Program Objectives

1. Provide students with the knowledge to apply evidence-based methods to problems of population health.
2. Support student-centered learning that encompasses knowledge of the breadth of the healthcare system.
3. Establish a comprehensive approach to understanding healthcare delivery predicated on the ability to work within transdisciplinary teams.
4. Provide students with skills and knowledge to support and use advanced health information technology systems.
5. Provide students with the data collection and analytic skills and knowledge to support organizational health informatics requirements including privacy and security.

Contribute through education, training and applied student research to meeting the triple aims of healthcare reform:  better health, improved outcomes, and lower costs for the region and the Commonwealth.

The Health Informatics program is aligned with the mission and strategic priorities of NKU.  The program was identified as a priority area by the External and Internal Advisory Committees for the Health Innovations Center.  With a focus on population health, the Center will be housed in a new $97 million facility and move beyond the traditional focus of the clinical aspects of healthcare to a holistic view of the health of the population.  Health informatics, the applied use of data, analysis and technologies, is central to modernization of the healthcare system, patient engagement, providing care to the underserved, and expanding care beyond the “four walls” of a clinic. 

As a program in a growing and immensely important field, the Health Informatics program supports the university’s mission by delivering an innovative, student-centered education which will empower our graduates to have fulfilling careers and meaningful lives, while contributing to the economic, civic, and social vitality of the region.^[1]  All five NKU goals of student success, talent development, innovation, engagement and institutional excellence are addressed in the structure, program outcomes and learning objectives for the program.^[2]  Key elements of the program include experiential learning through capstones and applied research, an alignment of the program with employer needs and future demand, and engaging working healthcare professionals in classroom interactions.

• Policy Objective 4 on increasing high-quality degree production and completion rates and close achievement gaps:The field of health informatics is innovative, critical to society, and graduates are in high demand.The potential development of articulation agreements with 2-year colleges within the Commonwealth will support improved completion rates and serve lower-income and underrepresented minority students.As an undergraduate program, it supports NKU’s initiatives for student success and talent development including recruiting and retaining traditional and post-traditional students.

  Policy Objective 6 on creating new knowledge and economic growth through basic, applied and translational research: Faculty and student research in this applied field will support healthcare transformation in the region and the Commonwealth.The Master in Health Informatics has a substantial track record in applied research, including work for the Cabinet for Health & Family Services.This work will be supported through the additional focus, including undergraduate research support and opportunities.

• Policy Objective 7 on increasing educational attainment and quality of life through regional stewardship, public service, and community outreach: The program directly supports the demand for workers who are critical to achieving the triple aims of health reform of better health, better outcomes and lower per capita costs. The program requires a student capstone which provides experiential learning and direct engagement solving problems in the community. Based upon experience with the Master in Health Informatics program, the community service nature of the program and the high demand for workers will attract new and non-traditional students.

   

• Policy Objective 8 on increasing academic productivity through program innovations: This objective is addressed through the alternative nature of course delivery, both online and traditional, the use of virtual labs (including electronic health records), and leveraging the assets of the College of Informatics at NKU (e.g., collaboratories, digitorium, servers, video capabilities). NKU is actively involved in health modernization initatives within Kentucky and nationally. The evolving needs are continually reflected in program outcomes and objectives, and learning outcomes.

Healthcare in the Commonwealth and across the nation is undergoing a transformation designed to meet the triple aims for improved outcomes, better population health, and lower costs.  Interoperable health data, health information exchange, and data-mining and analytics are central to the modernization of the health system.  Healthcare reform in Kentucky is predicated on the development of these systems and the introduction of patient-driven care through population health models.  These are core areas of health informatics.  There is an established need for workers in this new and rapidly growing field.  This degree program compliments the investments made in health innovation in our region and across the state and will provide workers for high demand positions while contributing to the health and well-being of the citizens of the Commonwealth.

Healthcare is a unique environment and workplace.  This curriculum focuses on the specialized skills and knowledge required from workers in health informatics. At the program level these include clinical and technical knowledge, compliance and privacy, legal and ethical considerations, financial resources and payment models, project management, health system design, and a basic knowledge of the biological sciences.   The individual courses explicate these outcomes into measureable outcomes which are linked directly to the application of health informatics in a clinical or other applied setting.

1. Health Innovations. NKU has embraced and is leading a population health innovation initiative that brings together its accumulated strengths in transdisciplinary innovation and experiential learning.  This includes a $97 million Health Innovation Center that will act as a focal point to tie together the interrelated domains of health innovation required to support the triple aim of healthcare reform and link internal and external assets to drive breakthroughs.

