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1 UWaterloo

The Development of a

Model Curriculum for

Applied Health Informatics

H. Dominic Covvey The University of Waterloo and Balanced View Consulting

Janice E. MacNeillHumber River Regional Hospital

AMIA 2000

2 UWaterloo

A Model Curriculum for Applied Health InformaticsOutline of Presentation

Definition of Applied Health Informatician (AHI) and Our Approach to Curriculum Development.

AHI Macro-Roles, the Challenges Faced by AHIs.

Example AHI Micro-Roles, and Skills and Knowledge for Selected Challenges.

AHI Competency Categories.

Next Steps

The University of Waterloo AHI Diploma Program.

Questions, Answers, and Discussion.

3 UWaterloo

A Model Curriculum for Applied Health Informatics

Working Definition:

Applied Health Informatician

4 UWaterloo

The Need for a Skills-Focused AHI Program Productive Health System AHI Macro-Roles

Based on J. Glaser, AMIA Spring 99 Workshop Strategist and visionary.

Architect: information and systems (e.g., CIS).

Analyst of complex processes (e.g., referral patterns).

Designer (e.g., of efficient systems and processes).

Implementer.

Evaluator.

Manager.

5 UWaterloo

A Model Curriculum for Applied Health Informatics

Our Approach

to

Curriculum Development

6 UWaterloo

A Model Curriculum for Applied Health Informatics Our Approach

Define and characterize present and future AHI Macro-Roles. CIO Director Analyst Internal Consultant

Characterize the Challenges faced by AHIs in performing these roles. IT/IM Strategic Planning. Procurement.

Determine the Micro-Roles (sub-functions or tasks) AHIs must perform to address these challenges (identified a total of 184).

Identify the Skills, Knowledge and Experience (competencies) that will give the AHIs the required capabilities.

Define a Curriculum that imparts the skills, knowledge, and experience.

Local Objective: Design and develop a diploma program at the University of Waterloo (EPHIP).

Equate to job functions

7 UWaterloo

A Model Curriculum for Applied Health Informatics Preliminary Work

Initial planning think-tank in 1994 (Boal, Covvey, Dixon, MacNeill). Defined the AHI role. Recognized the need for significant work to define a “body of skills”,

and an AHI educ. program for people in the field.

Developed early versions of the Macro-Roles, Challenges, etc. template.

Held focus sessions on role-types, challenges, micro-roles, skills. In April 1999, November 1999, January 2000. Results: generated interest, and generated many improvements.

In Summer of 1999 conceptualized the HEALNet curriculum

development process; application for funding submitted in Fall/99.

8 UWaterloo

A Model Curriculum for Applied Health Informatics The Curriculum Development Process

Obtained funding (MRC: COF- 37627) during the late Fall of 1999.

Performed stakeholder analysis and identified potential participants: HI curriculum developers. HI teachers. Potential and current HI students. Employers (health and health-related industries). Representatives of professional organizations. Potential certifiers of HI professionals.

Held a kick-off videoconference to prepare participants for work: 11 locations across the U.S. and Canada participated. Approximately 100 participants.

Developed templates containing straw versions of Macro-Roles, Challenges, and Micro-Roles, as well as some competencies.

9 UWaterloo

A Model Curriculum for Applied Health Informatics The Curriculum Development Process (2)

Organized participants into 3 working groups, each with on-line (led by a facilitator) and offline components. Applied Health Informatics (AHI). [Covvey] Research and Development Health Informatics (RDHI). [Zitner] Clinician Health Informatics (CHI). [Bernstein]

Convened ~10 2-hour on-line workshops involving each working group, beginning in March 2000. Enabled by document and audioconferencing (Sprint’s) Edited and expanded templates; discussed issues. Materials circulated to off-line participants via e-mail.

Held a plenary session of all groups in June 2000 to review progress.

Completed on-line working group sessions in mid-September 2000.

10 UWaterloo

A Model Curriculum for Applied Health Informatics The Curriculum Development Process (3)

Currently are reviewing, collating, and tabulating products. Correlating Challenges with Macro-Roles (which position

faces which challenges). Documenting the Experience required versus each Challenge. Performing individual quality reviews: 1-2 Challenges and their

associated Micro-Roles and Competencies are reviewed for completeness by volunteers with relevant expertise.

Plan to release draft versions of documentation Nov. – Dec. 2000. List of Macro-Roles and their definitions. List of Challenges. List of required Competencies relative to each challenge. Mapping of Macro-Roles to Challenges. Categorized (course-like) Competencies. Guidelines for the definition of graduate level content.

