S TATE COUNCIL OF HIGHER EDUCATION FOR VIRGINIA PROGRAM PROPOSAL COVER SHEET 1. Institution 2. George Mason University 3. Title of proposed program Health Informatics 5. Degree designation Master of Science (MS) Program action (Check one): Spin-off proposal New program proposal 4. CIP code 51.2706 6. Term and year of initiation Fall 2011 7a. For a proposed spin-off, title and degree designation of existing degree program 7b. CIP code (existing program) 8. Term and year of first graduates 2011 9. Date approved by Board of Visitors 10. For community colleges: date approved by local board date approved by State Board for Community Colleges 11. If collaborative or joint program, identify collaborating institution(s) and attach letter(s) of intent/support from corresponding chief academic officers(s) 12. Location of program within institution (complete for every level, as appropriate). School(s) or college(s) of Division(s) of College of Health and Human Services (CHHS) Department of Health Administration and Policy (HAP) Campus (or off-campus site) Fairfax Distance Delivery (web-based, satellite, etc.) Some courses may be online 13. Name, title, telephone number, and e-mail address of person(s) other than the institution’s chief academic officer who may be contacted by or may be expected to contact Council staff regarding this program proposal. Dr. P.J. Maddox, Professor and Chair, Department of Health Administration and Policy, CHHS, GMU 703-993-1982 [email protected] TABLE OF CONTENTS DESCRIPTION OF THE PROPOSED PROGRAM ...............................................................................................1 OVERVIEW .................................................................................................................................................................1 C URRICULUM ............................................................................................................................................................8 ADMISSION REQUIREMENTS ......................................................................................................................................9 F ACULTY .................................................................................................................................................................10 ASSESSMENT ...........................................................................................................................................................10 B ENCHMARKS OF S UCCESS ......................................................................................................................................12 EXPANSION OF AN EXISTING PROGRAM ...................................................................................................................13 C OLLABORATIVE OR STANDALONE PROGRAM ........................................................................................................14 JUSTIFICATION FOR THE PROPOSED PROGRAM.......................................................................................14 R ESPONSE TO CURRENT NEEDS ...............................................................................................................................14 EMPLOYMENT DEMAND ..........................................................................................................................................16 S TUDENT DEMAND ..................................................................................................................................................27 DUPLICATION ..........................................................................................................................................................27 PROJECTED RESOURCE NEEDS........................................................................................................................32 APPENDICES.........................................................................................ERROR! BOOKMARK NOT DEFINED.37 APPENDIX A – PROPOSED CURRICULUM....................................................................................................................1 APPENDIX B – C OURSE DESCRIPTIONS ......................................................................................................................1 APPENDIX C – ABBREVIATED CV’S FOR FACULTY ....................................................................................................1 APPENDIX D – LETTERS OF S UPPORT (D1) AND JOB ANNOUNCEMENTS WITH URL AND DATE (D2) ........................1 APPENDIX E – SURVEY INSTRUMENT ..............................................................ERROR! B OOKMARK NOT DEFINED.1 i Description of the Proposed Program Overview George Mason University requests approval to offer a Master of Science (MS) degree in Health Informatics. The degree will be offered by the Department of Health Administration and Policy in the College of Health and Human Services (CHHS) in collaboration with the Applied Information Technology Program in the Volgeneau School of Engineering. The proposed degree will build upon existing courses, academic and professional qualifications and strengths of extant faculty and resources from the College of Health and Human Services and Volgeneau School of Engineering that are required support a new academic offering beginning Fall 2011. The purpose of this 33-credit graduate degree program is to educate students on the application of principles of computer and information science to the organization, analysis, management, and use of information in the health care system. Graduates will be prepared to facilitate the advancement of emerging information technologies into the health care setting. Graduates of the program will have competencies needed to support the design of user centric health information systems that protect patient privacy and ensure availability of actionable information to a variety of health care professionals, administrators and policy-makers. This, to facilitate high quality, safe patient care, evidenced-based practice, administrative operations as well as bio-medical and health services research, while meeting regulatory requirements. This new Master of Science (MS) in Health Informatics (HI) will prepare students to become health information analysts, administrators, and practitioners in the US and internationally. It will offer the national and international health care and medical community the tools needed to manage health information systems in their entire life cycle from evaluation of information needs, design, development, implementation, to operation and continuous improvement. The information systems should be able to support healthcare professionals in their decisions by providing prompt, accurate and relevant information about patients; facilitate interoperability and data exchange while ensuring privacy and security of health data; and provide accurate administrative information to ensure the financial sustainability of health care organizations. Technological advances have widened the dissemination of knowledge and accessibility especially applied for health care. However, technology has also created new challenges and placed increased responsibility on all parties involved: health care providers, insurance, medical professionals, managers, policy makers, and health delivery organization. Whatever the promise of technology, its adoption and use (especially ‘meaningful use’) are critical to manage. Since 1995, the US Agency on Healthcare Research and Quality and other federal agencies and initiative have been supporting development of health information infrastructure nationwide. Since 2009, the American Recovery and Reinvestment Act (ARRA) with Health Information 1 Technology for Economic and Clinical Health (HITECH) provisions has established a funding stream for implementing and using health information technology that amounts to between $14 billion and $27 billion, plus an appropriation of $2 billion alone for the Office of the National Coordinator.1 This investment ushers a new “gold rush” in health IT as the US has adopted five key goals of health IT: “… improving the quality, safety, and efficiency of health care while reducing health disparities; engaging patients and families; improving care coordination; ensuring adequate privacy and security protections for personal health information; and improving population and public health”. 2 This has been a long journey. In 2005 during her testimony before the U.S. House of Representatives (July 27), Dr. Carolyn Clancy identified the importance of the use of health specific IT use and adoption: “For many health care providers, the need to address specific local threats to the safety and quality of patient care is immediate; an increasing number of practitioners and organizations have made or will soon make investments in health IT. Leaders in health care recognize that improvement requires both incentives and the capacity to respond to those incentives. Our focus is on building the capacity within health care settings—large and small, urban and frontier—for the effective use of health IT, and disseminating findings rapidly. The benefits of health IT need to begin now for as many Americans as possible. The results of these investments represent tangible benefits that will be accelerated as the private-public collaboration to facilitate a nationwide information infrastructure develops”.3 To support these new and challenging needs, the field of health informatics includes a variety of knowledge and skills relevant for organizational planning and management of Health IT as well as micro-systems design, performance and regulatory compliance. It emphasizes specialized knowledge and skills that pertain to the capture of health data (standards and inter-operability) as 4 well as adoption and “meaningful use” of health data as specified by the HITECH act. Myriad new skills and roles have been identified by the Office of the National Coordinator for Health Information to facilitate the acquisition of and use of new and existing health information systems, increase meaningful use and address/problem-solve HIT adoption lag. This graduate program will prepare graduates with knowledge, skills and abilities to address current and emerging health data/information system development/implementation and technical and user based problems. And it will prepare graduates to develop solutions/innovations to address the challenges and problems associated with the current state of Health IT. 1 “Guiding The Health Information Technology Agenda” by David J. Brailer, Health Affairs, April 2010 2 "Health IT Gold Rush Under Way" by Nancy Ferris, Health Affairs, April 2010 3 C. Clancey testimony before the Committee on Government Reform, Subcommittee on the Federal Workforce and Agency Organization, U.S. House of Representatives, July 27, 2005. Retrieved from http://www.ahrq.gov/news/test072705.htm 4 2 “HITECH Act lit a fire under health systems”, Healthcare IT News, HIMSS, Jun 15, 2010. Students who complete this degree will be prepared to address complex health informatics problems by analyzing technical/system problems and end user needs/issues to develop innovative solutions to support HIT adoption and the meaningful use of health data. Students will work closely with faculty who are leading research scholars and experts in health systems, health records and regulatory requirements as well as information technology and engineering experts. In addition to learning health data infrastructure, information technology applications, economics and organizational theory, students will hone their critical thinking and integration skills to develop a wide range of knowledge, skills and abilities for health informatics through research, writing and practice. Academic Units The proposed program builds upon the intrinsic strengths of the two academic units that are collaborating to field the degree: The College of Health and Human Services (CHHS) and the Volgeneau School of Engineering (VSE). These strengths include expertise in applied information technology management, computer science, health informatics, healthcare systems, organizations and policy, statistical methods, health data security and privacy, data mining, strategic thinking, values and culture, as well as change management and risk communications in healthcare. The College of Health and Human Services (CHHS) was established in 2005 and includes the Department of Health Administration and Policy, Department of Global and Community Health, the School of Nursing, and the School of Social Work. Two new departments join the CHHS in 2011, the Department of Nutrition and Department of Disability and Rehabilitation Sciences. The Department of Health Administration and Policy (HAP) is the academic home of the degree and its principle faculty from CHHS. In addition to academic schools and programs, the CHHS houses a number of collaborative research centers, several of which have direct interest in the education and research in health informatics: The Center for Health Policy Research and Ethics (CHPRE) (http://chpre.gmu.edu). CHPRE conducts widely respected health policy and health services research, and communicates the latest in research knowledge to health care policy and decision makers. CHPRE is also home to the internationally renowned annual Washington Health Policy Institute (http://hpi.gmu.edu). The Center of Discovery Science and Health Informatics (DSHI) (http://dshi.gmu.edu/), which conducts basic and applied research on developing computational theories, analytic methods, and software applications that support decision making and discovery of knowledge from healthcare data. This includes data mining, artificial intelligence and other knowledge discovery methods and tools tailored towards the meaningful use of health data, health services research, evidenced based practice, and decision support for a variety of health system stakeholders and end-users (clinicians, managers, researchers, policy makers, and consumers) from all sectors of the health system. The center also 3 houses a secure repository of longitudinal health datasets used for research and teaching purposes. o The Machine Learning and Inference Laboratory (MLI) is housed in DSHI and conducts research on the development of intelligent systems capable of advanced forms of learning, inference, and knowledge generation, and applies them to realworld problems (especially health policy problems and impacts). The Center for Study of Chronic Illness and Disability (CCID) (http://chhs.gmu.edu/ccid/index.html) which performs research to study factors that lead to disability, its prevention, or amelioration (practice and policy) and trains next leaders in rehabilitation science. The Volgeneau School of Engineering was established in 1985, as the first engineering school in the United States to focus its scholarship primarily on information technology and math-based engineering as opposed to traditional physical, material-based engineering. Today, its component departments reflect the evolution of engineering disciplines, including Civil, Environmental and Infrastructure Engineering; Electrical and Computer Engineering; Computer Science; Systems Engineering and Operations Research; Statistics and; Applied Information Technology. The School’s programs cover the spectrum of IT education, from introductory courses in IT technology, to cutting edge research at the doctoral level where it offers degrees in 6 areas. The School includes 12 research centers and 9 research labs. One research Center in particular is closely linked to the academic mission of the proposed degree: The Center for Health Information Technology. The Center for Health Information Technology (http://hit.gmu.edu) conducts technology and engineering focused interdisciplinary research on Health IT. It brings together knowledge leaders in areas related to health policy, health informatics, computer science and information technology to address Health Information Technology issues facing the Nation; promotes and establish relationships with industry, health care stakeholders, universities, foundations, non-profits and government agencies to transform the current healthcare system; responds to the needs of state governments and the federal government to revitalize and transform the healthcare system to improve the delivery and quality of care, while reducing the cost of care. Current HIT Center projects include the following: Agent-based Secure and Privacy-Preserving Architectures for Electronic Health Records; Virtual Medical Records; and Mobile Health in Support of Wellness. The HIT Center research program complements the MS in Health Informatics by providing a venue for students to work on novel projects that are also relevant to their studies. The Master of Science in Applied Information Technology program (http://ait.gmu.edu/ graduate/) is the academic collaborator in VSE whose faculty are working with HAP to support the proposed degree. The AIT Departments specializes in applied IT education to meet the demand among private sector companies and federal agencies for program and project managers credentialed in information technology, analysis and management and, leadership and ethics. 