By Mark Crawford
Healthcare needs more than EHRs, it needs people who can implement and maintain them. New federally sponsored health IT exams set workforce competencies, helping job seekers demonstrate knowledge and employers benchmark qualifications.
As the US moves toward industry-wide adoption of electronic health records (EHRs), the Bureau of Labor Statistics forecasts a shortage of about 50,000 qualified health IT workers to meet the growing IT needs of hospitals and other healthcare affiliates.
In an effort to address that shortage, the Office of the National Coordinator for Health IT (ONC) targeted $116 million for a health IT workforce development program focused on training workers in one of six roles in EHR implementation and management. One piece of the four-part program is a health IT competency exam program, which launched in May 2011.
The exams were designed for individuals completing six-month Community College Consortia training programs, another piece of the program, and anyone seeking to demonstrate their competency. In April 2010 ONC awarded a $6-million, two-year cooperative agreement to Northern Virginia Community College to create the exam program.
Passing the competency exams is intended to help job seekers demonstrate their knowledge to employers and employers gauge both prospective and current employees.
"ONC felt there would be a need for an external and nationally standardized measure of achievement for students who would complete six-month training programs offered by a wide range of institutions," explains Adam Wong, a management and program analyst for the office of the chief scientist within ONC. "This measure will complement the assessments and other evaluations performed by the individual schools."
The exams are not restricted to graduates of the consortia program. Anyone with relevant experience can take them. ONC expects that current employees also could use the exams to further their careers.
"We also felt that, consistent with adult learning principles, any individual wishing to contribute to the health IT workforce should have an opportunity to demonstrate competency, whether or not that individual had completed a formal training program. The competency exam could serve that function as well," according to Wong.
Mike Niederpruem is vice president of certification services at AHIMA, which developed the exams as a subcontractor in the cooperative agreement. The HIT Pro exams are a long-term validation of an individual's healthcare and IT skills, he says. Individuals who pass them can be considered competent and ready to implement or manage EHR activities.
"Professionals who take these exams can gain an edge by learning new technologies and procedures, as well as position themselves for new careers that are on the horizon," Niederpruem says. "They will prove a readiness to seize new opportunities in an expanding market."
Because the exams set benchmarks for competencies, they can be useful throughout the industry, Wong says.
"For example, employers can use the exams as a simple qualification tool for potential new hires and also assess their own staff and remaining personnel needs," he says. "Institutions of higher education can also utilize the exams to evaluate and improve their health IT programs."
Sample Exam Blueprint
A candidate guide, available on www.hitproexams.org, offers a description of each of the six roles and exam blueprints for the corresponding tests.
For example, the practice workflow and information management redesign specialist role is described as follows:
Workers in this role assist in reorganizing the work of a provider to take full advantage of the features of health IT in pursuit of meaningful use of health IT to improve health and care. Individuals in this role may have backgrounds in health care (for example, as a practice administrator) or in information technology, but are not licensed clinical professionals.
The blueprint breaks down the roles into domains and competencies. The redesign specialist examination currently features seven domains:
- Fundamentals of Health Workflow Process Analysis and Redesign
- Usability and Human Factors
- Health Management Information Systems
- Quality Improvement
- Introduction to Information and Computer Science
- Terminology in Health Care and Public Health Settings
- The Culture of Health Care
In total, the domains contain more than 60 competency statements, each of which is tested in the exam and weighted equally.
Six Tests for Six Roles
Six HIT Pro exams comprise the program, each one testing a health IT workforce role ONC has defined as instrumental in implementing and managing EHR systems:
- Clinician/practitioner consultant
- Implementation manager
- Implementation support specialist
- Practice workflow and information management redesign specialist
- Technical/software support staff
Exam development began with comprehensive job analyses for each of the six roles. "These tasks include assessing workflow, selecting hardware and software, working with vendors, installing and testing systems, diagnosing IT problems, and training staff on various systems," Niederpruem says.
Each exam consists of 125 multiple-choice questions and can last up to three hours. Exams are administered at more than 1,000 test centers across the country.
