AMIA 2000

1. AMIA 2000 The Development of a Model Curriculum for Applied Health Informatics H. Dominic Covvey The University of Waterloo and Balanced View Consulting Janice E. MacNeill Humber River Regional Hospital

2. 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. A Model Curriculum for Applied Health Informatics Working Definition: Applied Health Informatician

4. The Need for a Skills-Focused AHI ProgramProductive 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. A Model Curriculum for Applied Health Informatics Our Approach to Curriculum Development

6. A Model Curriculum for Applied Health InformaticsOur 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. A Model Curriculum for Applied Health InformaticsPreliminary 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. A Model Curriculum for Applied Health InformaticsThe 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. 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. A Model Curriculum for Applied Health InformaticsThe 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. A Model Curriculum for Applied Health InformaticsParticipants 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. A Model Curriculum for Applied Health InformaticsParticipants 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. A Model Curriculum for Applied Health Informatics AHI Macro-Roles

14. A Model Curriculum for Applied Health InformaticsAHI 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. A Model Curriculum for Applied Health Informatics Challenges Faced by AHIs

16. A Model Curriculum for Applied Health InformaticsChallenges 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. A Model Curriculum for Applied Health InformaticsChallenges 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. A Model Curriculum for Applied Health InformaticsChallenges 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. A Model Curriculum for Applied Health Informatics Example AHI Micro-Roles

20. A Model Curriculum for Applied Health InformaticsMicro-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. A Model Curriculum for Applied Health InformaticsMicro-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. A Model Curriculum for Applied Health Informatics AHI Skills and Knowledge

23. A Model Curriculum for Applied Health InformaticsExample 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. A Model Curriculum for Applied Health InformaticsExample 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. A Model Curriculum for Applied Health InformaticsSkills 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. A Model Curriculum for Applied Health Informatics AHI Competency Categories

27. A Model Curriculum for Applied Health InformaticsCompetency 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. A Model Curriculum for Applied Health InformaticsCompetency 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. A Model Curriculum for Applied Health Informatics Example Competency Category With Skills and Knowledge

30. A Model Curriculum for Applied Health InformaticsExample 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. A Model Curriculum for Applied Health InformaticsExample 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. A Model Curriculum for Applied Health Informatics Next Steps

33. A Model Curriculum for Applied Health InformaticsNext 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. A Model Curriculum for Applied Health Informatics The U of Waterloo Diploma in AHI Program

35. A Model Curriculum for Applied Health InformaticsOrientation 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. A Model Curriculum for Applied Health Informatics Questions, Answers, and Discussion

37. A Model Curriculum for Applied Health Informatics Reserve Slides

38. A Model Curriculum for Applied Health InformaticsThe 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. A Model Curriculum for Applied Health InformaticsHealth 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.