4 Background In recent years, concerns about the performance of the US healthcare system have increased, garnering the attention of policy makers and the public. At the heart of the current healthcare debate is the fact that the US spends much more per capita than other industrialized countries on healthcare without achieving better outcomes in population health. The ever-increasing share of spending on healthcare has seriously negative consequences on US economy and the wellbeing of middle class families. More than 30 million people do not have health insurance (mostly because they could not afford it) and among those who are insured, there is increasing dissatisfaction about its cost and quality. Per President Obama, “The increases projected in federal spending in coming decades as a share of the economy are due entirely to the projected growth in Medicare, Medicaid and Social Security which, in turn, is driven by rising health-care costs and the aging of the population. The single biggest factor is rising health-care costs, not just in Medicare and Medicaid, but throughout our health-care system." 5 The historic health care reform bill (PPACA) addresses many new and long-standing concerns and will have lasting impacts on public welfare, the role of government and US economy in healthcare (and vice versa) and will directly affect everyone from employers to health care providers, insurers and patients.6 The American Recovery and Reinvestment Act (ARRA) of 2009 and its Health Information Technology for Economic and Clinical Health (HITECH) statutes and the Patient Protection and Affordable Care Act (PPACA) were enacted to improve/reform the US health system through complex provisions.7 The provisions of ARRA and PPACA will engage states, health systems and health care providers to bring about improvements in health care quality, reduce costs and increase access enabled by improvements and federal mandates for the adoption and use of 8 health information technology and meaningful use of sharing health information. The PPACA stresses high-quality, affordable health care and mandates the development of a national strategy to improve health care delivery, patient outcomes and population health by January 2012. Congress, recognizing that electronic data collection is critical to achieving national quality goals, made coordination with the nation health IT strategy, as outlined in HITECH, a central part of this effort. The PPACA also includes provisions for improving health care quality; reinforces and rewards (by financing incentives) better care and more efficient health care. This includes establishment of innovative pilot programs for payment reform wherein the importance of Health IT is explicitly identified. It also establishes a PatientCentered Outcomes Research Institute. Other provisions include coordination of health IT standards for uniform implementation and integration of administrative and financial data 5 The opening remarks at the Fiscal Responsibility Summit convened by President Obama, February 23, 2009, in Washington, D.C. http://www.nytimes.com/2009/02/23/us/politics/23text-summit.html (as of April 12, 2010) 6 Robert Wood Johnson Foundation, “What is the Impact of the Patient Protection and Affordability Act?” http://www.rwjf.org/files/research/65049.pdf. accessed 1/15/2011 7 Federal ARRA Implementation Plan http://www.hhs.gov/recovery/reports/plans/master_hhs_plan06212010.pdf 8 Buntin MB, Jain SH, Blumenthal D, 2010, “Health Information Technology: Laying the Infrastructure for National Health Reform”, Health Affairs, 29(6):1214-257. 5 transactions for processes such as insurance enrollment and claims submissions and payment, consistent with and building upon HITECH clinical data initiatives. Finally, the most discussed provisions of the health reform act are related to increasing insurance coverage through large Medicaid expansions, reforming insurance markets and creating fair and efficient health 9 insurance exchanges, all of which have health IT related mandates. But the challenges of realizing health reform are rooted in endemic problems and resistance to change. In public and private sectors alike, health service providers are theoretically ‘empowered’ by the technology tools and information to ensure high seamless communication, improve safety/quality and produce efficiencies in service delivery. Unfortunately, wide spread adoption of Health Information systems and electronic health records and the “meaningful use” of health information for administrative and clinical purposes is limited. While Physicians and health care providers benefit from tools like clinical decision support systems, EHR's, telemedicine, and other IT platforms that facilitate patient care service delivery and/or management, their use is not wide-spread.10 Neither have efforts to establish wider data interoperability and data sharing been successful on a large scale. Nonetheless, proponents of information technology join with policy analysts in anticipation that wider adoption and use of health information and expanded information sharing can add value and create health care quality and efficiency improvements. Public and private health care agencies need better data management tools that aggregate information from their disparate databases to enable consolidation of information; perform data analysis; and provide health care providers, program managers and policy makers alike with data (evidence) to support their decisions. This includes data to support future decisions at a variety of levels ranging from clinicians to policy makers for a range of concerns from health planning, care coordination and program management, streamlined administrative operations, as well as improving the health care cost, quality and access.11 An influential study by RAND Corporation found “if most hospitals and doctors’ offices adopted HIT, the potential efficiency savings for both inpatient and outpatient care could average over $77 billion per year”; “around 200,000 adverse drug events could be eliminated each year, at an annual savings of about $1 billion”; and….“health IT helps with disease prevention and chronicdisease management”.12 The new mandate for increased utilization of electronic health records, it is important to recognize that such systems must operate in a very complex medical environment under strict regulatory constraints. To meet to federal mandates and achieve some of the expected benefits of HIT adoption and use, the expertise from a new generation of specialists in health informatics is needed to work with healthcare organizations, governments and various stakeholders to evaluate their health related information needs, identify problems, develop and implement health IT solutions. As Dr. David Blumenthal, National Coordinator in Health Information Technology puts it, “The purpose of health information technology is to support health reform, and it is part 9 IBID Congressional Budget Office. An analysis of health insurance premiums under the Patient Protection and Affordable Care Act, Washington DC. Available from: http://www.cbo.gov/ftpdocs/107xx/doc10781/11-30premiums.pdf 11 Blumentahl D, Tavenner M, 2010, “ The “Meaningful Use” Regulation for Electronic Health Records”, New England Journal of Medicine, 363:3. Download at: http://www.nejm.org/doi/pdf/10.1056/NEJMp1006114 12 “Health Information Technology: Can HIT Lower Costs and Improve Quality?” RAND Health Research, http://www.rand.org/pubs/research_briefs/2005/RAND_RB9136.pdf (as of April 10 2010) 10 6 13 of that larger puzzle. It is not a stand-alone goal or an end in itself.” The development, adoption and meaningful use of health IT is a complex undertaking that requires the support of health IT specialists who know and understand the consumers and end-users of health information as well as the supporting technologies for health information. Blementhal further explains, ‘Health information technology should not be viewed as “magic,” something which can be dropped into the current health care environment to yield automatic savings. HIT is “necessary” to generate savings in the health care sector, but “not sufficient,” he said. HIT’s most promising potential role in containing cost is in easing and standardizing the compilation of data for use in comparative effectiveness studies.14 Our new focus on health reform, unfolding requires a new generation of efficient systems to facilitate recording, storage, retrieval, and exchange of health data as well as effective tools to extract useful information for evidence-based medicine and facilitate comparative-effectiveness research. A new generation of specialists/experts in applied health informatics is needed now to address complex end user and organizational requirements of health information systems. Additionally, these graduates will be able to work effectively with engineers and technicians to ensure the development of systems and applications that will provide timely information and secure data/information sharing to support a variety of interdependent uses and functions in 15 health care/service organizations and support longitudinal research. The MS in Health Informatics is designed to provide students with these skills. Introduction The mission of George Mason University is to educate the new generation of leaders for the 21st century—men and women capable of shaping a global community with vision, justice, and clarity. This mission encourages freedom of thought, speech, and inquiry in a tolerant, respectful academic setting that values diversity; provides innovative and interdisciplinary courses of study to enable analytical and imaginative thinking to make well-founded ethical decisions while nurturing a faculty who excel at teaching, are active in research, capable of providing a broad range of intellectual and cultural insights, and are responsive to the needs of GMU students and their communities. This degree supports the GMU mission to educate new leaders by providing graduate students with innovative and interdisciplinary courses for developing clarity and creativity in health information infrastructure management and implementation, and strives to integrate and address the needs of various healthcare stakeholders and regulators and does so with high ethical standards. This degree will shape the analytical and imaginative thinking of graduate students as experts and leaders in applied health informatics. 13 Guiding The Health Information Technology Agenda” by David J. Brailer, Health Affairs, April 2010 14 Peter Orzag. Alliance for Health Reform Briefing at Dirkson Senate office building, June 20, 2008. http://www.allhealth.org/briefing_detail.asp?bi=131 (accessed 10/5/09) 15 Office of the national Corrdinator for Health Information Technology, “Improving Patient Care”, http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204 (accessed 1/2011) 7 Curriculum The proposed HI program is an interdisciplinary degree that builds upon and extends the existing Health Information Management concentration offered under the Health Systems Management MS degree. The proposed interdisciplinary Master of Science degree builds on the strengths and resources of the Health Administration and Policy Department and the Volgeneau School of Health Information Technology, Applied Information Technology Program to produce a high quality, efficient graduate program that will uniquely serve career development and student learning needs in a highly specialized degree. The curriculum is comprised of 11 graduate level courses (33 credits total), with interdisciplinary courses from 5 knowledge domains Health Informatics Curriculum IT infrastructure in healthcare Data-infrastructure in healthcare Analytics/Methodology Technology for health data Organizational and regulatory environments Student’s Program Plan and Advising Students admitted will be advised by the Program Director and academic teaching/advising faculty from the Department of Health Administration and Policy. Thesis/Non-Thesis Project Practicum Students in the Master in Health Informatics complete a 20 hour/week (15 week) health informatics practicum with requirements for a non-Thesis project. The practicum and project are conducted under the supervision of HAP faculty and a technology firm or community agency. Curriculum Overview The HI program curriculum is comprised of a common core, 3 groups of electives and a practicum or research project. There are 21 core credits, 9 elective credits and 3 credits for the non-thesis practicum. Thus, the curriculum is comprised of the common core and electives from five knowledge domains: IT infrastructure in healthcare, Health data infrastructure, Analytics/Methodology, Technology and Organizational and Regulatory environments. The completion of the program 8 core and required elective credits will provide students with a strong foundation in theoretical and applied critical thinking, analytical skills as well as applied technical expertise in health information systems. The following sources were instrumental in helping us appreciate the relevant trends and drivers for the future of health informatics and therefore the design of our curriculum: (1) academic and professional experience of HAP and AIT faculty; (2) analysis of the selected academic leaders in academic health informatics (Oregon Health and Science University, Ohio State University, University of Utah, University of Alabama-Birmingham, University of Washington, University of California-Davis and Johns Hopkins University); (3) the recommendations of authoritative professional societies (national and international) such as International Medical Informatics Association (IMIA), American Medical Informatics Association (AMIA) and American Health Information Management Association (AHIMA) and (4) Guidelines, regulations and initiatives by the Office of National Coordinator for Health Information Technology (ONC). Lastly, the input of prospective employers of our graduates was consulted. This program requires 33 credit hours. Students may complete studies over part-time or full time matriculation options. Model matriculation pathways are presented in the Appendix B. This appendix also presents courses, credit hours and course descriptions for all core and elective courses available in the curriculum Admission Requirements A B.A. or B.S. degree or equivalent from an