Sunday, December 20, 2009

Section 3016: More!

The Office of the National Coordinator for Health Information Technology (ONC) has released two more funding opportunity announcements (FOAs) for HIT workforce development. These are in addition to two previous FOAs that aim to establish community college consortia and the curricula they will utilize for rapid, short-term training of the workforce.

The first new FOA (OC-HIT-10-002) is entitled, Competency Examination for Individuals Completing Non-Degree Training. This FOA continues the emphasis on community colleges, consisting of a cooperative agreement for the development of competency testing for six job roles for which short-term community college programs are being developed. A single $6 million award will be given to an institution of higher education to perform this task. The awardee will be tasked with creating a detailed “blueprint” for implementation of the program, based on the competencies for the six workforce roles and providing structure for the content of the examinations. The awardee will be expected to collaborate with community colleges and competency-based subject matter experts to provide examinations that are suitable for the community college student population and other examinees. The awardee must also work with industry and employer groups to ensure that the materials are responsive to emerging workforce needs. They will be required to administer the exams through computer-based testing centers and the cost of the award must include their free administration to the 10,000 individuals who will be trained by the community college consortia.

The second new FOA (OC-HIT-10-003) is entitled, Information Technology Professionals in Health Care: Program of Assistance for University-Based Training. The goal of this to create training grants for university-based programs to train higher-level professionals to be part of the workforce that achieves the meaningful use of HIT. This FOA addresses a concern of many that all training was going to be carried out by community colleges. However, this FOA makes it clear that there is a role for many others, including at the leadership level, to move us toward the meaningful use of electronic health records (EHRs). A total of $32 million will be allocated for 8 awards that are funded over 39 months (three academic years plus some lead-in time). The total awards will be for a maximum of $4 million for single institutions and $6 million for consortia of institutions. All four-year institutions and universities are eligible to apply.

These FOAs bring the total spending on HIT workforce development to an impressive total of $118 million:
  • Community college consortia - $70 million
  • Curriculum development centers - $10 million
  • University-based training - $32 million
  • Workforce competency assessment - $6 million
I will devote the rest of this posting to the university training FOA. Individuals trained by the programs funded through this FOA will assume more highly specialized roles and serve as leaders in supporting the meaningful use of HIT. The training will cover six workforce roles identified by ONC:
  • Clinician/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
The FOA states that the roles listed are not rigidly defined purposefully because the field is evolving. This will give programs the ability to create new and creative approaches to educating these individuals. Of note is that there is a clear role for public health positions and not just for individuals in healthcare. Applications must describe job titles and key responsibilities that the training for these roles will fill.

Priority for funding will be given to institutions that already have existing baccalaureate, certificate, or master’s degree programs. Institutions must address at least three, and preferably more up to all six, job roles. Applications will be accepted from universities that both plan to expand their existing programs as well as create new ones.

Funding will only support “new students,” defined as those not enrolled in an HIT educational program on the date that the FOA was published, which is December 17, 2009.

Programs will be funded for 39 months (3 years, 3 months), starting in 2010, to allow three cycles of academic years. The first academic year must begin with the fall term of 2010.

Two types of students will be supported:
  • Type 1 – programs that can be completed in less than one year, ideally in less than 6 months, leading to a certificate or master’s degree without thesis
  • Type 2 – programs that require more than one year to complete, typically a master’s degree with thesis
Programs must maintain a ratio of five Type 1 students for every Type 2 student. Priority will be given to programs that use “creative and flexible” mechanisms to expand capacity, such as distance learning and part-time enrollment.

The FOA notes that $6,500 per trainee for program development and training related expenses will be awarded for costs associated with faculty and staff salaries, program administration, program-related equipment, faculty travel necessary to successfully implement the program, and trainee child care. It also states that for all types of trainees, the grants will support (up to a fixed maximum) trainee tuition and fees. For trainees in master’s degree programs with a required thesis, funding will additionally support health insurance sponsored or required by the awardee institution and a stipend for each trainee enrolled in the program on a full-time basis. (Although the maximum amount for annual health insurance is $2000, which I note somewhat tongue-in-cheek gives us the maximum incentive to bring about health care reform and cost control as soon as possible!)

Allowable costs include (quoted from the FOA):
  • Developing and revising curricula in medical/health informatics and related disciplines.
  • Recruiting and retaining students to the program involved.
  • Acquiring equipment necessary for student instruction, including the installation of test bed networks for student use.
  • Establishing or enhancing bridge programs in the health informatics field s between community colleges and universities.
  • Faculty release time to prepare for teaching in these programs.
  • Professional salaries for management of the process to create the program.
Tuition and fees for both types of trainees is supported. For Type 1 trainees, up to $10,000 may be budgeted. For Type 2 trainees, up to 60% of regular tuition and fees, not to exceed $16,000 per year, may be budgeted. Type 2 trainees may also receive an annual stipend of $15,000 and annual health insurance coverage of $2,000. F&A costs of 8% of non-tuition expenses may be budgeted.

Evaluation will be consist of close monitoring of a number of milestones in the FOA related to matriculation, graduation, and employment. A mid-award review will take place after the these milestones are compiled after the 18th month of program operation.

An important part of the proposal will be the proposed strategy for the program. It must include the following (quoted from the FOA):
  • The role being addressed and (for consortial programs) the name of the institution that will be home to the program.
  • The overall educational goals for the program.
  • Whether the applicant is proposing to establish a new program or to expand an existing one.
  • The duration of the training and whether a degree or certificate will be awarded. If a degree, specify the degree and which institutional department will award it. If a certificate, specify the proposed title of the certificate and which department will award it.
  • If the program is a new program, when the training program will matriculate its first trainees.
  • Whether the program addresses health care, public health, or both.
  • The target number of trainees to be enrolled in this program per year, and, separately, the number of these trainees to be supported by funds from this grant.
  • The curriculum for the program listing titles and credit hours (or trainee time commitment) of all required courses and other required experiences. For each required course/experience, indicate whether it is currently offered or whether it will require development. Include in an appendix, a brief (approximately 200 word) description of each required course or experience.
  • The faculty members who will be offering the required courses and other experiences. Biosketches for these faculty members must be included in a separate section of the application.
  • Mechanisms for student mentoring and advising, also specifying how trainees’ progress through the program will be monitored and evaluated.
  • If the program requires supervised research or scholarship (a terminal project, thesis, or dissertation), a description of the resources that will be available to students as venues for this work.
The four collective FOAs represent a comprehensive and well-resourced approach to growing the HIT workforce. A $118 million investment in HIT workforce is an excellent expenditure of economic recovery funds. I will have more to say in the future but for now I need to start my proposal writing!

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