Community colleges should be tapped for HIT experts

July 15, 2009 | Patty Enrado, Special Projects Editor

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WASHINGTON – Community colleges are a "perfect fit" for filling an IT void and training a new workforce to assist small physician practices, according to Allan Korn MD, senior vice president of Clinical Affairs and CMO at BlueCross BlueShield Association.

Physicians in small and medium-size offices historically face two barriers to getting appropriate electronic infrastructure: Cost and IT assistance. While cost can be overcome, IT assistance for the small physician office is virtually nonexistent, said Korn,

When payers, hospitals and integrated delivery networks implement IT, they hire consultants, whose fees are far beyond the reach of small physician offices. What resources are available for the little guy?

The answer is community colleges, said Korn. It's a perfect fit for filling an IT void and training a new workforce, he said. Korn believes that the community college system has the ability to create a two-year curriculum that develops skills in process change management and IT, and knowledge of physician office workflow and other operations such as CPT coding.

This program would produce a cadre of well-trained people and serve the local community of physicians at reasonable hourly fees – anywhere between $50 to $75 an hour. These entrepreneurs could even branch out to other markets. The bottom line is that this business would be self-sustaining, Korn said. "People would flock to that," he said.

It's not enough to provide financial incentives to small to mid-size physician offices to implement EHRs, Korn insists. Failures in system conversions will doom the push for adoption, he said. "What other business would throw away an entire business? We're asking doctors to do that with these implementations," he said. "It's such a simple idea" that would fill a big void, Korn said. The idea has to get to the right people.

"It's an awesome idea," said Roxanne Fulcher, director of Health Professions Policy for the American Association of Community Colleges (AACC). Fulcher said that a certificate program in IT is already on her development list, but it wouldn't surprise her if the idea is farther along at one of the 1,200 community colleges in the country.

Community colleges meet the needs of their communities, she said. Programs are employer driven. Community colleges are also businesses, said James McKenney, vice president of Economic Development and International Programs for AACC. Such a program needs to be scalable and sustainable for the local community, he said.

Fulcher noted that a grassroots way to get the ball rolling is to have a band of physicians go to their local community college and send the message: "If you train people, we'll hire them." She admitted that it takes a "long time" for curriculum changes, but a couple of models could be put into place in the meantime.

Post licensures would serve the needs of the working healthcare professional and current students in healthcare and get workers out in the field. A stackable certificate program would enable students to customize their skill sets by earning multiple certificates in IT and other healthcare industry areas. While the model of an IT professional on site would likely have difficulty being sustainable, a health IT specialist or consultant akin to a traveling nurse, which is what Korn is advocating, is a great idea, Fulcher said.

Any community college that decides to take on the development of a program would need help in determining what the curriculum would look like, she said. The HITECH Act authorizes federal assistance through the Dept. of Health and Human Services to schools for the purpose of, among other things, developing and implementing HIT curricula, courses and certification programs. If a community college developed an associate degree in health IT, next steps such as the degree's career pathway would need to be considered, she said.

"With IT and changes in the healthcare environment, maybe it's time to take a look at healthcare professions and create new professions," Fulcher said. "This could be one of them."

Reader Comments (2)Login to Post a Comment

M. Jacobs says: Community Colleges and Health IT

July 16, 2009 | 5:51PM GMT

I am managing a research project studying the health informatics workforce in two hospital systems, and an allied community college program. The research report will be submitted to our funder later this month. Unfortunately, based on this research, I cannot agree with the conclusions of the AACC or the writer, which are not based on research. IT programs and two year degrees may not be the best "starter set" to provide the services outlined for community physicians or hospitals - a clincal perspective, and an understanding of workflow is critical in implementing and optimizing EMR. I do agree that a community college approach must be considered as a part of a much longer term health career approach which includes the broader spectrum of soft skills and clinical understanding required to work in this arena.

Remy says: Community College - No way

July 15, 2009 | 3:10PM GMT

This is what happens when you start requesting direction from people who do not implement HIT systems. Physicians are giving up control when they implement an EHR to someone who is knowledgeable. You cannot expect someone to become an expert in the areas of change management, training and the many complexities of healthcare organization to facilitate the needs of a physician in 2 years of coursework. This is a curriculum at a university where there is a relationship at a local medical school or college for practical learning.
I have seen this same reduced cost bandaid in many hospital implementations, former clinical people walk users through a technical tasks like printing. Or worse, technical people spewing technical jargon to nurses without regard to medical terminology or healthcare regulations. It is Babel. You can't have physicians in a stressful position when lives are clearly at stake. They need professionals with expert knowledge. Interesting how it was fine to pay bank $200-300/hour to track assets, but we must reduce cost with community college grad when it comes to human life.
As an HIT professional who embarked on this career path after 4 years of college and working in a healthcare setting, it is daunting. Critical thinking skills and problem solving ability is essential. The ability to understand technical and medical terminology is key to the success of any implementation.
People in the ivory towers imagine that it's really simple to just pop in software and get physicians going on an EHR. Truthfully, there is no way to explain hospital workflows because no hospital functions the same. Just as no physician's office functions the same way. It requires a specific skill set that is not only found in a hospital, but demands an understanding of regulations such as HIPAA, State Healthcare Laws and JCAHO.
Just like banks acquired knowledgeable resources, these same resources are available in the market. However their rates are inflated to $200+/hour by large consulting firms. Most experienced HIT consultants receive $70-120/hr. The markup is from the firms who insist upon additional hours and inflated resources for implementations.
If physicians move out the fat cats who bill them exorbitant bill rates and contract directly with knowledgeable consultants with references, the issue of cashflow would be addressed realistically.