accredited university or college is required for admission to the HI program. Although the field or major is not a criterion for admission, the applicants are expected to have taken basic level computer science/technology, mathematics, and statistics. An undergraduate grade point average of 3.25 (on a 4.0 scale) or above is preferred. Admission requirements are as follows: 1. An earned bachelor’s degrees; 2. Two official transcripts of all college and university work completed. Students presenting international credentials are required to provide official transcripts, degree certificates or diplomas, and certified translations of the documents in English (if applicable); 3. A 750-1,000 word written statement of the applicants’ goals and interest in the program; 4. At least 1 year experience in the medical or health related policy, service or technology sectors. This may be waived, with the approval of the academic program director and if HAP 678 Introduction to the U.S. Health System course (3) is successfully completed (additional program pre-requisite for students without health related experience); 5. A current résumé; 9 6. Two letters of recommendation. At least one recommendation should be from an individual who is qualified to attest to the candidate's academic potential; 7. TOEFL scores for international students – minimum score of 575 (paper-based) or 230 (computer-based). In addition, students may be required to be tested by the GMU English Language Institute; 8. GRE or GMAT combined score of 1000 on the GRE or 480 on the GMAT. This requirement may be waived for applicants who have an earned MS or higher degree. The decision for admission will be based upon several factors that may indicate an applicant’s potential for success in graduate studies. Important among them is the undergraduate GPA and work experience. Faculty The Department of Health Administration and Policy has 16 full-time faculty and more than 17 adjunct and affiliate faculty members. Of these, approximately 9 full time faculty who teach HAP courses specified in the curriculum. The AIT Department has approximately 8 collaborating faculty. Collectively, the faculty’s scholarly expertise covers in-depth practical experience, as well as policy and research experience in the range of courses to be offered in the program. Additional full-time faculty will be added as program enrollment increases. See Appendix C for abbreviated faculty biographies. Assessment The objective of the MS in Health Informatics degree program is to prepare students to work in various roles that support the adoption and use of electronic health information in a variety of health related entities (hospitals, practices, insurance and service companies, etc) and government agencies. Upon completion of the program of study (MS in HI) is to prepare students in the following five areas/objectives: 1. Organization of the U.S health system Objective: Analysis and evaluation of clinical, administrative and specialty information technology applications and information needs for various healthcare settings 2. Characteristics of health information systems Objective: Conceptualized application or system interfaces for ease of data entry, data transfer, and data display 3. Health informatics methodology and technology for the processing of health data, information and knowledge including data representation principles Objective: Analysis and evaluation of the infrastructure of health data including classification, coding systems, lexicons, nomenclatures, standards and thesaurus and the 10 technical methods and languages used to record, store, retrieve and integrate and protect the data. 4. Decision-support including application acquisition and representation of knowledge Objective: Design, integrate, implement and manage knowledge-based applications to facilitate administrative and clinical decision support systems and evidence based practice models. 5. Health Informatics Project Management Objective: Develop technical methods and procedures for intra- and inter-organizational health data exchange (between departments, Regional Health Information Organizations (RHIO); other health care providers and health data banks Graduates of the program will be prepared to: 1. Analyze how information technology impacts health data collection, storage, retrieval, communication works (e.g. authentication, chip cards, pen based systems, distributed systems, workstations, networks, security, user interface) 2. Understand how U.S. health care systems work and appreciate the importance of health information systems and the meaningful use of data for essential and optimized health systems operations. 3. Analyze the complex workflows and interactions among different players involved in healthcare delivery (patients, healthcare providers, payers and the governments) in which data are created, processed and consumed. 4. Appreciate how information availability and quality affects patient care quality and the cost of care. 5. Work effectively with the regulatory environment in which health care organizations operate, in particular, in conformance to requirements for patient safety, health data privacy and security. 6. Understand the infrastructure of health data including classification, coding systems, lexicons, nomenclatures, standards and thesaurus. 7. Apply technical methods and languages used to record, store, retrieve and integrate and protect the data. 8. Interpret health information, data extraction and reporting requirements to support a variety of end-users and functions. 9. Integrate the life cycle of an IT system/s in health entities and projects. 10. Analyze and synthesize the factors that influence/ensure the success of IT adoption and meaningful use in the healthcare environment. Outcomes Assessment As with all academic programs in George Mason University, assessment of student learning in the proposed program will take place at the level of the student, the course, and the program. Students will be assessed in a number of ways throughout the program. Scholarly ability will be evaluated through course grading in classes, using objective examinations, as well as written and research projects. Oral, written, and analytical skills will be considered in course grading, depending upon the course. 11 In order to assure that students achieve the major objectives of the program, student learning will also be assessed using a systematic evaluation of all courses, tracking students’ academic progress, a student self-assessment survey (pre- and post program), a capstone practicum comprehensive exam and a graduating seniors program satisfaction survey. Course evaluations are conducted every semester for every course in the academic program. These evaluations provide the student’s perspective on course effectiveness. Evaluation results are published online. Copies of survey and other Institutional Report assessments may be found on the GMU IRR website (http://irr.gmu.edu/). After the first year of program implementation, the faculty will seek accreditation for the program from the Commission on Health Informatics Accreditation (CHAAIM). Strategic Program Evaluation At the conclusion of the first three years, an interdisciplinary panel consisting of GMU HAP and VSE program faculty, the HAP Program Coordinator, HAP Chair and the VSE Applied Information Technology Program Director will review the metrics of student success and enrollment trends to identify strengths and identify areas of possible improvement. The comments of the panel will be utilized in conjunction with the recommendations of the external advisory sub-committee to evaluate the program and identify opportunities for improvement. All GMU Academic entities are reviewed on a seven-year academic program review cycle. Program review takes place under the guidance of the Office of Institutional Assessment and requires three semesters to complete. The outcomes of the process are a series of deliverables: a self-assessment report and academic plan written by program faculty; a report by a review team external to the program; and changes made to enhance the program. The five year program review will be conducted to make changes necessary enhance the program on an on-going basis, prior to the Benchmarks of Success The major criterion to be used to assess the HI program will be graduation rates, comprehensive exam pass rates, capstone practicum grades and program accreditation. Additional benchmarks of success will include meeting projections for enrollment, post graduate employment or acceptance rates into further graduate studies, as well as alumni satisfaction with the program. Overall, the proposed program has established the following benchmarks of success: 100% of enrollment targets will be met by 2014. 90% of full-time students will complete the program in two years or less. 75% of part-time students will complete the program in three years or less. 12 85% of all program graduates will report being satisfied or highly satisfied with the academic program at graduation. Approximately 5% of program graduates are expected to pursue advanced doctoral or other professional education; 98% will be successfully admitted to doctoral or other professional education programs. Achievement of CAHIIM accreditation As with all HAP academic programs, regular, on-going interdisciplinary program review occurs under the purview of the HAP/CHHS Program Evaluation Committee. Expansion of an Existing Program The MS in Health Informatics is proposed to replace the current graduate program offerings in Health Systems Management. Two concentrations (1) Management of Health Information Systems and (2) Health Care Security and Privacy under the HSM will be folded when the new degree is established. The MSHI degree has been developed to offer more courses to produce graduates with more specialized knowledge and skill than can be acquired by individual HSM concentrations. Limitations of Current Programs The Health of Information Systems (HIS) and Health Care Security and Privacy (HSP) certificate and graduate degree program concentrations under the Health Systems Management Program are limited to five only courses in each concentration to meet student learning needs related to specialized health informatics applications. As such, they lack the breadth and depth of knowledge and skill that a full maters degree curriculum can provide. Other limitations in current programs include a lack of courses to understand/evaluate the complex interactions between health care clinical and administrative personnel and their interaction with technical/engineering experts who design and support HIT. Neither do current program curriculum help graduates understand the requirements of health care regulators and corporate compliance officers. Rationale for Program This program is unique and distinct from extant Information Systems programs in VSE and Health Systems Management (HAP) in that primary focus is on understanding the clinical and administrative data in healthcare settings (their security, privacy, interoperability) and efficient utilization of health data, as well as understanding the interrelatedness of health/medical care providers and their needs for and use of information technology. The degree will serve the career development and learning needs of two main groups of students: (a) health care and health system management professionals seeking expertise in applied information technology and health care data/decision support and (b) information technology professionals seeking expertise and career development in health care operations and organizations to support future 13 employment in health sectors and service organization. Additionally, this program approaches health informatics from an interdisciplinary and systems thinking perspective, beyond the silobased confines of traditional health care clinician programs or computer science and systems engineering programs. This innovative program has been designed to provide the foundation and skills necessary to produce the next generation of health informatics specialists who can ensure the information needs of complex health care delivery systems and engage in electronic health records and health information system adoption and expanded use that health reform requires. Collaborative or Standalone Program This is a GMU standalone program. No other organization was involved in its development, and no other organization will collaborate in its operation. Distance Education This is primarily a traditional ground based education program. Selected courses in the curriculum may be available taught in part or in while as distance education courses. Courses where students may elect to enroll in a distance education learning format are indicated in the list of classes found in Appendix A. Justification for the Proposed Program Response to Current Needs The overarching problem with the healthcare system in the United States is exceptionally high cost of care without achieving the better health outcome. The trend is worsening and unsustainable. There is no controversy about the existence of the crisis although people of different political persuasions may disagree on what is the best mechanism to solve it. Many problems that contribute to high cost and poor quality of care can be attributed to the lack of good health information. The lack of interoperability between health information systems is the 16 main cause of over-testing and over-treatment . The lack of good quality health data stymies the research on effectiveness of different treatment courses. In such an information vacuum, physicians and patients often oft for most hi-tech and expensive treatments that may not have actual benefits. The lack of data also stymies the efforts to measure the quality of care in order to match financial rewards to the quality of care. Our proposed program MS in Health Informatics with its focus on health data and health information systems use will prepare students to address these urgent problems. 