http://www.healthit.gov/providers- professionals/curriculum-development- centers Community College Training Program: http://www.healthit.gov/providers- professionals/community-college-consortia http://www.healthit.gov/providers- professionals/community-college-consortia University Based Training Program: http://www.healthit.gov/providers- professionals/program-assistance- university-based-training http://www.healthit.gov/providers- professionals/program-assistance- university-based-training Joint Work Force Task Force: Health Information Management and Informatics Core Competencies for Individuals Working With Electronic Health Records: http://library.ahima.org/xpedio/groups/pu blic/documents/ahima/bok1_040723.pdf http://library.ahima.org/xpedio/groups/pu blic/documents/ahima/bok1_040723.pdf Recommendations of the International Medical Informatics Association (IMIA) on Education in Biomedical and Health Informatics. First Revision. http://www.ncbi.nlm.nih.gov/pubmed/200 54502 http://www.ncbi.nlm.nih.gov/pubmed/200 54502 EU UK Health Informatics Career Framework: https://www.hicf.org.uk/ https://www.hicf.org.uk/ UK Council for Health Informatics Professions: www.ukchip.org www.ukchip.org – Pre-recognition of elements from various constituencies are built in, and submitted academic and commercial courses (face-to-face and e- learning) are recognized under the UKCHIP EQAS scheme as meeting UKCHIP standards. – UKCHIP Standards have been cross-mapped to the professional requirements of a number of learned / professional societies, the discipline-specific embedded HI skills necessary in otherwise professionals’ curricula, and organizations and against generic technology standards (such as the EU e-competence framework, SFIA+ requirements) – A number of registrants have been self-assessed for competence, as applied to their own non-UK national situation and have committed to the UKCHIP Code of Professional Conduct. e-ICE NHS England http://www.cln.nhs.uk/eice/online-learning/online-learning http://www.cln.nhs.uk/eice/online-learning/online-learning – commissioned learning materials for clinicians, managers and domain new entrants regarding HI concepts HI Society of Ireland work on EU e-Competence framework; within aegis of CEPIS IT developments – towards eCompetence Framework for eHealth Medicine for Managers is a freely available basic guide to clinical conditions for non-clinical specialists, is of interest to HI professionals also in developing domain knowledge Europe for Patients: http://ec.europa.eu/health- eu/europe_for_patients/health_workforce/ http://ec.europa.eu/health- eu/europe_for_patients/health_workforce/

30. Appendix A Vocabulary and Terminology 29

31. Vocabulary and Terminology 30 Healthcare workforce: Clinical providers Health IT professionals Information management professionals Information technology professionals Clinical engineers Allied healthcare teams or ancillary care providers Public health leaders Administration Knowledge management professionals Education, training, development and research professionals Records management (medical, clinical and organizational) Senior management of health IT facilities and services Project, program and portfolio management professionals Clinical informatics and user experience involvement Baseline- there will not be solely ONE of these markers. It will vary, dependent upon: Role requirements and job specification Technological development, availability and deployment level and domain- specific landscape in the country, constituency or organization Other terms?

32. Appendix B Roles 31

33. Appendix B: Potential List of Roles 32 US Suggested Roles Clinician or public health leader Health information management and exchange specialist Health information privacy and security specialist Research and development scientist Programmers and software engineer Health IT Sub-Specialist Practice workflow and information management redesign specialists Clinician/practitioner consultants Implementation support specialists Implementation managers Technical/software support Trainers *ONC Workforce Development For Universities http://www.healthit.gov/providers- professionals/program-assistance-university-based-traininghttp://www.healthit.gov/providers- professionals/program-assistance-university-based-training ONC Workforce Development for Community Colleges http://www.healthit.gov/providers- professionals/community-college-consortia”http://www.healthit.gov/providers- professionals/community-college-consortia EU Suggested Roles Physician Nurse Practical nurse Laboratory nurse Hospital physicist Clinical engineer Technician Receptionist Statistician Administrative personnel (several types) Manager of the ICT systems Application developer Application specialist Database manager ICT user support person