Thursday, April 9, 2009

Richard Katz on Electronic Health Records

Adoption of Electronic Health Records (EHR) and Its Impact on Job Creation, Retraining and Placement


The Department of Labor Workforce Investment System has an opportunity to prudently fund innovative service delivery strategies to upgrade the skills of incumbent workers, retrain dislocated workers, and leverage the portability of registered apprenticeship programs to meet increased staffing demands created by accelerated Electronic Health Records (EHR) physician adoption rates.

This article provides an overview of how Title IV of the American Recovery and Reinvestment Act (The Health Information Technology for Economic and Clinical Health portion of the Stimulus Bill) received a $19 billion investment that will trigger the demand for thousands of high-paying, high-growth healthcare jobs on a national basis.


In the $787 billion American Recovery and Reinvestment Act, two parts of the Stimulus package are relevant to this employment and training opportunity:

1) Under Title VIII, an additional $3.95 billion has been allocated for employment and training services under the Department of Labor Employment and Training Division.
a) The President’s intent for this funding is to create and preserve high-growth, high-paying jobs particularly in the areas of health care and other growth industries
b) Highly skilled, “dislocated” workers from declining industries, as well as incumbent workers, would be eligible to participate in Workforce Investment Act-funded employment and training programs
c) These training programs would be operated by partnerships between health care employers, vendors and related stakeholders, and local/regional Workforce Investment Act service providers.
d) From the employer’s perspective, the benefits of partnering with the WIA systems include:
i) Recruiting highly skilled workers from declining industries with transferable skills
ii) Reducing cost associated with implementing EHR through Stimulus funding
iii) Recuing overall costs associated with health care delivery
iv) Branding their organization as a leader in EHR adoption.

2) Under Title IV of the Act (Health Information Technology for Economic and Clinical Health (HITECH), the government has allocated $19 billion within Health and Human Services to encourage health care organizations to adopt and effectively utilize electronic health records. Below are some of the important findings that create the opportunity for federal, state and local workforce investment agencies to retool the skills of workers and re-establish themselves in viable career paths:

a) The majority of the funds ($17 billion will go to physicians and hospitals that effectively use robust, connected EHR systems. All of the incentives include payments for up to five years, but the largest incentive payments will be provided early in the program,in 2011.. It is estimated that physicians could earn from $44,000 to $64,000 over five years from Medical/Medicaid subsidies.[Physicians and hospitals that fail to adopt an EHR will eventually be penalized, beginning in 2015, through lower Medicare and Medicaid reimbursement.] The second portion of $2 billon is labeled Discretionary Funding and has yet to be fully defined.
b) Within the last few weeks, there has been a proliferation of articles about EHR. For example:

Impact on Job Creation and Dislocated Worker Training and Placement (Page -2- )

i) According to one vendor put the reference here article, “To gain maximum financial incentives, physician groups need to begin planning the rollout EHR systems as soon as possible. While many of the details of the law remain to be worked out—including the complete definition of “meaningful electronic health records usage”-providers can’t afford to wait for all the details to be ironed out before moving forward. To gain the maximum amount of Medicare and Medicaid incentives, physician groups must have a qualifying records system in place by 2011.”
ii) “IBM and Partners Help Healthcare Clients Adopt Electronic Health Records”
iii) “Tampa Bay Becomes First Community to Jump-Start America’s E-Health Revolution: Project Jump-Start will convert 10,000 Regional Physicians to E-Prescribing as First Step toward Connected Electronic Health Records…. U.S. Rep. Kathy Castor (D-Tampa) voiced her support. The intent of the Recovery Act is jobs, jobs, jobs,” The program will create132 new jobs: 111 trainers and 21 support staff.”
iv) “Wal-Mart to bring electronic health records into small medical offices.”
c) Only about 17% of the nation’s physicians are using computerized patient records, according to a survey last year in the New England Journal of Medicine. A major roadblock has been getting smaller providers to make the investment. 75% of the nation’s doctors still practice in small offices, with 10 or fewer doctors, and simply don’t have the money to spend on computer technology.
d) According to one major software vendor, “a bigger issue remains simply finding enough qualified employees. Some IT analysts show there is currently 139,000 job openings and only 49,000 people seeking those jobs.”
e) HRMS analysis of available dislocated worker skill sets versus EHR occupational requirements confirms an opportunity for job creation and placements. Examples include:
i) Sales and Sales Support
ii) Training
iii) Data Entry, Scribes and Database Managers
iv) Hardware and Software Installers
v) Internet Connectivity, Networking and Interoperability
vi) Customer Support
vii) Project Management
viii) EHR user auditors and analysts
ix) Software Engineers, Programmers, Analysts and Technician
f) HRMS is studying the training curricula necessary to prepare dislocated workers for EHR. Initial findings indicate that ‘layers’ of health care industry knowledge to existing occupations are the primary drivers to building a successful customized job training program.
Recommendations and Next Steps for Local and State WIA Executive Directors
1. Conduct a local or regional labor market study to determine hiring projections for health care employers, vendors and other stakeholders created by accelerated Electronic Health Records adoption. (HRMS is currently gathering data on both a local and national level)
2. Partner with one or more employers, to design and implement an EHR Job Creation and Placement Program funded by an ETA customized training demonstration grant, State discretionary funding or local Workforce Investment Board. (HRMS is currently working with a major health care provider in California to establish a customized EHR job training program.

Since 1993, HRMS has been a successful service provider under both JTPA and WIA with a specialty in designing and managing successful employer-based, technology-driven, customized job training programs, on both a local and national level.

Feel free to contact me if you would like to learn more about EHR job creation and placement opportunities in your area.
Richard Katz, CEO HRMS, Inc. Profile

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