16 Sox, H. C., Helfand, M., Grimshaw, J., Dickersin, K., Tovey, D., Knottnerus, A., Tugwell, P. (2010). Comparative effectiveness research: Challenges for medical journals. The American Journal of Managed Care, 16(5), e131-133. Retrieved from http://www.ajmc.com 14 The proposed program with its focus on patient level health informatics and health data as well as enterprise health information systems is unique and forward-looking; it is not available at any other academic entity in the Virginia Commonwealth, Maryland or the District of Columbia. US Needs Recent regulations enacted by the Federal Government (ARRA and PPACA) require that all 17 health care providers maintain electronic patient records and that these records be secure. As a result, health information managers must keep up with current computer and software technology and with legislative requirements.18 In addition, as patient data becomes more frequently used for quality management and in medical research, health information managers must ensure that databases are complete, accurate, and available only to authorized personnel.19 The World Health Organization (WHO) Ministerial Summit in Mexico called for the establishment of support for a substantive and sustainable program of health systems research aligned with countries’ priority needs and aimed at achieving internationally agreed-upon healthrelated development goals, including those contained in the United Nations Millennium 20 Declaration. Students graduating with the MSHI degree will be prepared to efficiently operate complex health information systems to meet information demands of medical professionals and healthcare managers (adoption and use), to ensure interoperability with external entities, to analyze the information demands of organizations and initiate and manage IT projects to satisfy those information needs; to conduct a broad array of data analysis projects to measure the quality of care and organizational performance goals. Their in-depth knowledge of health information systems and health data will be valuable in helping health care organizations to bring about much needed changes in US health care system: to make sure health data are interoperable and available for analytic research, to help ensure the quality of care, eliminate wastes and control the rising healthcare cost. International Needs The contents of the proposed MHI program are carefully aligned with the recommendations of the International Medical Informatics Associations (IMIA) spelled out in IMIA Endorsed Documents: “Recommendations of the International Medical Informatics Association (IMIA) on 17 Retrieved fromhttp://www.bls.gov/spotlight/2009/health_care/home.htm Federal ARRA Implementation Plan http://www.hhs.gov/recovery/reports/plans/master_hhs_plan06212010.pdf 19 Sox, H. C., Helfand, M., Grimshaw, J., Dickersin, K., Tovey, D., Knottnerus, A., Tugwell, P. (2010). Comparative effectiveness research: Challenges for medical journals. The American Journal of Managed Care, 16(5), e131-133. Retrieved from http://www.ajmc.com 18 20 15 WHO. (2005) WHA 58.34 Ministerial Summit on Health Research. Retrieved from http://www.who.int/rpc/summit/en/ Education in Health and Medical Informatics (1999)” and “Medical Informatics Scientific Content Map (2002 version)” (http://www.imia.org/endorsed/endorsed.lasso). The recommendations are: a) every profession in health care even needs core health informatics knowledge; b) Graduates should, apart from the practice-oriented application of methods and tools from health and informatics, be enabled to independently participate in research and in the methodical advancement within the field of health and medical informatics. In contrast to bachelor programs, higher degrees should include formal preparation and abstraction as well as the afore-mentioned qualification of graduates independently contributing to the methodical and scientific advancement that predominates. The objectives of health informatics, is to focus on the processing of data, information and knowledge in health care with an emphasis on the need for advanced knowledge and skills of health informatics, of mathematics, as well as of theoretical, practical and technical informatics/computer science. The IMIA standards are consistent with our program graduate competency goals. Thus, graduates of the proposed MS HI program will be able to effectively operate not only in the US market but also in international settings. Needs in Virginia Virginia public colleges and universities are an important source of health informatics experts for the Commonwealth, the National Capital region, and the nation. As seen above, the demand on health informatics specialists in Virginia is following the same trend that holds at national level and is strongly affected by decisions and regulations by Federal government in the healthcare reform. Given the subject matter and focus of the MHI degree, there is great demand, regionally and nationally, for a graduate degree the MHI program will deliver. No other program in the Commonwealth of Virginia offers similar curriculum or provides the same skill-set and depth of academic learning in patient level health informatics with focus on data and information systems as does the proposed MHI program. This assertion is discussed in detail in the duplication analysis section found later in this proposal. Employment Demand A report to the US congress based on analysis of HIMSS Analytics™ Database describes the current employment patterns and potential demands for IT professionals in health care settings in the United States (US), the summary results are: There are approximately 108,390 IT professionals in health care the US. The amount of IT staff hired varies by level of EHR adoption, with the rate of IT FTE per bed started at a level of 0.082 FTE per bed at the lowest level of the EHR Adoption Model (Stage 0) and increasing to 0.210 FTE bed at higher levels (Stage 4). To move the entire country to higher levels of adoption (Stage 4) will require an additional 40,784 IT professionals. 16 For IT staff, Gartner Research assessed integrated delivery systems of varying size. In 85 of such organizations studied, there was a consistent finding of about one IT staff per 56 non-IT employees in major IT job categories of programmer/analyst (51%), support (28%) and telecommunication (16%). The Health Information Management and System Society (HIMSS; www.himss.org), a not-for-profit organization focused on global health IT leadership for the optimal use of information technology (IT) and management systems list the major job functions of IT staff as the following: Health Information Consultant, Clinical Documentation Specialist, Associate / Chief Information Officer, EHR Systems Administrator, Software Application Coordinator, Security Database Analyst, Director of Health Information Services, Clinical Content Manager, Clinical Analyst, Hospital Compliance Auditor, Application Analyst, IT Project Manager, Healthcare Coding Specialist, Health Information Specialist, and Health Information Technician. Additionally, career demand information is found in the US Bureau of Labor Statistics. A discussion of Occupational Outlook Reports follows. BLS Occupational Outlook Handbook, 2010 Edition 21 Academically, health informatics has three major facets or domains: Information systems Informatics, Information technology. Information systems are concerned with such issues as information systems analysis, design, implementation, and management. Informatics is concerned with such issues as the structure, function and transfer of information, socio-technical aspects of health computing, and humancomputer interaction. Information technology is concerned with such issues as computer networks, database and systems administration, security, and programming. These three facets are aligned for the purpose of meeting the information needs of the various stakeholders within health care and related systems. Components of each of these facets are highly interactive with each other, requiring knowledge and skills that are shared between them. The result is a critical synergy within the discipline of health informatics. Educational programs in health informatics (such as ours) include content from all three facets. Graduates of a program will have formal exposure and show an understanding of the interconnections between the three facets. 21 Bureau of Labor Statistics, U.S. Department of Labor, Career Guide to Industries, 2010-11 Edition , Healthcare, on the Internet at http://www.bls.gov/oco/cg/cgs035.htm (visited January 21, 2011 ). 17 At present, the BLS does not track health informatics professions per se. Unfortunately, the BLS occupation codes lag behind CIP designations for career pathways in health informatics. As this is an important evolving area of the health workforce, the American Health Information Management Association (AHIMA) is working with Congressman David Wu (D-OR) to urge the Department of Labor’s Bureau of Labor Statistics (BLS) to update their Standard Occupational Classifications (SOC) for health information management (HIM) professionals (http://www.ahima.org/advocacy/news.aspx#soc). As a result, we present data from both the Health Care and Information Technology 22 Occupational Outlook reports. BLS Table 2. Employment of wage and salary workers in healthcare, 2008 and projected change, 2008-2018. (Employment in thousands) Employment, 2008 Occupation Number All Occupations Percent Percent Change, 2008-18 14,336.0 100.0 22.5 614.6 4.3 16.8 Professional and related occupations 6,283.9 43.8 22.5 Office and administrative support occupations 2,540.3 17.7 19.7 Management, business, and financial occupations NOTE: Columns may not add to total due to omission of occupations with small employment. SOURCE: BLS National Employment Matrix, 2008-18. BLS Table 3. Employment in healthcare by industry segment, 2008 and projected change, 2008-18 (Employment in thousands) Industry segment Healthcare, total 2008 Employment 2008-18 Percent change 14,336.0 22.5 Hospitals, public and private 5,667.2 10.1 Nursing and residential care facilities 3,008.0 21.2 Offices of physicians 2,265.7 34.1 958.0 46.1 Home healthcare services 22 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Computer Systems Analysts, on the Internet at http://www.bls.gov/oco/ocos287.htm (visited January 21, 2011). 18 BLS Table 3. Employment in healthcare by industry segment, 2008 and projected change, 2008-18 (Employment in thousands) Industry segment 2008 Employment 2008-18 Percent change Offices of dentists 818.8 28.5 Offices of other health practitioners 628.8 41.3 Outpatient care centers 532.5 38.6 Other ambulatory healthcare services 238.5 6.8 Medical and diagnostic laboratories 218.5 39.8 SOURCE: BLS National Employment Matrix, 2008-18 Computer network, systems and database managers The BLS predicts the overall employment of computer network, systems, and database administrators will increase by23 percent from 2008 to 2018, much faster than the average for all occupations. In addition, this occupation will add 286,600 new jobs over that period. Growth, 23 however, will vary by specialty. This is much faster than the average for all occupations. Computer networks are an integral part of business, and demand for these workers will increase as firms continue to invest in new technologies. The increasing adoption of mobile technologies means that more establishments will use the Internet to conduct business online. This growth translates into a need for systems administrators who can help organizations use technology to communicate with employees, clients, and consumers. Growth will also be driven by the increasing need for information security. As cyber attacks become more sophisticated, demand will increase for workers with security skills, some of which will be employed in health care. The BLS predicts the employment of database administrators is expected to grow by 20 percent from 2008 to 2018, much faster than the average. Demand for these workers is expected to increase as organizations need to store, organize, and analyze increasing amounts of data. In addition, as more databases are connected to the Internet, and as data security becomes increasingly important, a growing number of these workers will be needed to protect databases from attack. Employment of network systems and data communications analysts is projected to increase by 53 percent from 2008 to 2018, which is much faster than the average and places it among the fastest growing of all occupations. 23 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Computer Systems Analysts, on the Internet at http://www.bls.gov/oco/ocos287.htm (visited January 21, 2011). 19 BLS Projections Data from the National Employment Matrix Occupational Title Computer network, systems, and database administrators SOC Code Employment, 2008 Change, 2008-18 Projected Employment, 2018 Number Percent 30 Detailed Statistics — 961,200 1,247,800 286,600 — — Database administrators 151061 120,400 144,700 24,400 20 [PDF] [XLS] Network and computer systems administrators 151071 339,500 418,400 78,900 23 [PDF] [XLS] Network systems and data communications analysts 151081 292,000 447,800 155,800 53 [PDF] [XLS] All other computer specialists 151099 209,300 236,800 27,500 13 [PDF] [XLS] NOTE: Data in this table are rounded. See the discussion of the employment projections table in the Handbook introductory chapter on Occupational Information Included in the Handbook. Network and computer system administrators by health care and social sectors24 BLS Career Category 2008 Employment Total employment, all workers 339.5 Health care and social assist. Health 2008 Percent of industry 0.22 Percent of occup 2018 Employment 2018 Percent of ind Percent of occ Percent Change Employment change 100.00 418.4 0.25 100.00 23.23 78.9 17.1 0.10 5.05 24.8 0.12 5.92 44.62 7.6 15.5 0.11 4.57 22.7 0.13 5.43 46.34 7.2 care 24 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Computer Systems Analysts, on the Internet at http://www.bls.gov/oco/ocos287.htm (visited January 21, 2011). 20 25 Medical and health services managers by healthcare and social sectors BLS Career Category Total employment, all workers Health care and social assist. Health care 2008 Employment Percent of occup 2018 Employment 2018 Percent of ind Percent of occ Percent Change Employment change 283.5 2008 Percent of industry 0.19 100.00 328.8 0.20 100.00 16.01 45.4 212.6 1.26 75.01 251.0 1.20 76.32 18.03 38.3 206.8 1.44 72.97 243.7 1.39 74.11 17.82 36.9 Health Information Technicians Health information technicians see: Medical records and health information technicians Medical records and health information technicians Job Outlook The BLS predicts that employment is expected to grow faster than average. Job prospects should be very good; technicians with a strong background in medical coding will be in particularly high demand. “Employment in occupations related to health care is projected to increase in coming years. Employment growth is expected to be driven by technological advances in patient care, which permit a greater number of health problems to be treated, and by an increasing emphasis on preventive care.”26 Employment Change Employment of medical records and health information technicians is expected to increase by 20 percent through 2018—faster than the average for all occupations—because of rapid growth in the number of medical tests, treatments, and procedures that will be increasingly scrutinized by health insurance companies, regulators, courts, and consumers. Also, technicians will be needed to enter patient information into computer databases to comply with Federal legislation mandating the use of electronic medical records. New jobs are expected in offices of physicians as a result of increasing demand for detailed records, especially in large group physician practices. New jobs also are expected in home health care services, outpatient care centers, and nursing and residential care facilities. Although employment growth in hospitals will not keep pace with growth in other health care industries, many new jobs will, nevertheless, be created. Cancer registrars (and others who support public health data reporting systems) should also experience job growth. 25 Bureau of Labor Statistics, U.S. Department of Labor, Career Guide to Industries, 2010-11 Edition , Healthcare, on the Internet at http://www.bls.gov/oco/cg/cgs035.htm (visited January 21, 2011 ). 