11 UWaterloo

A Model Curriculum for Applied Health Informatics Participants in AHI Curriculum Development

Mary Lou Ackerman, csehc@saintelizabeth.com Sten Ardal, Central East Health Info Partnership, ardal@cehip.org Ann Bolster, bolsta@cma.ca Jennifer Briand, HEALNet, briandj@fhs.csu.mcmaster.ca Heidi Brown, Data General Inc., heidi_brown@dg.com Dominic Covvey*, University of Waterloo, dcovvey@sprynet.com Deborah Del Duca, Cdn. Health Record Assoc., delduca@ibm.net Myrna Francis, IBM, mfrancis@ca.ibm.com Candace Gibson, U. of Western Ontario, candaceg@julian.uwo.ca Alan Goldstein, Meditech, agoldstein@meditech.com Theodore Hoekman, Mem. U. of Nfld., thoekman@morgan.ucs.mun.ca Lewis Hooper, Private Consultant, lewis.hooper@home.com

12 UWaterloo

A Model Curriculum for Applied Health Informatics Participants in AHI Curriculum Development

Steven Huesing, Huesing and Associates, hccc@v-wave.com Carolyn Kay, Canadian Health Record Association, carokay@ibm.net Kent Maclean, CIHI, kmaclean@cihi.ca Janice MacNeill, Humber River Regional Hosp., jmacneill@hrrh.on.ca Naomi Mensink, N Mensink Consulting, nmensink@netcom.ca David Mowat, Health Canada, david_mowat@hc-sc.gc.ca Walter Panko, University of Illinois at Chicago, Wpanko@uic.edu Keith Pearse, University of Alberta, kpearse@utah-inter.net Denis Protti, University of Victoria, School of HIS, dprotti@uvic.ca Annette Valenta, University of Illinois at Chicago, Valenta@uic.edu Toby Walrod, University of Victoria, School of HIS, twalrod@uvic.ca Patrick Yung, Health Information Services Program, yung@siast.sk.ca

13 UWaterloo

A Model Curriculum for Applied Health Informatics

AHI

Macro-Roles

14 UWaterloo

A Model Curriculum for Applied Health Informatics AHI Macro-Roles

IT Leader (CIO, VPIS,) Director IS Clinical Informatician IT/IM Resources/Project Manager Internal Health IT Consultant System/Applications Expert Process Analyst Evaluator Educator/Trainer Programmer-Deployment Support Policy Planner

15 UWaterloo

Challenges Faced by AHIs

A Model Curriculum for Applied Health Informatics

16 UWaterloo

A Model Curriculum for Applied Health Informatics Challenges Faced by AHIs (30)

Collaboration. Understanding of the Nature of the Health System and Current Issues,

and Identification of Desired Outputs. Formulation of IT/IM Components of the Strategic Plan. IT/IM Strategic Business Planning, IT/IM Strategic Market Planning. IT/IM Needs Analysis. Determination of the Organization’s IT/IM Situation (IT/IM Audit). Definition and Implementation of Organizational Approach to IT/IM,

IT/IM Organizational Structure/Culture, and IS Department Structure/Culture.

Determination of the State of the Industry, Analysis of the Competition, and Identification of Viable Vendors and Solutions.

IT/IM Technology Assessment. Evaluation, Adoption, and Implementation of Standards.

17 UWaterloo

A Model Curriculum for Applied Health Informatics Challenges Faced by AHIs (30)

IT/IM-Related Policy Development. Development of the Justification For and the Value of Systems. Obtaining Consensus on Solutions, Budget, Plan. Procurement of Solutions (Products and Services). Re-engineering of Work and Information Management Processes. Implementation of Solutions. Planning and Day-to-Day Management of IT/IM Resources. Management of Other’s (e.g., Population, System) Data (Quality

Audits, Combining Data, Transmission, etc.). Integration of Multiple Systems. Maintenance and Support of Solutions. Evaluation of Solution Outcomes. Management of Change (Acting as Change Agent). User, Customer, Inter-Departmental and Public Liaison, Relations,

Communications, and Publication.

18 UWaterloo

A Model Curriculum for Applied Health Informatics Challenges Faced by AHIs (30)

Evaluation of Solution Outcomes. Management of Change (Acting as Change Agent). User, Customer, Inter-Departmental and Public Liaison, Relations,

Communications, and Publication. Continuing Education. System and Methods Customization and Ad Hoc Development. Utilization of Technology (Personal Productivity, Specific Tools). General Day-to-Day Issues.

