High Tech U

Colleges Train HIT Staff for Physician Practices

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Practice Management Feature – July 2011

Tex Med. 2011;107(7):55-61.

By Crystal Conde
Associate Editor

Implementing a certified electronic health record (EHR) system and then achieving meaningful use are no small tasks for a medical practice. The federal government recognizes that and has made $116 million in grants available nationwide to ramp up training for a robust, qualified workforce to assist physicians.

Community colleges and universities throughout Texas use the federal money to enhance or create certificate and degree programs that will prepare medical office staff, recent college graduates, and information technology (IT) professionals to oversee health information technology (HIT) at multiple sites, including the physician practice.

According to the U.S. Bureau of Labor Statistics and Department of Education, approximately 50,000 qualified HIT workers will be needed to meet the federal mandate requiring health care professionals to implement EHRs by 2015.

Eric Weaver, MHA, Austin Sports Medicine practice administrator, is taking advantage of funding for Health IT Workforce Development Program activities supported by the Office of the National Coordinator for Health Information Technology (ONC).

He's studying to earn a graduate certificate in health information management (HIM) from the Professional University Resources and Education for Health Information Technology (PURE-HIT) consortium, led by Texas State University in San Marcos.

Jake Manuel, MD, an Austin Sports Medicine orthopedic surgeon, recognizes the value in Mr. Weaver's training.

"There is particular concern that small and medium-size practices may not completely understand the risks that EHR software might bring because they lack the technical expertise, management sophistication, and economies of scale that larger practices and hospitals have. The physicians in our group are quite pleased with how Eric has pursued formalized training in HIT at Texas State. Whenever we decide to adopt an EHR, we are confident that he will be able to apply his knowledge and training to ensure a successful outcome," Dr. Manuel said.

Last April, ONC granted $32 million to nine colleges and universities under the Program of Assistance for University-Based Training. Of the funds, Texas State University in San Marcos received $5.4 million – the largest award in the nation for a university-based training program – to be the lead institution for the PURE-HIT consortium in Texas. Texas State collaborates with The University of Texas at Austin College of Natural Sciences and The University of Texas Health Science Center at Houston School of Biomedical Informatics to educate students on HIT.

ONC also awarded five regional groups made up of 82 community colleges a share of $68 million to develop or improve non-degree HIT programs that can be completed in six months or less. In the Community College Consortia, Texas is part of Region D. Texas institutions in the Region D Consortium are Dallas County Community College District, Houston Community College, and Midland College.

The grant covers all of Mr. Weaver's tuition; he pays only for textbooks.

He travels to San Marcos once a week for an evening class but uses an online portal to submit his homework assignments and to take tests.

Austin Sports Medicine is a paper records-based practice, but is purchasing an EHR system with plans to achieve meaningful use.

At Texas State, Mr. Weaver learns the legal aspects of health information, the health care quality improvement process, EHR implementation, workflow mapping, and data mining.  He says his training has been "eye-opening."

"I now understand the link between operational processes and patient quality. I'm learning how technology can allow physicians to be more efficient and take better care of patients. I'm acquiring these skills now so that when the practice is ready to implement an EHR, I can be more hands-on with the implementation," he said.

Mr. Weaver says the program allows him to immediately apply what he's learning in the physician practice.

"Not all medical offices have the resources or expertise to use best practices when adopting new technology. Physician practices should capitalize on these federally funded workforce training programs to get more practice administrators versed in HIT and health informatics," he said.

Partners in Education

Programs offered through PURE-HIT train students to work in public health informatics, HIM and health information exchange, privacy and security, research and development, programming and software engineering, and as HIT subspecialists.

All of the certificate programs can be completed in one year or less, and all of the master's degree programs can be completed in two years or less. Additionally, ONC expects all of the programs to be sustained once they've been established with grant funding support.

Program graduates will be prepared to work in public health, HIM, or EHR implementation for physicians' offices. Members of the health care professions are among the targeted populations for recruitment to the program.

Potential employers for program graduates may include HIT vendors, the government, public health agencies, regional extension centers, hospitals, and physicians’ offices. Graduates who work with hospitals or in physicians' offices can help implement EHR systems and assist in achieving meaningful use.