26 Retrieved from http://www.bls.gov/spotlight/2009/health_care/home.htm 21 Job Prospects The BLS predicts job prospects should be very good. In addition to job growth, openings will result from the need to replace technicians who retire or leave the occupation permanently. Technicians with a strong background in medical coding will be in particularly high demand. Changing government regulations and the growth of managed care have increased the amount of paperwork involved in filing insurance claims. Additionally, health care facilities are having some difficulty attracting qualified workers, primarily because employers prefer trained and experienced technicians prepared to work in an increasingly electronic environment with the integration of electronic health records. Job opportunities may be especially good for coders employed through temporary help agencies or by professional services firms who support health care entities. Health Information Managers Health information managers see: Medical and Health Services Managers Medical and Health Services Managers Job Outlook The BLS predicts the employment of medical and health services managers is expected to grow 16 percent from 2008 to 2018, faster than the average for all occupations. The healthcare industry will continue to expand and diversify, requiring managers to help ensure smooth business operations. Job opportunities will be good, especially for applicants with work experience in healthcare and strong business management skills. Medical and health services managers with experience in large hospital facilities will enjoy an advantage in the job market, as hospitals become larger and more complex. Competition for jobs at the highest management levels will be keen because of the high pay and prestige. Job opportunities should be good, especially for applicants with work experience in the health care field and strong business management skills. BLS Projections Data from the National Employment Matrix Occupational Title Medical and health services managers Change, Projected 2008-18 SOC Employment Employment Code 2008 2018 Number Percent 119111 283,500 SOURCE: BLS National Employment Matrix, 2008-18 22 328,800 45,400 16 BLS Table 2. Employment of Wage and Salary Workers in Healthcare, 2008 and Projected Change, 2008-2018. (Employment in thousands) Employment, 2008 Occupation All Occupations Number Percent Percent Change, 2008-18 14,336.0 100.0 22.5 614.6 4.3 16.8 Professional and related occupations 6,283.9 43.8 22.5 Office and administrative support occupations 2,540.3 17.7 19.7 Management, business, and financial occupations NOTE: Columns may not add to total due to omission of occupations with small employment. SOURCE: BLS National Employment Matrix, 2008-18. According to the Bureau of Labor Statistics (BLS), healthcare will generate 3.2 million new wage and salary jobs between 2008 and 2018, more than any other industry. Ten of the twenty fastest growing occupations are forecasted where job openings are expected across all healthcare employment settings. Job growth is increasing as a result of employment growth and the need to replace workers who retire or leave their jobs. Wage and salary employment in the healthcare industry will increase 22 percent through 2018, compared with 11 percent for all other industries combined.27 Healthcare firms employ large numbers of workers in professional and service occupations. Together, these two occupational groups account for 76 percent of jobs in the industry (BLS Table 2). The next largest share of jobs, 18 percent, is in office and administrative support. Management, business, and financial operations occupations account for 4 percent of employment, with other occupations accounting for 2 percent of the total. 28 Employment Change The BLS predicts employment of medical and health services managers is expected to grow 16 percent from 2008 to 2018, faster than the average for all occupations. The health care industry will continue to expand and diversify, requiring managers to help ensure smooth business operations. The BLS anticipates managers, in all settings will be needed to improve quality and efficiency of health care while controlling costs, as insurance companies and Medicare demand higher levels 27 Bureau of Labor Statistics, U.S. Department of Labor, Career Guide to Industries, 2010-11 Edition, Healthcare, on the Internet at http://www.bls.gov/oco/cg/cgs035.htm (visited January 21, 2011 ). 28 IBID 23 of accountability. Managers also will be needed to oversee the computerization of patient records and to ensure their security as required by law. Additional demand for managers will stem from the need to recruit workers and increase employee retention, to comply with changing regulations, to implement new technology, and to help improve the health of their communities by emphasizing preventive care. The BLS anticipates hospitals will continue to employ the most medical and health services managers over the 2006-16 decade. However, the number of new jobs created is expected to increase at a slower rate in hospitals than in many other industries because of the growing use of clinics and other outpatient care sites. Despite relatively slow employment growth, a large number of new jobs will be created because of the industry’s large size. The BLS predicts employment will grow fastest in practitioners’ offices and in home health care agencies. Many services previously provided in hospitals will continue to shift to these settings, especially as medical technologies improve. Demand in medical group practice management will grow as medical group practices become larger and more complex. Medical and health services managers also will be employed by health care management companies that provide management services to hospitals and other organizations and to specific departments such as emergency, information management systems, managed care contract negotiations, and physician recruiting. Job Prospects The BLS anticipates job opportunities will be good, especially for applicants with work experience in the health care field and strong business management skills should have the best opportunities. Medical and health services managers with experience in large hospital facilities will enjoy an advantage in the job market, as hospitals become larger and more complex. Competition for jobs at the highest management levels will be keen because of the high pay and prestige. Virginia Employment Commission / Virginia Workforce Connection http://www.vaworkconnect.com/ does not yet contain industry by sector information on the following: health information, health technology, or health informatics. The health industry sector information comprises legal entities (i.e., funds, plans, and/or programs) organized to provide medical, surgical, hospital, vacation, training, and other health- and welfare-related employee benefits. The North American Industry Classification System (NAICS), the standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the U.S. business economy was queried using key words: health information, health technology and did not obtain any NAICS code results with which to access VEC industry information. NAICS was developed under the auspices of the Office of Management and Budget (OMB), and adopted in 1997 to allow for a high level of comparability in business statistics among the North American countries. The U.S. Government Web site http://www.census.gov/eos/www/naics/ provides the latest information on the NAICS reference files. 24 The Department of Health Administration and Policy is seeking accreditation of the program from: The Commission for Accreditation for Health Informatics and Information Management (CAHIIM) is an independent accrediting organization whose Mission is to serve the public interest by establishing and enforcing quality Accreditation Standards for Health Informatics (HI) and Health Information Management (HIM) educational programs. http://www.cahiim.org/ http://library.ahima.org/xpedio/groups/public/documents/accreditation/bok1_046877.pdf The American Recovery and Reinvestment Act of 2009 The biggest factor affecting the demand for health informatics specialists in the next decade is 29 the Federal Government’s initiative on health information technology. In February 2009, President Obama signed into law “The American Recovery and Reinvestment Act of 2009” (ARRA) which is intended "to jumpstart the economy, create or save millions of jobs, and put a down payment on addressing long-neglected challenges." HHS has been entrusted with investing $145.7 billion over 10 years with health IT (HITECH) funding estimated at $27.4 billion. The most important goal of this program is to speed-up the adoption rate of Electronic Health Records (EHR) which currently is less than 10% using a definition that requires the presence of functionalities for physicians' notes and nursing assessments, information systems according to a 2009 New England Journal of Medicine article which found “more than 90% of U.S. hospitals do not even meet the requirement for a basic electronic-records system”.The majority of US hospitals do not utilize electronic record systems and only 17% of US physicians use one. Among hospitals without electronic-records systems, the most commonly cited barriers were inadequate capital for purchase (74%), concerns about maintenance costs (44%), resistance on the part of physicians (36%), unclear return on investment (32%), and lack of availability of staff with adequate expertise in information technology (30%). Jha AK,DesRoches CM, Campbell EG, Donelan K, Rao SR, Ferris TG, Shields A, RosenbaumS, Blumenthal D, “Use of Electronic Health Records in US Hospitals:, N Engl J Med 2009; 360:1628-1638 Through financial reimbursements under HITECH program (up to $11 million for a hospital and up to $48,400 for doctors) authorized by ARRA to health care providers who can demonstrate "meaningful uses" of EHR, the Federal Government has created an enormous incentives for physicians and hospitals to move toward adoption of EHR. This movement will directly increase the demand for health informatics specialists who will graduate from the proposed MS in Health Informatics program. Indeed, There is evidence that the market started reacting favorably to early federal stimulus efforts: InformationWeek magazine in Sept. 10, 2009: “Healthcare Market Hot For IT Staffing” (http://www.informationweek.com/story/showArticle.jhtml?articleID=219700374) reported: “A survey of 244 healthcare CIOs conducted recently by IT staffing firm Robert Half Technology found that 5% plan to increase hiring in the fourth quarter, compared to CIOs overall in the U.S. across all industries, where demand for IT talent is flat.” 29 Federal ARRA Implementation Plan http://www.hhs.gov/recovery/reports/plans/master_hhs_plan06212010.pdf 25 GMU Survey of Student Demand GMU conducted a survey of current and prospective students on their interest. A copy of the survey and its results can be found in appendix E. the survey indicates strong student interest in the program. Out of 111 respondents, 93 agreed that it was important for an MS in Health Informatics to be offered by GMU in Northern Virginia. Out of 111, 87 said they would like to pursue an MS in Health Informatics. More interesting, 15 out of 86 respondents were in a current master’s degree and were interested in transferring. Employer Demand Letters of support for a graduate Health Informatics degree at GMU were requested and received from local health agencies and IT firms. They can be found in Appendix D1. More importantly, An analysis of job opportunities in Health Informatics was also done and recently updated. From December 2010 through February 2011, 59 job opportunities were identified. Each job announcement with its URL is compiled and attached in Appendix D2. A summary appears in the table below. Job Announcements for Health Informatics Positions Organizations Total Grand Total Education Firms/ entities 4 Hospitals/ Health systems 32 Technology Firms Consulting Firms/Thin k Tanks 8 3 HC Business/Op erations Support Firms 12 Grand Total 59 Taken together, the student survey, letters of support from local health agencies and job announcements indicates strong support for the program 26 Student Demand _____________________________________________________________________________ S TATE COUNCIL OF HIGHER EDUCATION FOR VIRGINIA SUMMARY OF PROJECTED ENROLLMENTS IN PROPOSED PROGRAM Projected enrollment: Year 1 Year 2 Year 3 Year 4 Target Year (2-year institutions) Year 5 Target Year (4-year institutions) 2011 - 2012 2012 - 2013 20123- 20143 2014- 2015 2015- 2016 HDCT 51 FTES HDCT FTES 27 49 26 HDCT FTES 32 17 HDCT FTES 32 17 GRAD -- HDCT 25 FTES 19 GRAD 11 Assumptions: 90% Retention 40% Full-time students, 60% Part-time students Full-time student taking 9 credit hours Part-time student taking 4.5 credit hours Full-time students graduate in 2 years Part-time students graduate in 4 years Duplication This proposed program is classified under the new CIP 51.2706 of the Classification of Instructional Programs 2010 Edition CIP 2010 (http://nces.ed.gov/ipeds/cipcode/Default.asp) CIP 2010 definitions for code 51.2706 and related codes are cited below: CIP 51.2706 Medical Informatics: A program that focuses on the application of computer science and software engineering to medical research and clinical information technology support, and the development of advanced imaging, database, and decision systems. Includes instruction in computer science, health information systems architecture, medical knowledge structures, medical language and image processing, quantitative medical decision modeling, imaging techniques, electronic medical records, medical research systems, clinical decision support, and informatics aspects of specific research and practice problems. 27 CIP 51.0706 Health Information/Medical Records Administration/Administrator: A program that prepares individuals to plan, design, and manage systems, processes, and facilities used to collect, store, secure, retrieve, analyze, and transmit medical records and other health information used by clinical professionals and health care organizations. Includes instruction in the principles and basic content of the biomedical and clinical sciences; information technology and applications; data and database management; clinical research methodologies; health information resources and systems; office management; legal requirements; and professional standards. For purposes of program assessment we examined other CIP codes for potential duplication of effort assessment, even though their purpose and career trajectories are distinctly different: CIP 26.1103 Bioinformatics: A program that focuses on the application of computer-based technologies and services to biological, biomedical, and biotechnology research. Includes instruction in algorithms, network architecture, principles of software design, human interface design, usability studies, search strategies, database management and data mining, digital image processing, computer graphics and animation, CAD, computer programming, and applications to experimental design and analysis and to specific quantitative, modeling, and analytical studies in the various biological specializations. CIP 11.0104 Informatics: A program that focuses on computer systems from a user-centered perspective and studies the structure, behavior and interactions of natural and artificial systems that store, process and communicate information. Includes instruction in information sciences, human computer interaction, information system analysis and design, telecommunications structure and information architecture and management. See also: 26.1103) Bioinformatics., 51.2706) Medical Informatics. Although there are overlaps in the contents of CIP 51.2706 (Medical/Health Informatics) and CIP 51.0706 (Health Information/Medical Records Administration/Administrator), their main difference is that while the latter emphasizes on the management of health information systems, in the training of Medical/Health informatics making meaningful use of that information in the context of medical knowledge structures and medical decision making are also included. The main difference between CIP 51.2706 (Medical/Health Informatics) and CIP 26.1103 Bioinformatics is that the former focuses on patient data level while the latter is mainly dealing with data at molecular level. The main difference between CIP 51.2706 (Medical/Health Informatics) and CIP 11.0104 Informatics in general is that Medical/Health Informatics provides a focus on the problems and issues in health care domain. The question about redundancy is answered at two levels. At SCHEV level and at GMU level. Search SCHEV website http://research.schev.edu/DegreeInventory Search for CIP code 51.2706 Medical Informatics returns an empty set. Search for CIP code 51.0706 Health Information/Medical