Push begins to ramp up health IT
Ever wonder how a pharmacist deciphers a physician's quickly scribbled notes on a prescription without making an error, or why in 2010 a fax machine is still needed to transmit a patient's medical records?
Now imagine an electronic prescription sent from the practioner's cell phone, and a health clinic that can quickly retrieve a patient's most up-to-date medical records from a credit card–shaped electronic chart that he carries with him.
In the coming years, experts predict that such information technology will play a significantly larger role in the care and management of a person's health.
The federal government is giving a not-so-gentle push.
Through Medicare and Medicaid, it will offer billions of dollars in incentives to hospitals and health care providers over the next five years to develop and implement health information technology, such as e-prescriptions and patient-centered electronic health records.
To ramp up this development, a massive and highly trained work force will be needed. Johns Hopkins is set to do its part.
University faculty recently received two federal grants—totaling more than $5.5 million—that will help put Johns Hopkins at the forefront of training in this expanding field.
Harold Lehmann, associate professor at the School of Medicine and director of training and research for Johns Hopkins' Division of Health Sciences Informatics, has been awarded $3.75 million to develop post-baccalaureate and master's-level health IT work force training programs at the schools of Medicine, Public Health and Nursing.
The grant was awarded under the Health Information Technology for Economic and Clinical Health Act, part of the 2009 American Recovery and Reinvestment Act. Patricia Abbott, an associate professor of health systems and outcomes in the School of Nursing, and Jonathan Weiner, professor of health policy and management at the Bloomberg School of Public Health, will co-direct the grant.
The program's goal is to rapidly increase the availability of people qualified to serve in health information technology roles in all health care settings to enhance patient care and population health.
"There is bipartisan support for this initiative and lots of data that tell us that health IT can help save lives—and isn't that what we're trying to do?" Lehmann said. "I have no doubt that good health IT will promote quality care. We feel it will enhance patient safety and ultimately save money."
Health information technology, Lehmann said, can reduce paperwork and help eliminate medical errors by transmitting accurate and timely information to health care providers.
"Currently, there is no integration. Many people see more than one doctor, and for their physicians to share information requires a lot of time-consuming back-and-forth. Faxes need to be sent, forms signed," he said. "Now picture a database a medical provider can use to see all your records, including your most recent visit to your primary care physician."
Abbott points out that patients are obtaining care in a variety of settings, from the home to the hospital, to the nurse-managed clinic in the neighborhood. "It is critically important that we capture all of the data related to patient care, regardless of locale," she said. "If we fail to coalesce the data, then we will continue to propagate waste and inefficiency while increasing the chances of medical error."
Lehmann said that a great many people will be needed to develop and manage innovative applications of information technology and information systems that address biological, clinical or public health priorities, and to study how the information is organized and used.
Johns Hopkins is one of nine universities awarded funds to advance this training.
The university will specifically use this grant to further develop informatics courses already offered across the three schools and to offer partial funding to students. The grant emphasizes shorter-format programs, such as certificate training in clinical informatics, applied health informatics and public health informatics. Such courses are already offered by Johns Hopkins but will now be expanded and many made available online beginning in fall 2010.
The School of Medicine also offers a 12-month master of science degree in applied health sciences informatics, and a research informatics master of science program, which is completed in 24 months. The grant will offer tuition assistance to a limited number of these students.
Lehmann will oversee the training courses along with Nancy K. Roderer, director of the Division of Health Sciences Informatics and director of the Welch Medical Library.
The Clinical Informatics Certificate, administered by the School of Medicine, takes six to eight months to complete. In the School of Nursing's new eight-month certificate program in applied health informatics, students will earn 13.5 academic credit hours, which may then be applied toward a master's degree.
The Public Health Informatics Certificate program is run by the Bloomberg School's Department of Health Policy and Management and is composed of six quarter-long courses, taken either for a certificate or as part of an existing degree program.
Lehmann says that the academic informatics division at Johns Hopkins has worked for more than 10 years to create a full program of education for the informatics work force, ranging from innovative informatics research to leadership in design, implementation and deployment of health IT in clinical care and in public health.
"This grant, building as it does on our existing activities, gives us a terrific opportunity to grow these efforts even further and to have Johns Hopkins play a major role in supporting the health IT landscape for Maryland and the mid-Atlantic region, as well as for public health nationally."
In a separate but related award, Abbott received a $1.8 million HITECH grant to develop a curriculum for health information technology work force development.
"Despite mounting evidence that electronic health records have the power to transform health care, many hospitals, clinicians and others aren't using them," Abbott said. "The shortfall of HIT workers—approximately 50,000—is a major barrier to HIT adoption. Unfortunately, the country's educational system is not currently prepared to train this desperately needed work force."
The School of Nursing's new Curriculum Development Center is one of five centers that will develop a six- to 12-month informatics curriculum for deployment in U.S. community colleges. The aim is to give these colleges the ability to educate HIT workers, while helping college instructors supplement their own level of knowledge.
The curriculum will be developed in collaboration with Johns Hopkins' schools of Medicine, Public Health and Business, as well as four local community college partners.
An advisory board will include academic HIT experts and representatives from HIT employer groups.
"Anyone who takes these HIT courses in their local communities will have the benefit of a rigorous curriculum built by high-level university experts. Geography is irrelevant; no matter where the students are located, they will be able to access high-quality training," Abbott said.
The two grants create a unique interdisciplinary team-centered approach to resolving work force shortages in HIT, Abbott said.
"Collaborating on the Curriculum Development Center and the university-based training program at the same time will create a great HIT synergy here at Johns Hopkins," she said.
Kelly Brooks-Staub of the School of Nursing and Gary Stephenson of Johns Hopkins Medicine contributed to this article.