Exam blueprints, which describe the scope of the exams, break each role down into domains. Each domain features statements outlining the expected competencies. (See table, above.)
Niederpruem notes that the exams do not lead to a certification.
"Passing the exam is different from a certification, a more extensive process that typically results in credentials being listed after one's name and involves ongoing maintenance and/or renewal requirements," Niederpruem says. "Certification also typically requires or recommends relevant professional experience.
"In contrast, both newcomers and experienced professionals can sit for the HIT Pro exams, and there are no ongoing maintenance or renewal requirements."
Baseline competency has not yet been determined. "We are using actual exams completed to determine the level of competency," Wong explains. "Once we have a sufficient sample size for each exam, we'll be able to calculate the pass/fail level."
Expectations for Advancement
So far one of the biggest challenges for the exam program has been generating awareness within the health IT community. In an effort to jump-start the program and get experienced workers into the field, ONC subsidized the HIT Pro exams in the months following their launch, making them available to eligible candidates at no cost.
Members of the Community College Consortia and other eligible entities (such as other accredited academic institutions, healthcare employers, and state and local employment agencies) in the US and territories could request exam vouchers.
Every person who took an exam by August 31 received a voucher for a second exam at no cost, which can be used for a retake or for an additional exam focused upon a different workforce role, according to Niederpruem.
For candidates who are not eligible to receive a free voucher, the exam price for the initial attempt is $299. The price for retakes and for additional exams is $199.
As of mid-July a total of 3,260 free exam vouchers had been distributed; 34 exams had been delivered and 206 were scheduled.
"We expect these numbers to continue to grow as individuals who currently have vouchers complete their exam preparations and as awareness builds about the program," says Niederpruem.
Paula Arceneaux, MHA, RHIA, CCS, is a facility information security officer for Healthcare Corporation of America's Gulf Coast division office in Sugar Land, TX. She is responsible for ensuring the systems housing protected health information meet all organizational and HIPAA standards. As part of her goal to obtain certification as a health IT professional, Arceneaux took the implementation manager exam in July.
"The exam was straightforward," she states, though she was surprised by the breadth of the questions.
Arceneaux believes the exam will boost her career. "I have been in the healthcare industry for 33 years, all in the area of health information management," she says. "The HIT Pro exam will help me reach my goal of leading an EHR implementation team... With the transition from paper-based records to EHR, I think the HIT Pro program will position HIM professionals to be leaders in the evolving field of health IT."
Carolyn Gilbert, DDS, CCA, CPC-A, also expects the exam to expand her career opportunities.
A retired dentist who returned to school for the HIM post-baccalaureate program at Regis University in Denver, CO, Gilbert completed a Community College Consortia six-month program in March, then took the clinician/practitioner consultant exam in June. She plans to sit for AHIMA's RHIA certification in May 2012.
Other graduates of the training program have used the exams to help identify professional development needs.
Frank Lillo is an EHR consultant to Indian River State College, in partnership with the South Florida Regional Extension Center in St. Lucie, Martin, and Palm Beach counties, FL. His job is to help small provider practices understand the EHR incentive program, identify and evaluate certified EHR software technology, prepare to earn meaningful use incentives, and improve the patient experience.
"After graduating from the first offering of the HITECH grant training program, I wanted to take the certification exam to benchmark my understanding of the body of knowledge that was presented during the course," Lillo explains.
He sat for the practice workflow and information management redesign specialist exam in June. "I plan to continue my learning, and the exam results will help me determine a plan," he says.
To prepare for the exam, Lillo recommends focusing on the modules that pertain most to the specific role being tested. "The total amount of study material is vast, and trying to cram for it all would be nerve wracking and probably counterproductive," he says.
Information on the exam program, candidate guides that include exam blueprints, and registration information are available at www.hitproexams.org.
Mark Crawford (firstname.lastname@example.org) is a freelance writer based in Madison, WI.
"Standardized Testing: HIT Pro Exams Test Competencies in Health IT Roles"
Journal of AHIMA