Records Administration/Administrator also returns an empty set. 28 Search for CIP code 51.0701 Health/Health Care Administration/Management o George Mason University, MS Health/Health Care Administration/Management o Marymount University: MS Health/Health Care Administration/Management o Virginia Commonwealth University: MSHA/MHA Health/Health Care Administration/Management Search for CIP 26.1103 Bioinformatics returns o Virginia Commonwealth University, BS Bioinformatics o Virginia Commonwealth University, MS/MBIN Bioinformatics o Virginia Tech, PHD Bioinformatics Search for CIP 26.1199 o George Mason University MS Biomathematics and Bioinformatics Search of the SCHEV inventory shows that this proposed program is not duplicated by other programs of CIP 51.2706 or CIP 51.0706 offered by any institution in Virginia. Further information on our findings for this and what might seem duplicative to those who are not familiar with this new, specialized career area follows. Programs at GMU In the following we review the curriculum of programs that have an information systems management education purpose and explain why our proposed program is not duplicate of any other programs offered at GMU or elsewhere. School of Management has a BS in Information Systems and Operations Management and does not offer MS degree related to Health Information Systems. The Volgenau School of Information Technology and Engineering’s Computer Science Department offers MS in Information Systems with the following description. This professional degree program focuses on the technical, managerial, and policy issues associated with designing, building, and maintaining information systems in non-healthcare related organizations. Data, information, and knowledge are crucial to the modern enterprise, and the MS in information systems (MS-ISYS) addresses both the theoretical and engineering aspects of specifying, designing, implementing, and managing large-scale information systems. The goals of the MS-ISYS are to provide a high-quality program that allows students with diverse baccalaureate and professional backgrounds to obtain the MS degree; provide a technical body of knowledge, together with hands-on project experience, that will allow students to analyze, design, build, deploy, maintain, and manage information systems in large organizations such as industry, government, and nonprofits; and provide a course of study that allows 29 professionals to pursue a technical or a managerial approach to general business and government information systems, excluding healthcare delivery entities. The career paths open to graduates include technical and management positions from this degree are in business and government sectors (non-healthcare) in such roles as systems analyst, data administrator, information architect, database administrator, systems architect, decision analyst, data warehouse administrator, database programmer, web-based information systems designer and programmer, information engineer, and knowledge engineer. Management positions include chief information officer, chief knowledge officer, chief privacy officer, project manager, and webmaster in non-health related organizations/entities. The proposed MS program in Health Informatics provides education and training in health care domain knowledge and skills which are absent in the courses and course contents of the engineering program MS in Information Systems. College of Science Department of Bioinformatics and Computational Biology offers MS Bioinformatics and Computational Biology with the following description. This degree addresses the growing national and regional demand for trained computational biologists. It combines a solid foundation in biotechnology with the computational skills required for bioinformatics. The flexibility of the degree structure permits students to custom design their curriculum under an advisor’s guidance, making the MS in bioinformatics especially relevant for students employed in today’s diverse biotechnology workplace. Students completing the program are qualified to pursue careers that require knowledge of current bioinformatics methods and the ability to develop new bioinformatics software. The Department of Bioinformatics and Computational Biology also offers MS program in Bioinformatics Management with the following description This degree addresses the regional and national need for technically trained managers who will be able to lead teams of bioinformaticians in both the public and private sectors. The degree combines a solid foundation in bioinformatics research, tools, and techniques, with the management skills needed to address the associated legal, ethical, managerial, and business issues. The MS in bioinformatics management is intended for students seeking advancement in their current bioinformatics careers that requires an advanced degree in bioinformatics combined with management expertise. Students with a general background in biological science or computational methods who are planning to enter the field of bioinformatics as managers and would like to strengthen their bioinformatics and managerial expertise. The difference between the proposed MS in Health Informatics and this MS program in Bioinformatics and Computational Biology or Bioinformatics Management is that the latter focus is on the algorithms and methods used for the biological processes at the cellular level and the processes and functions and system management are focused on biologicical analytics based systems. This emphasis is illustrated by the core courses: BINF 630 - Bioinformatics Methods; BINF 631 - Molecular Cell Biology for Bioinformatics; BINF 634 - Bioinformatics Programming; BINF 734 - Advanced Bioinformatics Programming and BINF 730 - Biological Sequence Analysis. The evidence shows that the proposed program of MS in Health Informatics is not duplicate of any programs offered at GMU. 30 The American Medical Informatics Association maintains an authoritative list of academic training programs in health informatics (https://www.amia.org/informatics-academic-trainingprograms). In Virginia, there are two universities who identify master’s degree programs related 30 to health informatics: the UVA Mindset program in Systems Engineering and at GMU the Health Systems Management, Health information Systems Management Program and the MS in Bio-Informatics and Computational Biology Management program31. Only the GMU Health Systems Management, Management of Health Information Systems offers a curriculum specialized in Health Informatics. Both the UVA Mindset program and GMU VSE program are systems engineering programs that support students taking an elective course or focusing their research in a health related area. None but the GMU HAP HSM program (recall that this program will be replaced by the new MS in Health Informatics degree program) offers an indepth program focused on health informatics. None of these programs is CHAIIM accredited, nor designed to meet accreditation criteria (other than the proposed program). The University of Virginia offers an MS in Systems Engineering with a concentration in Health 32 Care called Mindset (CIP 14.2701) . The concentration is fielded through a research focused experience in health care applications as follows: Students focus their Systems Engineering training in one of five areas of departmental expertise: Computational statistics and simulation, Human factors, Optimization and control, Risk and decision analysis or Systems integration. Students work with faculty on research projects to apply techniques and tools from these areas to problems related to healthcare, under the collaborative guidance of a primary mentor in the Department of Systems and Information Engineering. The GMU College of Science MS in Bioinformatics Management and Computational Biology (CIP ) addresses the growing national and regional demand for trained computational biologists. The degree combines a solid foundation in biotechnology with computational skills required for bioinformatics. Students completing the program are qualified to pursue careers that require knowledge of current bioinformatics methods and the ability to develop new bioinformatics software. Five-year enrollments and graduation totals are presented next. 30 http://www.sys.virginia.edu/healthcare/ 31 http://catalog.gmu.edu/preview_program.php?catoid=5&poid=1064&returnto=111 32 http://web.sys.virginia.edu/graduate/concentrations.html 31 Table 5: Completions for Programs in the Commonwealth Enrollments: UVA (14.2701 all majors; Health Care Systems Program new in 2007); HC Mgt, and not informatics UVA (51.2299; all majors including Public Health Research) GMU (52.999); Bioscience Mgt http://research.schev.edu/enrollment/E16_Report.asp Graduates: UVA (14.2701 all majors) 33 Fall 2005 NA Fall 2006 NA Fall 2007 Fall 2008 Fall 2009 89 Fall 2005 NA Fall 2006 NA Fall 2007 NA Fall 2008 47 (all majors) Fall 09-10 63 (all majors) UVA (51.2299; all majors) GMU (52.999 Bioscience Mgt) Source: http://research.schev.edu/Completions/C1Level2_Report.asp 0 Projected Resource Needs The Department of Health Administration and Policy has the resources to support the proposed MS in Health Informatics. These resources will be reallocated from the HSM concentration. As a result, the new academic program is expense neutral. The subsections that follow detail the resources required to operate the program from its initiation in 2012-2013 through the target year of 2016-2017. Assessments of the future need for instructional faculty are based on the following ratio of student enrollment to faculty effort: 9 FTE of enrollment require one FTE of faculty for instruction. Based on current enrollment projections, the proposed program will require 3.00 FTE to launch (taking in consideration the students returning students from the concentrations), and maintain through the target year of 2016-2017. Full-time Faculty Currently, the Department of Health Administration and Policy has 3 full-time academic faculty who are committed to the program. We project that the MS in Health Informatics will require 2.00 FTE of full-time faculty support to launch and maintain the program (currently available). Part-time Faculty from Other Academic Units Current faculty in the Volgeneau School of Engineering field teaches and support courses that will be utilized in this degree. We project that the proposed program will require 1.00 of instructional effort to launch and maintain the program. Those faculty and courses also are present. 33 State Council of Higher Education for Virginia, Completions Summary, on the Internet, at http://research.schev.edu/Completions/C1Level2_Report.asp (visited December 20, 2010). 32 Adjunct Faculty The MS in Health Informatics will only require occasional use of adjunct instructional effort to operate the program. Graduate Assistants No additional GRAs are need to initiate and support the proposed program. GRAs are allocated to the department through a tuition premium that was begun for all CHHS courses in AY10-11. The Department has 3 GRAs allocated each academic year. Classified Positions No additional classified positions are needed to initiate the program; current CHHS/ HAP, VSE/AIT resources will be utilized. Therefore, the proposed program will only require 0.50 FTE of classified support to launch and maintain the program after full student FTE are reached. Targeted Financial Aid No additional financial aid is needed. Students that will enroll in this degree are not expected to increase financial aid demand. Current GMU resources will be adequate. We also note that scholarships from HIMSS and Virginia AHIMA are available to our students. Equipment Because no new faculty or classified staff will be hired to support the proposed program, the MS in Health Informatics will not require new equipment purchases. Library The University Libraries routinely commit $3000 to the purchase of related materials for new master’s programs. A considerable collection already exists because of the current certificates and HSM program for journals and text books relating to health informatics/health information technology. Telecommunications Because no new faculty or classified staff will be hired to support the proposed program, the MS in Health Informatics will not require new telecommunications equipment or software. Space No additional space needed to initiate the new program. Other Resources The MS in Health Informatics requires no resources beyond those described above. 33 ______________________________________________________________________________ PROJECTED RESOURCE NEEDS FOR PROPOSED PROGRAM Part A: Answer the following questions about general budget information. Has or will the institution submit an addendum budget request Yes No to cover one-time costs? Has or will the institution submit an addendum budget request to cover operating costs? Yes No Will there be any operating budget requests for this program that would exceed normal operating budget guidelines (for Yes No example, unusual faculty mix, faculty salaries, or resources)? Will each type of space for the proposed program be within Yes x No projected guidelines? Will a capital outlay request in support of this program be forthcoming? Yes No Part B: Fill in the number of FTE positions needed for the program x x x Expected by Target Enrollment Year 2016-2017 Program Initiation Year 2012-2013 On-going and reallocated x Added (New) Added (New)** Total FTE positions Full-time faculty* 2.00 0.00 0.00 2.00 Part-time faculty (faculty FTE split with other unit(s)) 1.00 0.00 0.00 1.00 Adjunct faculty 0.00 0.00 0.00 0.00 Graduate assistants 0.00 0.00 0.00 0.00 Classified positions 0.50 0.00 0.00 TOTAL 3.50 0.00 0.00 0.50 3.50 * Faculty dedicated to the program ** Added after initiation year 34 Part C: Estimated resources to initiate and operate the program Expected by Target Enrollment Year 2016-2017 Program Initiation Year 2012-2013 Full-time faculty 2.00 0.00 0.00 2.00 $180,000 $0 $0 $180,000 $55,242 $0 $0 $55,242 1.00 0.00 0.00 1.00 salaries $90,000 $0 $0 $90,000 fringe benefits $27,621 $0 $0 $27,621 0.00 0.00 0.00 0.00 salaries $0 $0 $0 $0 fringe benefits $0 $0 $0 $0 0.00 0.00 0.00 0.00 salaries $0 $0 $0 $0 fringe benefits $0 $0 $0 $0 0.50 0.00 0.00 0.50 $15,000 $0 $0 $15,000 $6,317 $0 $0 $6,317 $285,000 $0 $0 $285,000 $89,180 $0 $0 $89,180 $374,180 $0 $0 $374,180 $0 $0 $0 $0 $3,000 $0 $0 $3,000 Telecommunication costs $0 $0 $0 $0 Other costs (specify) $0 $0 $0 $0 $377,180 $0 $0 $377,180 salaries fringe benefits Part-time faculty (faculty FTE split with unit(s)) Adjunct faculty Graduate assistants Classified Positions salaries fringe benefits Personnel costs salaries fringe benefits Total personnel cost Equipment Library TOTAL 35 Part D: Certification Statement(s) The institution will require additional state funding to initiate and sustain this program. Yes Signature of Chief Academic Officer x No Signature of Chief Academic Officer If “no,” please complete Items 1, 2, and 3 below. 1. Estimated $$ and funding source to initiate and operate the program. Funding Source Reallocation within the department or school (Note below the impact this will have within the school or department.) Reallocation within the institution (Note below the impact this will have within the school or department.) Program initiation year 2012- 2013 Target enrollment year 2016 - 2017 $256,559 $256,559 $120,621 $120,621 $0 $0 Other funding sources (Please specify and note if these are currently available or anticipated.) 