19 UWaterloo

A Model Curriculum for Applied Health Informatics

Example AHI Micro-Roles

20 UWaterloo

A Model Curriculum for Applied Health Informatics Micro-Roles: Example (1)

Challenge: Formulation of IT/IM Components of the Strat. Plan Micro-Roles:

Comprehension of Organizational Strategy Interpretation (e.g., Translating IT Concepts + Industry to

Management; bridging) Presentation of Potential Strategic Opportunities for IT/IM Involvement of Senior Management in IT/IM Strategic Planning

Process Involvement of Other Stakeholders in the IT/IM SP Process Development of IT/IM Responses (IT/IM Strategic

Requirements) Strategic Options Analysis Development of Multi-Year Budget Promoting the Plan and Budget Throughout the Organization

and to the Board Management of Expectations

21 UWaterloo

A Model Curriculum for Applied Health Informatics Micro-Roles: Example (2)

Challenge: Procurement of Solutions (Products and Services). Micro-Roles (Non-Vendor):

Mobilization and Mgmt of Stakeholder Participation in the Proc. Process

Development of Statement of Required Capabilities (Functional and Informational), Required Performance, Technologies, Other Requirements, and System Architecture

RFP or Other Procedure for Obtaining Vendor Responses Management and Documentation of Site Visits, Demos, and Other

Assessments Assessment or Defn of Business Ethics Environment and Applic.

Laws Evaluation of Compliance of Vendors’ Offerings with

Requirements and Architecture Identification of Preferred Solutions Preparation and Negotiation of Contracts Contract Finalization and Ordering

22 UWaterloo

A Model Curriculum for Applied Health Informatics

AHI Skills and Knowledge

23 UWaterloo

A Model Curriculum for Applied Health Informatics Example Skills and Knowledge

Challenge: Formulation of IT/IM Components of the Strategic Plan Micro-Role: Comprehension of Organizational Strategy

Skills: Listening Skills, Synthesizing Skills, Systems Thinking

Knowledge: The Nature and Operation of the Health System, Health System Management and Organization, Understanding Corporate Culture (regarding acceptable approaches, methods, values), Principles of Systems Thinking

Micro-Role: Interpretation (e.g., Translating IT Concepts + Industry to Management; bridging)

Skills: Forecasting Skills, Communication Skills, Failure Analysis

Knowledge: IT and IM Basic Concepts, The Nature and Operation of the Health System, The Nature and Capabilities of Health IT/IM Vendors and Products, Principles of Failure Analysis; Knowledge of How Non-Health Organizations Address IT/IM

24 UWaterloo

A Model Curriculum for Applied Health Informatics Example Skills and Knowledge

Challenge: Formulation of IT/IM Components of the Strategic Plan Micro-Role: Presentation of Potential Strategic Opportunities

for IT/IM Skills: Presentation Skills, Data Analysis Skills, Leadership

Skills, Communication Skills, Interpretation, Teaching Skills

Knowledge: The Nature and Capabilities of Health IT/IM Vendors and Products, Infrastructural Technologies, The Nature and Operation of the Health System

  Micro-Role: Involvement of Senior Management in IT/IM

Strategic Planning (SP) Process Skills: Motivation Techniques, Leadership Skills,

Facilitation Skills, Communication Skills Knowledge: Health System Management and Organization,

Understanding Business and Clinical Processes, The IT/IM Strategies of Other Organizations

25 UWaterloo

A Model Curriculum for Applied Health Informatics Skills and Knowledge Elements

Identified: Skills: 203 Knowledge Elements: 167

These were subsumed under 22 “competency categories” that roughly correlate with courses or course modules. Some might be pre-requisites.

26 UWaterloo

A Model Curriculum for Applied Health Informatics

AHI Competency Categories

27 UWaterloo

A Model Curriculum for Applied Health Informatics Competency Categories

We have identified 22 competency categories: Personal Competencies for AHI Professionals General Computing Competencies for AHI Professionals Health Computing Competencies for AHI Professionals Key IT Usage Competencies for AHI Professionals General Health System-Related Competencies General Business and Management Competencies General IS Department Management Competencies Team and Human Resources Management Competencies Re-Engineering and Management of Change Competencies Strategic and Operational Planning Competencies Assessment of the Value, Effects, and Cost of IT

(Competencies)