Susan Fenton, PhD, RHIA, assistant professor and project director for PURE-HIT at Texas State, says the HIT programs are ideal for students who need a flexible class schedule. For example, Texas State offers the graduate certificate classes in HIM once a week in the evenings in San Marcos and broadcasts the classes to the Baylor Health Care System in Bryan Tower in Dallas, The University of Texas at Tyler Health Science Center, and Texas State University School of Nursing in Round Rock.

As part of the training for the graduate certificate, students choose elective courses, which include clinical data analysis, data mining, database management, and IT systems project management.

Texas State also offers a privacy and security certificate, which can be completed entirely online.

"The privacy and security certificate would be perfect for someone from a clinical background who becomes responsible for HIT in a medical practice. The certificate will give them a solid foundation in HIT and EHRs, with a focus on privacy and security of health information," Dr. Fenton said.

Both the HIM certificate and the privacy and security certificate can be completed in one year. Students take two classes in the fall and spring semesters and one class for the summer semester.

Dr. Fenton says federal grants cover a majority of tuition and fees at each institution for Texas residents. For specific information on financial assistance and enrollment requirements, visit the website of the institution. (See "Apply Online!")

Grant funding ends in summer 2013. Each institution will be responsible for sustaining the programs. Student financial aid will be available.

To take advantage of the tuition assistance available through the federal grant now, Dr. Fenton urges prospective students to apply soon.

Hands-on Training in HIT

Leanne Field, PhD, distinguished senior lecturer and director of the HIT programs at UT Austin, says students receive tuition assistance of up to $10,000 and career development services to help find a job. The three HIT programs are:

  • Health information management and exchange specialist certificate: a nationally recognized program designed for post-baccalaureate students at UT Austin and other universities;
  • Health information privacy and security certificate: a program designed for UT Austin computer science students; and
  • Public health leader certificate: training in public health informatics designed for employees of the Texas Department of State Health Services.  

Of the $5.4 million awarded to the PURE-HIT consortium by ONC, UT-Austin's College of Natural Sciences received $2.7 million to develop the certificate programs, designed to educate 179 students in the next three years.

Dr. Field says the inaugural summer certificate program included six weeks of didactic and simulation-based training, followed by a two-and-a-half-week practicum experience offered at multiple sites in Austin and around the state.

UT Austin graduated its first class of 54 students in July 2010. Graduates took part in professional on-site job interviews and received ongoing support from a career expert to help them successfully find employment. Within eight months of graduation, 92 percent of graduates seeking employment in HIT found jobs with HIT vendors, health care organizations, consulting companies, and government agencies.

Dr. Field says the summer certificate program was the first in the nation to graduate students from an ONC-funded program and place them in jobs.

The nine-week certificate program will be repeated this summer and fall, with the goal of educating up to 100 students prepared to enter the workforce before the end of 2011. The College of Natural Sciences also is rapidly developing professional education programs for physicians, medical professionals, and veterans, and for others seeking credentials to enter the HIT field.

Dr. Field says HIT adoption affects a physician's clinical, administrative, and support staff. That's why, she says, staff members need to understand the capabilities of the new technologies and the ways they can improve practice efficiency.

"By empowering the staff members to be part of a team that can integrate these processes, the office can become more productive while improving costs, quality, and access to health care."

Experts in EHR Implementation

A robust and appropriately trained HIT workforce is necessary as physicians work to qualify for meaningful use incentive payments, says James Turley, PhD. The Centers for Medicare & Medicaid Services (CMS) set meaningful use criteria that physicians must meet to receive incentives.

Physicians can qualify for up to $44,000 in Medicare incentive payments from 2011 to 2016 and up to $63,750 in Medicaid incentive payments from 2011 to 2021.

Penalties for failure to demonstrate meaningful use of an EHR exist under the Medicare incentive program but not under the Medicaid program. Medicare payments to physicians decrease by 1 percent in 2015, 2 percent in 2016, and 3 percent in 2017. Possible cuts will continue up to 5 percent by 2019 if 75 percent of office-based physicians do not achieve meaningful use.

To view the meaningful use rules and to register for the incentive programs, visit the CMS website or TMA's online Federal Stimulus Package Resource Center.

The UT Health Science Center at Houston offers a Master of Science in Applied Health Informatics that allows graduates who complete 36 semester credit-hours to assess, implement, maintain, and evaluate EHRs and health information systems.