2. Statement of Impact/Other Funding Sources. Reallocation within the department or school. The resources necessary to operate the MS in Health Informatics reside in the Department of Health Administration and Policy, currently supporting the Health Information Systems Management Program. These resources will be reallocated to support the proposed program that will replace this HSM concentration. As a result, the new academic program is expense neutral. Reallocation within the institution. Institutional resources supporting the current HSM, Health Information Technology Management concentration are available and will be utilized to support the proposed new program. In addition, the University Libraries routinely allocate $3000 to new master’s programs. Other funding sources. No other funding is required to support the proposed MS in Health Informatics. George Mason University will not request additional funding to launch or maintain the program. 36 3. Secondary Certification. If resources are reallocated from another unit to support this proposal, the institution will not subsequently request additional state funding to restore those resources for their original purpose. x Agree Signature of Chief Academic Officer Disagree Signature of Chief Academic Officer 37 APPENDICES 38 Appendix A – Proposed Curriculum A-1 MS Health Informatics Curriculum: Course Matrix # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 A-1 Course Course number Core Cr Load Introduction to US Healthcare System* HAP 678 Core 3 1 HAP 700 Core 3 1 Introduction to Health Informatics HAP 701 Core 3 1 Health Data: Vocabulary & Standards HAP 709 3 1 Healthcare Databases* Core Information Systems Analysis and INFS 622 3 1 Design Core HAP 752 Core 3 1 Advanced Health Information Systems Topics in Information Security ISA 697 Core 3 1 Health Management Practicum and HAP 790 3 1 Capstone Seminar Core Students will select 1 course from each of three groups: AIT 597 3 Developing IT Leaders of Integrity Topics in the application of AIT 590 Group 1: 3 information technology Leadership 1 Project Management In Health HAP 713 and IT 3 Information Technology Management Software Requirements Analysis and SWE 620 3 Specification HAP 730 3 Healthcare Decision Analysis* Medical Decision Making and Decision Group II: HAP 770 3 Support Systems Healthcare 1 Data Mining in Healthcare HAP 780 Decision 3 support Analytic Models in Health Services HAP 820 3 Management, Policy, and Research Regulatory Requirements for Health HAP 547 3 Care Systems Group III: Cost-Effectiveness for Health Care Policy and HAP 762 3 1 Management and Policy Decisions Regulatory Conformance Legal Issues Relevant to Health Care HAP 750 3 Administration 11 Total required for the degree * = Available as a web-based/Distance education course Total credit 3 3 3 3 3 3 3 3 3 3 3 33 Introduction to US Healthcare System HAP 678 2 Introduction to Health Informatics HAP 700 3 Health Data: Vocabulary & Standards HAP 701 4 Healthcare Databases 5 Information Systems Analysis and Design HAP 709 INFS 622 6 Advanced Health Information Systems HAP 752 7 HAP 790 x x 8 Health Management Practicum and Capstone Seminar Topics in Information Security ISA 697 x x 9 Developing IT Leaders of Integrity A IT 597 10 Topics in the application of information technology A IT 590 11 HAP 713 12 Project Management In Health Information Technology Software Requirements Analysis and Specification 13 Healthcare Decision Analysis 14 Medical Decision Making and Decision Support Systems Data Mining in Healthcare Analytic Models in Health Services Management, Policy, and Research Regulatory Requirements for Health Care Systems HAP 820 16 17 18 19 A-2 Cost-Effectiveness for Health Care Management and Policy Decisions Legal Issues Relevant to Health Care Administration x x x x x x x x x x x x x x x x x x x x HAP 730 x x x x x x HAP 770 x x x HAP 780 x x x x x x HAP 547 HAP 762 HHS 750 x x x SWE 620 Organization/ Regulatory x 1 15 Technology Course number Methodology Course Data infrastructure # IT infrastructure A-2 Program Competency Mapping x x A-3 An Example 3-Semester Plan of Study by Course FALL SEMESTER 1. Introduction to US Healthcare System (3 credits) 2. Introduction to Health Informatics (3 credits) 3. Health Data: Vocabulary and Standards (3 credits) 4. Group 1: Developing IT Leaders of Integrity (3 credits) SPRING SEMESTER 1. Healthcare Databases (3 credits) 2. Information Systems Analysis and Design (3 credits) 3. Advanced Health Information Systems (3 credits) 4. Group 2: Healthcare Decision Analysis (3 credits) SUMMER or FALL SEMESTER 1. Topics in Information Security (3 credits) 2. Health Management Practicum and Capstone Seminar (3credits) 3. Group 3: Regulatory Requirements for Health Care Systems (3 credits) Total: 33 Credits A-3 Appendix B – Course Descriptions # Course Summary 1 Introduction to Health Informatics (3 cr) Code (HAP 700) This is an introductory course to the inter-disciplinary science of health care informatics. Students will learn about data and information as exchanged at all points of care in a person’s life cycle encounter with healthcare services. Study the applications implemented in healthcare settings with the history of evolution to be cognizant of the challenges overcome. Students in course gain knowledge of the driving forces that affect the evolution of informatics applications from technical evolution, research and policy directions, the standards organizations and research funding agencies. They will learn formal methods to analyze current information applications in healthcare, from data collection to clinical decision support. Learn in the course basics of technology assessment, the roles and contributions expected from an inter-disciplinary health informatics team member. 2 Health Data: (HAP 701) This is an introductory course to standardization and standards Vocabulary & Standards applicable in health IT. Topics include: the theory of standardization, (3 cr) standardization processes and the organizations involved in standardization. Students will learn the organizations and structures of standards applicable in healthcare including LOINC and SNOMED CT for terminology; CDA and CCR for documents; CCOW for architecture and HL7 and DICOM for data transfer. 3 Introduction to US (HAP 678) Introduction to the U.S. Health System: Explores structure, function, Healthcare System and financing of U.S. health care delivery systems. Explores development of (3 cr) various subsystems of care and ways: public, private, and social forces influence politics of health care, shape the system, and affect public health. Includes analysis of systems infrastructure and sociopolitical context of U.S. health care system. 4 Advanced Health (HAP 752) This course provides a comprehensive overview of electronic health Information Systems record systems (EHR) in offices, hospitals, and RHIOs. Topics include data (3 cr) modeling, database design, data exchange, and review the role of health system standards and terminologies in information health exchange and tools of data integration, the security solutions for privacy and confidentiality. It also discusses system architectures, redesign of workflows and modeling implementation. CORE 5 Healthcare Databases (3 cr) CORE B-1 (HAP 709) Introduces design and use of health and medical databases, providing hands-on experience. Explores uses of medical record systems. Includes review and analysis of databases and database management system s. Examines application of databases to clinical and managerial transaction; Manipulation of large databases, create link table queries, write SQL application programs, understand sources of data conflicts, and identify methods of integrating ODBC databases with legacy data. Features semester-long data integration group project. CORE CORE CORE 6 Project Management for (HAP 713) Project Management in Health Information Technology Covers the GROUP 1 Health Information body of knowledge in project management as applied to information technology Technology (3 cr) and prepares students to take project management professional certification exam. Includes: needs assessment, requirement gathering, project planning, project cost analysis, project control, project risks, and management of personnel within projects. 7 Health Care Decision Analysis (3 cr) (HAP 730) Students analyze practice patterns and find optimal methods of 8 Analytic Models in Health Services Management, Policy, and Research (3 cr) (HAP 820) An advanced statistics course in applied linear and multiple GROUP 2 regression analysis, including polynomial regression, indicator variables and covariance analysis, model selection and validation, methods for measurement errors, diagnostic methods for outliers, influence and multi -collinearity, nonlinear regression, logistic regression with non-normal distributions, correlations, and time-series analysis and forecasting as used in health services administration research and policy analysis. (HAP 780) Data Mining i n Health Care An introductory course to data mining GROUP 2 and knowledge discovery in health care. Methods for mining health care databases and synthesizing task-oriented knowledge from computer data and prior knowledge are emphasized. Topics include fundamental concepts of data mining, data preprocessing, classification and prediction (decision trees, attributional rules and Bayesian networks), constructive induction, cluster and association analysis, knowledge representation and visualization, and an overview of practical tools for discovering knowledge from medical data. These topics are illustrated by examples of practical applications in health care. GROUP 2 9 Data mining in Healthcare (3 cr) GROUP 2 improving them. Uses decision analysis and failure mode analysis in health care settings. Students integrate scientific evidence, patients’ preferences, and experts’ opinions to identify optimal alternatives. 10 Medical Decision Making and Decision Support Systems (New) (HAP 770) This course introduces systematic approaches to clinical decision making. It examines the methods and techniques used for estimating probability, (3 cr) measuring inaccuracy of clinical data, interpreting new information and extracting utility and patient preference. It also provides a n overview of decision support systems, Arden syntax, MLMs, alerts, notifications. 11 Cost-Effectiveness for (HAP 762) A survey course in health services research methods for the GROUP 3 Health Care application of economic evaluation techniques used in health care policy analysis Management and Policy and clinical or administrative applications for health care service planning and Decisions (3 cr) evaluation. Content introduces methods applied to health care technology assessment, medical decision making, health resource allocation, and policymaking 12 Legal Issues Relevant to (HHS 750) Legal Issues Relevant to Health Care Administration focusing on Health Care HIPAA. Prepares health professionals to understand legal principles, statutes, Administration (3 cr) regulations, and case law related to managing health care organizations and health professionals’ practice. May compare legal health care issues from domestic and international perspectives. B-2 GROUP 3 13 Regulatory (HAP 547) Helps health care professionals understand link between GROUP 3 Requirements for Health infrastructures of organization and regulatory and accreditation processes for Care Systems (3 cr) health care organizations. Covers major accrediting agencies and their roles, accreditation principles, and survey process. Focuses on hospitals with reference to ambulatory care, managed care organizations, rehabilitation centers, laboratories, and home health and long-term care facilities. Emphasizes requirements of Joint Commission on Accreditation of Health Care Organization and regulations mandated by Health Care Finance Administration. 14 Capstone Health (HAP 790) Team-based field practicum in health management, problem analysis, Management Practicum and project management in health care or service organization. Learning teams and Seminar (3 cr) define complex problem in assigned facility and analyze problem with recommendations for management decision action. Analysis provides context in which theoretical concepts and management skills are applied. Uses case study analyses to explore problem solving approaches in variety of situations and health care or service organizations. 15 Information Systems (INFS 622) Integration of computing technologies, system analysis, system Analysis and Design design practices, and management criteria in the design of large -scale information (3 cr) management and decision support systems. 16 Topics in Information Security (3 cr) CORE CORE (ISA 697) Special topics in information security and assurance not occurring in CORE regular ISA sequence. May be repeated for credit when distinct offerings of course differ in subject. 17 Developing IT Leaders (AIT 597) This course introduces students to the practice of leading with GROUP 1 of Integrity (3 cr) integrity. Through selected readings, discussions, team projects, in-class activities and guests, students identify their core values, study the attributes of effective and toxic leaders and, examine the difference between managing and leading. Students practice and receive in-class coaching to hone their leadership skills. The course considers the cultural and organizational influ ences and focuses on leadership’ s ethical dimensions. 18 Topics in the application (AIT 590) Topics in the application of information technology. The topics are GROUP 1 of information chosen in such a way that they do not duplicate existing AIT courses. Students technology (3 cr) are expected to participate actively through class dialogues and the crafting of IT solutions to specific problem areas. 