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TCC forum examines workforce challenges presented by electronic health records

Panelists Thursday morning at a forum on electronic health records (EHR), sponsored by Tidewater Community College at its Virginia Beach Campus, agreed that the goal of better patient care and lower health care costs is a good one, and worth the effort.
By July 1, hospitals will need to demonstrate to the Centers for Medicare and Medicaid Services (CMS) that they can perform such tasks as transmitting prescriptions electronically; letting patients view, download and transmit health records; and use secure electronic messaging to communicate with patients. The bar they have to meet is known as “meaningful use.”
If they do, they can continue to participate in Medicare and Medicaid. If not . . . well, no one wants to contemplate that.
Eligible providers, such as medical practices, will need to reach the same milestone by Oct. 1.
“But they don’t make it easy at CMS,” said Dr. J. Miller Trimble, director of information technology patient care systems at Sentara Healthcare.
The purpose of the forum, “EHR: From Paper to Digital and Beyond,” was to elicit experts’ insights about the state of electronic health records and their implementation, and to outline a role for TCC in developing the necessary workforce. The moderator was former TV health reporter Kathryn Barrett.
“What stood out to me is that this is not really about the management of records,” TCC President Edna V. Baehre-Kolovani said. “It’s about patient care.”
In addition to Trimble, the panelists were Debbie Condrey, chief information officer at the Virginia Department of Health; Dr. Sallie Cook, chief medical officer for VHQC, formerly known as the Virginia Health Quality Center; Heather Milteer, a registered nurse who directs the quality and risk department of Bayview Physicians Group; and Dr. Cynthia Romero, a long-time family practitioner in Hampton Roads and former state health commissioner.

They agreed that workforce development is a main ingredient in the successful implementation of EHR.

“A key piece is informatics,” Condrey said. “We have this data about Virginia residents, from cradle to grave essentially. What can we do with it?  For example, she said, geocoding of data might specify where in the state certain health issues are more prevalent.
Cook said that it’s important for EHR practitioners to have clinical experience. “Some of the best job candidates we see are practice managers or administrators,” she said. “They understand that one size does not fit all.”
Trimble characterized such people as bilingual: They speak “geek” and “clinical.” He said the Sentara Health IT workforce is attracted from the clinical environment, such as the nursing units. Generic EHR training, on configurations and applications, is also important, he said.

Health IT employees have to understand the day-to-day impact on patient care when systems aren’t working, Milteer said. “With IT, it’s sometimes lost that everything affects patient care,” she said. Patient outcomes are the key measure of success.

Customer orientation, communication ability and listening to patients – what the panel characterized as “soft skills” – must be part of any EHR training. Romero also identified teamwork, the ability to work with diverse perspectives, and attention and awareness as important dimensions. “They will often be working with people from different language backgrounds, and physicians of all ages,” she said.
Baehre-Kolovani noted that TCC trained more than 4,200 people in 11 states in health IT under a U.S. Department of Health and Human Services grant. It has now received a U.S. Department of Labor grant of nearly $24 million that has a goal of implementing health IT curriculum across all 23 of Virginia’s community colleges.
“TCC can bring people together to help them with their needs,” she said. “This can reduce redundancies, reduce costs and improve care.”

The college is exploring the establishment of an electronic health records collaborative to be a clearinghouse for training and information regarding workforce development. Michelle Charters is leading that effort. “Health care is one of the last industries moving as fast as possible toward electronic records,” she said. “I hope we can be part of that for better safety and patient care.”