ONC Defines a Taxonomy of Robust Healthcare IT Leadership

As in my post "More On Healthcare Management By Domain Neutral Generalists", Roy Poses' post "Health Care Leaders: Don't Know Much About Health Care" and many others on the topic of ill informed healthcare management (query link) at Healthcare Renewal, a common theme is lack of appropriate education and background in many of today's healthcare leaders.

ONC, the Office of the National Coordinator of health IT at HHS, has apparently now defined a taxonomy of health IT leadership in their funding opportunity announcements (FOA's).

Note the formal educational recommendations I've highlighted. Seems they’ve heard the message about the importance of cross-disciplinary -- and formal -- education for health IT leaders and even lower level workers:

From the Founding Opportunity Announcement "Program of Assistance for University-Based Training" at http://healthit.hhs.gov/portal/server.pt?open=512&objID=1428&mode=2

... Targeted Information Technology Professionals in Healthcare Roles

The six types of roles targeted by this FOA are:

(i) Clinician/Public Health Leader: By combining formal clinical or public health training with training in health IT, individuals in this role will be able to lead the successful deployment and use of health IT to achieve transformational improvement in the quality, safety, outcomes, and thus in the value, of health services in the United States. In the health care provider settings, this role may be currently expressed through job titles such as Chief Medical Information Officer (CMIO), Chief Nursing Informatics Officer (CNIO). In public health agencies, this role may be currently expressed through job titles such as Chief Information or Chief Informatics Officer. Training appropriate to this role will require at least one year of study leading to a university-issued certificate or master’s degree in health informatics or health IT, as a complement to the individual’s prior clinical or public health academic training. For this role, the entering trainees may be physicians or other clinical professionals (e.g. advanced-practice nurses, physician assistants) or hold a master’s or doctoral degree(s) in public health or related health field. Individuals could also enter this training while enrolled in programs leading directly to degrees qualifying them to practice as physicians or other clinical professionals, or to master’s or doctoral degrees in public health or related fields (such as epidemiology). Thus, individuals could be supported for training if they already hold or if they are currently enrolled in courses of study leading to physician, other clinical professional, or public-health professional degrees.

(ii) Health Information Management and Exchange Specialist: Individuals in these roles support the collection, management, retrieval, exchange, and/or analysis of information in electronic form, in health care and public health organizations. We anticipate that graduates of this training would typically not enter directly into leadership or management roles. We would expect that training appropriate to this role would require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in Health Information Management, health informatics, or related fields, leading to a university-issued certificate or master’s degree.

(iii) Health Information Privacy and Security Specialist: Maintaining trust by ensuring the privacy and security of health information is an essential component of any successful health IT deployment. Individuals in this role would be qualified to serve as institutional/organizational information privacy or security officers. We anticipate that training appropriate to this role would require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in health information management, health informatics, or related fields, leading to a university-issued certificate or master’s degree.

(iv) Research and Development Scientist: These individuals will support efforts to create innovative models and solutions that advance the capabilities of health IT, and conduct studies on the effectiveness of health IT and its effect on health care quality. Individuals trained for these positions would also be expected to take positions as teachers in institutions of higher education including community colleges, building health IT training capacity across the nation. We anticipate that training appropriate to this role will require a doctoral degree in informatics or related fields for individuals not holding an advanced degree in one of the health professions, or a master’s degree for physicians or other individuals holding a doctoral degree in any health professions for which a doctoral degree is the minimum degree required to enter professional practice.

(v) Programmers and Software Engineer: We anticipate that these individuals will be the architects and developers of advanced health IT solutions. These individuals will be cross-trained in IT and health domains, thereby possessing a high level of familiarity with health domains to complement their technical skills in computer and information science. As such, the solutions they develop would be expected to reflect a sophisticated understanding of the problems being addressed and the special problems created by the culture, organizational context, and workflow of health care. We would expect that training appropriate to this role would generally require specialization within baccalaureate-level studies or a certificate of advanced studies or post-baccalaureate-level training in health informatics or related field, but a university-issued certificate of advanced training in a health-related topic area would as also seem appropriate for individuals with IT backgrounds.

(vi) Health IT Sub-specialist: The ultimate success of health IT will require, as part of the workforce, a relatively small number of individuals whose training combines health care or public health generalist knowledge, knowledge of IT, and deep knowledge drawn from disciplines that inform health IT policy or technology. Such disciplines include ethics, economics, business, policy and planning, cognitive psychology, and industrial/systems engineering. The deep understanding of an external discipline, as it applies to health IT, will enable these individuals to complement the work of the research and development scientists described above. These individuals would be expected to find employment in research and development settings, and could serve important roles as teachers. We would expect that training appropriate to this type of role would require successful completion of at least a master’s degree in an appropriate discipline other than health informatics, but with a course of study that closely aligns with health IT. We would further expect that such individuals’ original research (e.g. master’s thesis) work would be on a topic directly related to health IT.

They've also called on Community Colleges to take the lead in producing worker bees:

http://healthit.hhs.gov/portal/server.pt?open=512&objID=1414&mode=2

It is also recommended that the teachers of these worker bees have a formal cross disciplinary background.

These are encouraging signs, as they lend significant formalism to the current marketplace where, completely alien to the culture of medicine itself, anyone of any educational background (or no educational background) can be a healthcare IT / informatics "expert" and leader.

Even with these definitions, doing health IT "right" is still far, far harder than it looks, but at least the rigor of medicine is starting to be applied to the "anything goes" world of healthcare IT and IT workers in healthcare-related roles.

That domain has long suffered striking inattention to education and qualifications requirements, and a healthcare-dyscompetent leadership that I believe has significantly fueled healthcare IT difficulty and failure.

This is a helpful stance against devil-may-care attitudes such as those of major health IT leadership recruiters. From an article a number of years ago in the journal “Healthcare Informatics”:

I don't think a degree gets you anything," says healthcare recruiter Lion Goodman, president of the Goodman Group in San Rafael, California about CIO's and other healthcare MIS staffers. Healthcare MIS recruiter Betsy Hersher of Hersher Associates, Northbrook, Illinois, agreed, stating "There's nothing like the school of hard knocks." In seeking out CIO talent, recruiter Lion Goodman "doesn't think clinical experience yields [hospital] IT people who have broad enough perspective. Physicians in particular make poor choices for CIOs. They don't think of the business issues at hand because they're consumed with patient care issues," according to Goodman.

Now, if only ONC's thinking can percolate to the highest levels of healthcare and pharmaceutical leadership, including the "C" level and the boards of directors.

-- SS