28 UWaterloo

A Model Curriculum for Applied Health Informatics Competency Categories

We have identified 22 competency categories (2): General Technology/Systems Life-Cycle Management

Competencies Procurement Competencies Systems Implementation and Integration Competencies Systems Maintenance and Support Competencies System Customization/Ad Hoc Development Competencies Project Management Competencies Education and Training Competencies Vendor/Service Provider Competencies User and Process Observation and Assessment Competencies Security Management Competencies Information and Data Collection, Analysis and Management

Competencies

29 UWaterloo

A Model Curriculum for Applied Health Informatics

Example Competency Category

With

Skills and Knowledge

30 UWaterloo

A Model Curriculum for Applied Health Informatics Example Competency Category

Procurement Competencies Skills

Acceptance Testing Method/Procedure Compliance Analysis Techniques Contract Framework Contract Negotiation Technique Procurement Method (Including RFI/Q and RFP Writing,

Site Visit Design and Analysis Technique, Demo Design and Analysis Technique)

Needs Analysis Method Scenario Development Skills User Group Framework User Satisfaction and Acceptance Analysis and

Management Vendor Viability Assessment Framework Vendor/Product Comparison Framework

31 UWaterloo

A Model Curriculum for Applied Health Informatics Example Competency Category

Procurement Competencies Knowledge

Application Domain, Knowledge of Specific Contract Development, Principles of Corporate Strategy and Current Offerings, Knowledge of Health IT Product Knowledge, Basic Health IT/IM Vendors and Products, The Nature and Capab. of Industry Mkting, Promotion, and Sales Techniques, Knowledge of Needs Assessment and Evaluation, Principles of Product/Vendor State-of-the-Art, Knowledge of Products, Knowledge of Specific Requirements, Knowledge of Specific System Testing and Validation, Principles of User Acceptance Analysis, Principles of User Modeling, Principles of Vendor Marketplace, Knowledge of Vendor Values, Knowledge of

32 UWaterloo

A Model Curriculum for Applied Health Informatics

Next Steps

33 UWaterloo

A Model Curriculum for Applied Health Informatics Next Steps

Packaging and Publication of initial products of all 3 curriculum development efforts.

Consultation process: circulation to interested parties for improvement.

Place materials on their permanent website.

Development of a tool for students to determine educational needs.

Development of a tool for recruiters and human resources specialists to determine competency requirements for positions.

34 UWaterloo

A Model Curriculum for Applied Health Informatics

The U of Waterloo

Diploma in AHI Program

35 UWaterloo

A Model Curriculum for Applied Health Informatics Orientation of the U of Waterloo Program

A special emphasis will be placed on the skills component of the curriculum. This will make the program most relevant to AHI practioners.

Individual skill, knowledge, and experience elements will be delivered in the form of short, intense, and well-structured vignettes or “micro-courses” (modules of 1-3 hours) that are introduced via cases.

We believe these micro-courses will be highly suited to adult learning patterns.

They will be presented via distance education techniques (audio plus document conferencing) to address the needs of those already in the field.

For further information, contact: dcovvey@sprynet.com

jmacneill@hrrh.on.ca

36 UWaterloo

A Model Curriculum for Applied Health Informatics

Questions, Answers, and Discussion

37 UWaterloo

A Model Curriculum for Applied Health Informatics

Reserve Slides

38 UWaterloo

A Model Curriculum for Applied Health Informatics The Applied Health Informatician

Information and information technology… Needs and requirements elucidators. Problem characterizers, clarifiers, and solvers. Solution finders and procurers. Solution deployers, implementers, and evaluators. Solution and resources managers.

The AHI is driven by the needs of the health environment.

AHIs must be able: to understand the problem and the need for solutions. To consider alternate solutions and determine the optimal solution deliver the solution that addresses the need.

We contrast this with Theoretical Health Informaticians, who are

fundamentally scientists, conceivers of new knowledge and creators of

new tools, often driven by their own interests.

39 UWaterloo

A Model Curriculum for Applied Health Informatics Health IT Deployment Models

Employers of AHIs: As-Is Technology Deployers Use proven COTS. Are risk aversive. Creativity is focused on implementation and gaining value. Not developers.

Employers of RDHIs: Innovators/Academic Organizations Early adopters (alpha or beta), developers, customizers. Risk takers. Creativity focused on creating functionality and capability. Two types:

True Innovators: develop new solutions. Limited Innovators: adopt bleeding edge solutions.

Hybrids: Mixed approach: mostly COTS, but some development or

customization.

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