19 Software Requirements (SWE 620) In-depth study of object-oriented requirements modeling, including GROUP 1 Analysis and use case modeling, static modeling and dynamic modeling with Unified Specification (3 cr) Modeling Language (UML) notation. Students participate in group project on software requirements and specification using modern method. B-3 Appendix C – Abbreviated CV’s for Faculty Dr. William Cartwright Dr. William Cartwright received his Ph.D. in Economics from Indiana University in 1980. He is currently an Assistant Professor with the Department of health Administration & Policy at George Mason University. He is a health economist who had a long career in federal service, and he publishes and lectures on financing, cost-benefit analysis, cost-effectiveness analysis, and health policy. Dr. Alison Cuellar Dr. Alison Evans Cuellar earned her Ph.D. from the University of California, Berkeley in 2001. She is currently an Associate Professor in the Department of Health Administration & Policy at George Mason University. Her area of expertise is in health care systems, Medicaid, mental health, and justice involved populations, with contributions that include work on identifying and evaluating new organizational forms, such as hospital systems and physician alliances, and their effects on quality, efficiency, costs, prices, and technology adoption. Dr. Vicky Debold Dr. Vicky Debold earned her Ph.D. from the University of Michigan in 1999. She is currently a Research Faculty with the Department of Health Administration & Policy at George Mason University. She has worked in the health care field for more than 30 years as an ICU nurse, health care administrator, health policy analyst and faculty member focusing on safety and child health. Dr. Lisa Eckenwiler Dr. Lisa Eckenwiler earned her Ph.D. in Philosophy with a concentration in bioethics from the University of Tennessee-Knoxville in 1997. She is currently an Associate Professor of Philosophy and Director of Health Care Ethics at the Center for Health Policy Research and Ethics at Mason. Her areas of expertise have focused largely on research ethics, especially issues concerning vulnerable populations, and more recently, health worker migration and global health disparities. Dr. Anup Ghosh Dr. Anup Ghosh earned his Ph.D. in Electrical Engineering from the University of Virginia in 1996. He is currently a Research Professor and Chief Scientist in the Center for Secure Information Systems at George Mason University. His area of expertise is as a Senior Scientist and Program Manager in the Advanced Technology Office of the Defense Advanced Research Projects Agency (DARPA) where he managed an extensive portfolio of information assurance and information operations programs. C-1 Dr. Phan Giang Dr. Phan Giang earned his Ph.D. in Decision Science (with minor in Finance) from the University of Kansas in 2003. He is currently an Associate Professor with the Department of Health Administration & Policy at George Mason University. His areas of expertise are in healthcare informatics, decision analysis, applied probability, Bayesian statistics, and machine learning and artificial intelligence. Mr. Alan Goldberg Mr. Alan Goldberg earned his LL.M. from Boston University School of Law in 1978. He currently is an Attorney & Counsellor-at-Law in McLean, VA, practicing business and tax law including the delivery and regulation of health care, and information technology. His professional and academic background includes integrating business, health, and information technology law, in furtherance of complementing more and higher quality health care delivery and payment systems, and using computer technology efficiently and effectively as a part of such systems in compliance with regulatory and other governmental requirements. Dr. Jack Hadley Dr. Jack Hadley earned his Ph.D. in economics from Yale University in 1975. He is currently Professor and Senior Health Services Researcher in the Department of Health Administration & Policy, and Associate Dean for Finance and Planning in the Office of the Dean at George Mason University. His research emphasizes empirical analysis of issues in health care organization and financing, and has conducted studies of the financing and costs of care used by the uninsured, the determinants of health insurance coverage, the consequences of being uninsured, access to care, physician and hospital payment, medical education financing, hospital efficiency, assessment of the outcomes of medical treatment, and the effects of managed care on health care delivery systems. Dr. Lorens Helmchen Dr. Lorens Helmchen earned his Ph.D. in Economics from The University of Chicago in 2004. He is currently an Associate Professor in the Department of Health Administration & Policy. His area of expertise is in studying mechanisms that improve quality transparency in health care and patients’ incentives to choose effective medical treatment. Dr. Larry Kerschberg Dr. Larry Kerschberg earned his Ph.D. from Case Western University in 1969. He is Professor and Chair of the E-Center for E-Business at George Mason University. His career has focused on the synergy among various disciplines, being the co-creator of the Functional Data Model, and in 1999, he co-edited a special issue of the Journal of Intelligent Information Systems on the Functional Approach to Intelligent Information Systems. C-2 Dr. Panagiota Kitsantas Dr. Panagiota Kitsantas received her Ph.D. in Statistics from Florida State University in 2003. She is currently an Associate Professor in the Department of Health Administration & Policy at George Mason University. Her area of expertise pertains to the application of data mining techniques such as classification and regression trees, and methods of categorical data analysis and spatial statistics to investigate public health related issues in the fields of environmental health, maternal and infant health and substance abuse among adolescents. Dr. Matt Kluger Dr. Matt Kluger earned Ph.D. in Zoology from the University of Illinois in 1970. He is currently a Professor with the Department of Health Administration & Policy at George Mason University. During his career he has studied the biological basis of fever and related host defense responses, leading to the publication of over 200 articles and books, and has worked with numerous biotech and pharmaceutical companies. Dr. Tracey Koehlmoos Dr. Tracey Pérez Koehlmoos earned her Ph.D. in Public Health/Health Systems and Population Outcomes Research from the University of South Florida in 2005. She is currently an Adjunct Professor in the Department of Health Administration and Policy at George Mason University. Her areas of expertise are in managing complex tasks, program development and capacity building across the spectrum of health systems building blocks, and has a long-term and sincere commitment to South Asia and the people of the subcontinent and has lived and worked in Pakistan, Nepal and Bangladesh for more than 15 years. Dr. Peter Kongstvedt Dr. Peter Kongstvedt earned his M.D. from the University of Wisconsin. He is currently a Research Faculty with the Department of Health Administration & Policy at George Mason University. He is a well known and highly regarded independent national authority on the health care industry with particular expertise in health insurance and managed health care, and has 30 years experience in health care in a variety of roles: as a partner and senior executive in global consulting firms, a senior executive leading health plans, managed care and health insurance organizations, and as a practicing physician. Dr. Gary Kreps Gary Kreps earned his Ph.D. in Communication from the University of Southern California in 1979. He currently serves as the Eileen and Steve Mandell Endowed Chair in Health Communication at George Mason University, where he is Chair of the Department of Communication and Director of the Center for Health and Risk Communication. He is a leading health communication and health services scholar, and his research (published in more than 300 articles, books, and monographs) examines health communication/promotion, multicultural relations, social organization, & applied research methods. C-3 Dr. Jessica Lin Dr. Jessica Lin received her Ph.D. in Computer Science from UC Riverside in 2005. She is an Assistant Professor in the Department of Computer Science at George Mason University. Her research has focused on the mining of large datasets, images, texts and other types of multimedia data, and has published work on time series clustering, motif discovery, symbolic representation, visualization, and anomaly detection. Dr. Goodlett McDaniel Dr. James McDaniel earned his Ed.D. from North Carolina State University in 1988. He is currently the Associate Provost for Distance Education at George Mason University. His are of expertise is in health care management as a program director, health assistant administrator, corporate regional marketing director, interim CEO, and healthcare consultant. He is an expert in Distance Education. Dr. Mark Meiners Dr. Mark R. Meiners earned his Ph.D. from Georgetown University in 1978. He is a Professor in the Department of Health Administration & Policy at George Mason University. His area of expertise specializes in the areas of aging and health with emphasis on financing and reimbursement issues, and is nationally recognized as one of the leading experts on financing and program development in long-term care. Dr. Khalid Moidu Dr. Khalid Moidu earned his Ph.D. in Medical Informatics from Linkoping University in Sweden in 1992. His area of expertise in healthcare informatics extends into data management, software application/systems development, and the design, development, implementation, and maintenance of systems. Dr. Len Nichols Dr. Len Nichols earned his Ph.D. Economics from the University of Illinois in 1980. He is currently the Director of the Center for Health Policy Research and Ethics at George Mason University. His areas of expertise are in health economics and health services research for health systems. Dr. Teresa Panniers Dr. Teresa Panniers earned her Ph.D. in Nursing from the University of Rochester in 1991. She is currently an Associate Professor within the School of Nursing at George Mason University. Her area of expertise are in nursing informatics and nursing research. Dr. Martin Perlin Dr. Martin Perlin earned his D.B.A. from George Washington University in 1971. He is currently an Associate Professor and Coordinator of the CAHME accredited program in Executive Management C-4 with the Department of Health Administration and Policy at George Mason University. He has extensive experience in senior healthcare executive and management consultant, and served as Vice President for an academic medical center and Chief Executive Officer of a community hospital. Ms. Suniti Ponkshe Ms. Suniti Ponkshe earned her M.S. in Management Information Systems from Texas Tech University. She is currently a consultant to the Office of National Coordinator (ONC) of Health Information Technology and supports projects such as electronic health record certification criteria, certification process, regulation writing, strategic planning, standards and interoperability framework, research grants, special studies and external communication. Her area of expertise is as a senior healthcare executive with extensive experience in private and public healthcare sectors including small hospitals, ambulatory settings, academic medical centers, long term care facilities and government organizations, and has expertise in health information technology (HIT) vendor market and their applicability. Dr. Sreedhar Potarazu Dr. Sreedhar Potarazu earned his M.D. from George Washington University School of Medicine in 1988. He is the founder and CEO of VitalSpring Technologies Inc., a privately held enterprise software company focused on providing employers with applications to empower them to become more sophisticated purchasers of health care. He is an acclaimed ophthalmologist and entrepreneur who has been recognized as an international visionary in the business of medicine. Mr. Robert Quinn Mr. Robert Quinn earned his M.B.A. in Organization Management from Fordham University in 1982. He is currently the Director of the Master of Science in Applied Information Technology program at George Mason University. His area of expertise is as a career management consultant with a focus on leadership development and business process re-engineering in healthcare and services industries, and as a two-term member of the St. Mary's Hospital (New Jersey) Board of Trustees, he oversaw the transformation of its management information processes that enabled rapid retirement of its collateralized debt and acquisition of its key hospital competitor. Dr. Christopher Saunders Dr. Christopher Saunders earned his Ph.D. in Statistics from the University of Kentucky in 2006. He is currently an Assistant Research Professor in the Document Forensics Laboratory at George Mason University. His area of expertise is as a mathematical statistician who has been involved in computational statistics related to forensics and medical research. Dr. Liansheng (Larry) Tang Dr. Liansheng Tang earned his Ph.D. in Statistics from Southern Methodist University in 2005. He is currently an Assistant Professor in the Department of Statistics at the Volgenau School of Information Technology and Engineering at George Mason University. His research interests include diagnostic medicine, sequential clinical trials, wavelets and bootstrap methodology. C-5 Dr. Syed Tirmizi Dr. Syed Tirmizi earned his M.D. from the University of North Dakota Internal Medicine Residency Training in 1990. He is currently the Senior Medical Informatician & V.P. International Business for Quantros, Inc. He has been associated with the planning, development, testing and deployment of the Veterans Health Administration Electronic Health Record System (VistA) since 1993. Dr. Sorina Vlaicu Dr. Sorina Vlaicu earned her M.D. from Carol Davila University of Medicine and Pharmacy in 1996. She is currently an Adjunct Professor with the Department of Health Administration & Policy at George Mason University. Her areas of expertise are in informatics strong experience in health informatics privacy and security, health data interoperability and public policy. Dr. Duminda Wijesekera Dr. Duminda Wijesekera earned his Ph.D. in Computer Science from the University of Minnesota in 1997. He is currently an associate professor in the Department of Information and Software Engineering at George Mason University. His research interests have been in security, multimedia, networks, secure signaling (telecom, railway and SCADA), avionics, missile systems, web and theoretical computer science. Dr. Janusz Wojtusiak Dr. Janusz Wojtusiak earned his Ph.D. in Computational Sciences and Informatics from George Mason University in 2007. He is currently an Assistant Professor with the Department of Health Administration & Policy, and Director of the Machine Learning and Inference Laboratory at George Mason University. His area of expertise is in the area of artificial intelligence, clinical decision support, and healthcare knowledge discovery. Dr. Tony Yang Dr. Tony Yang earned his Sc.D. in Health Policy and Management from Harvard University in 2006. He is currently an Assistant Professor in the Department of Health Administration & Policy at George Mason University. His areas of expertise are in legal and policy issues in the healthcare sector. C-6 Appendix D – Letters of Support (D1) and Job Announcements with URL and Date (D2) E-1 Masters of Science in Health Informatics (MSHI) Survey 1. Which graduate degree program are you enrolled in? Not in a graduate program Response Response Percent Count 20.7% 23 0.0% 0 51.4% 57 MPH 3.6% 4 MSN 0.9% 1 23.4% 26 answered question 111 skipped question 10 M.S. in International Health / Global Health M.S. in Health Systems Management Other (please specify) 1 of 3 2. If you are in a degree or certificate program, please tell us which one (select one) Executive management Response Response Percent Count 47.4% 27 3.5% 2 0.0% 0 28.1% 16 Health Policy 14.0% 8 Assisted Living Management 7.0% 4 answered question 57 skipped question 64 Risk Management and Patient Safety Security and Privacy Health Information Technology Management 3. If you are in a graduate program, what is your expected month/year of graduation? Response Count 87 2 of 3 answered question 87 skipped question 34 4. Please choose the option that indicates your agreement with each statement below: Strongly Disagree Disagree Neutral 1.1% (1) 2.2% (2) 11.5% 1. It is important for an MS in Health Informatics to be offered in degree. 3. I would like to transfer from my current degree program into the MS HI program. 4. I am interested in a career in Health Informatics. Stronly Rating Response Agree Average Count 26.9% 66.7% (25) (62) 24.1% 12.6% 47.1% (10) (21) (11) (41) 15.6% 26.6% 34.4% (10) (17) (22) 7.0% (6) 8.1% (7) 3.2% (3) Northern Virginia. 2. I would like to pursue an MS HI Agree 4.6% (4) 7.8% (5) 4.53 93 3.86 87 2.81 64 3.94 86 2.97 63 4.21 80 4.16 69 3.90 69 3.90 87 answered question 107 skipped question 14 15.6% (10) 16.3% 20.9% 47.7% (14) (18) (41) 5. I am interested in fulfilling the requirements for admission to a doctoral program in Health 31.7% 36.5% (20) (23) 7.5% (6) 2.5% (2) 10.0% (8) 1.4% (1) 7.2% (5) 13.0% (9) 7.2% (5) 5.8% (4) 6.3% (4) 9.5% (6) 15.9% (10) Informatics. 6. I am confident that after graduation I will obtain a full-time 21.3% 58.8% (17) (47) 30.4% 47.8% (21) (33) 17.4% 29.0% 40.6% (12) (20) (28) 12.6% 20.7% 17.2% 46.0% (11) (18) (15) (40) position related to my degree. 7. I am interested in pursuing a graduate degree to enhance my current work/job. 8. I am interested in pursuing a graduate degree to obtain a raise and/or promotion. 9. I am interested in pursuing a graduate degree to make a career change. 3.4% (3) 3 of 3
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