The program is available online. Full-time students can complete the program in one year and part-time students in two years. Prospective students can apply for a federal scholarship that covers 60 percent of tuition and fees and provides a $15,000 stipend. Scholarships are still available for September admissions.

Dr. Turley and Juliana Brixey, PhD, both faculty members of the School of Biomedical Informatics, say the master's program offers practical EHR training that benefits physician practices.

"All of the courses in the program require students to complete a variety of hands-on projects. Students will graduate with a portfolio of what they've accomplished during the program and can show prospective employers the work they've been doing," Dr. Turley said.

Dr. Brixey says the program's focus on team building helps set it apart.

"Inherently, if you're working in the EHR arena, you'll be working with teams. We strive to train students to be able to support one another," Dr. Brixey said.

Dr. Turley says nurses, medical students, physicians, and medical technicians have enrolled in the master's degree program.

Elizabeth Cuevas, NP, and Cheryl Rubio will be among the first group of students to graduate with a Master of Science in Applied Health Informatics in December. Ms. Cuevas works part-time as a nurse practitioner at a Jasper urgent care clinic. Ms. Rubio has a background in HIT and hopes to work in a health clinic after she graduates.

Ms. Cuevas likes the flexibility afforded by the program's online format. She lives in Louisiana but is able to participate in classes from a distance. She decided to enroll in the master's program after participating in a challenging EHR implementation in a medical practice.

"I've been engaged in adoption of an EHR. I witnessed the lack of education during implementation. The people involved didn't understand why we were doing it, the end goals, or the importance. With my new skills and training, I want to be able to merge health care with IT and educate physicians about why the transition to electronic records is so important," Ms. Cuevas said.

Ms. Rubio hopes to assist physicians in achieving meaningful use.

"With my training, I'll be able to help bridge the gap for physicians to allow them to adopt an EHR successfully and meet the requirements for the meaningful use incentive programs," she said.

Cross Training

ONC wants to facilitate training of more than 10,500 new HIT professionals annually nationwide by 2012. The community college programs train professionals with experience in IT or health care to work as practice workflow and information management redesign specialists; clinician and practitioner consultants; EHR implementation support specialists and managers; technical and software support personnel; and trainers. The duration of the community college grant award is a maximum of two years.

At Midland College, the HITECH Workforce Program is available entirely online and aims to train members of the health care and IT workforce to meet the following goals:  

  • Nationwide adoption of EHRs,
  • Information exchange across health care entities and public health authorities,
  • Redesign of workflows within health care settings to gain quality and efficient benefits of EHRs, and
  • EHR transition while ensuring privacy and security of medical information.   

Melinda Teel, RHIA, CCS, program director and instructor for Midland's HITECH Workforce Program, says programs available through the Community College Consortia offer intense curricula that quickly prepare students for the HIT workforce.

Curriculum developers include Duke University, University of Alabama, Oregon Health Sciences University, Columbia University, and Johns Hopkins University.

Ms. Teel says graduates of Midland College's program can:  

  • Communicate well with EHR vendors to meet the practice's needs,
  • Identify any problems with the EHR system and address them,
  • Build reports and analyze data from the EHR for medical specialties, and
  • Successfully implement an EHR.  

"Midland College's HITECH Workforce Program provides cross training for IT and health care professionals. If we talk the same language, we can be more efficient and can communicate our needs better. That doesn't always happen now," Ms. Teel said.

Grant funds make it possible for Midland College to offer 100-percent tuition reimbursement for students who successfully complete the program in six months. Each certificate costs only $400.

At press time, Midland College had enrolled more than 100 participants in its program, and seven had graduated. Ms. Teel says prospective students can enroll for Sept. 6 and Sept. 30 start dates to take advantage of 100-percent tuition reimbursement under the federal grant.

Crystal Conde can be reached by telephone at (800) 880-1300, ext. 1385, or (512) 370-1385; by fax at (512) 370-1629; or by email.


Apply online!

Texas State University-San Marcos 
PURE-HIT Program

University of Texas Health Science Center at Houston
Master of Science in Applied Health Informatics

University of Texas at Austin
HIT Program

Midland College 
HITECH Workforce Program [PDF

Dallas County Community College District
HIT Program

Houston Community College
HITECH Health IT Program

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