2. The Informatics Context. The NKU College of Informatics, with its unique focus on the informational sciences and applied technologies is the natural home for this program.

3. Griffin Hall. The state has a considerable investment in this $52M state-of-the-art building that opened in summer 2011.  The program will take advantage of an existing Health Informatics laboratory, other advanced laboratories and learning spaces, existing faculty and expertise in the well-established graduate program in Health Informatics, research and development within the Center for Applied Informatics, and synergies and economies with existing academic programs.

There is no accreditation available for BS degrees in Health Inforamatics.

The NKU Steely Library provides adequate resources in the form of online journals, reference texts, and texbooks to support this program. 

Griffin Hall has dedicated laboratory facilities to health informatics.  Technology and software are already in place supporting the Graduate Program in Health Informatics which will be shared with this program.  An electronic health record system has been donated by a national vendor to NKU and will be used to train students leading-edge skills.  Some courses will utilize space resources in the NKU Health Innovations Center which will open in Fall, 2018.

Admission: High school or equivalent completion credentials verification & Satisfactory standardized test performance. Retention: College centralized student academic advising & Student course success markers.  Completion standards: Required applied capstone course & Program and Course level student learning outcomes with annual evaluation and assessment.

The Degree requires 120 semester credit hours

The proposed program can articulate with two year schools which provide an associate degree in health information management, health information technology, and information technology.  Initial discussions have occurred.  Coordination would involve required courses, syllabi and learning outcomes.  The plan is to develop formal “2+2” programs and eventually “2+1+1” graduate degree programs.

See evidence provided for student demand at the regional, state, and national levels.

Demand at the National Level

Estimates of National Workforce Needs

Providers are at various points in dealing with implementation and use of health informatics technologies and applications. Given the ambitious nature of public policies to support the meaningful use Health IT, the number of workers and breadth of skills will only increase beyond these estimates.

In July, 2014, the Health Information Systems Society (HIMSS) released its second annual Workforce Survey.^[5]  Summary findings in the HIMSS Workforce study include:

• 80% of responding provider organizations planned to hire additional health IT workers in the next year
• 98% of responding vendors and consultants planned to hire additional health IT staff in the next year
• More than 50% of providers reported that they hired between one and 10 FTEs in health IT is the past year and 20% indicated that they hired more than 20 FTEs in 2014.
• For staff retention, 60% of providers and 64% of vendors/consultants offered professional development opportunities
• For staff retention, 64% of providers and 34% of vendors/consultants offered paid tuition

The top 10 areas for health provider hires in each of the past two years are: clinical application support, help desk, IT management, project management, IT security, financial application support, system development and implementation, clinical informaticist/clinical champion, systems integration, and process/workflow design.  The proposed degree in Health Informatics includes each of those categories as content areas.

The top 10 IT staff areas for certification for healthcare provider organizations include: security professional, project manager, network/architecture support, database administrator, informatics professional, executive, programmer, process/workflow design, integration specialist, PC/server support professional.  Each of these content areas is including within the proposed program.  There is a separate breakout for Informatics professional. 

These priorities need to be considered within the context of the continued demand workers in this area.    Also the results are only for provider organizations and do not reflect consultants, vendors, payers, government, community organizations, and office-based providers. 

U..S Bureau of Labor Statistics and Online Jobs Postings:  State/Regional Forecasts

In examining third party sources for the demand for graduates of this program, the U.S Labor Department and the Kentucky Career Center both provide a source for the forecast for workers.  At this point, there is not a specific category for Health Informatics, but there is a similar category for Health Technology Specialist by the Bureau of Labor Statistics.  Also, it is possible to do keyword searches of online job databases by region for Health Information Technology.  The results for the Northern Kentucky region are in Table 1.

Table 1:  Health Technology Current Job Openings:  NKY Region[6]

The difference in these results is due to a broader geographic region and more sources for the Indeed.com estimate.  Both indicate a demand for workers.

Table 2 indicates the projected growth rate by the U.S. Bureau of Labor Statistics for Medical Records and Health Information Technology Specialists.

Table 2:  Projected National Growth Rate and Regional Employment[7]

Table 3 provides data on the projected growth rate for the occupation of Health Technologists and Technicians category from the Kentucky Career Center.  Once again, there is not a specific category for health informatics or health information technology but this serves as a reasonable proxy.

Table 3:  Commonwealth of Kentucky (2012 – 2022)[8]

The applicant pool consist of three elements:

1. Undergraduate students enrolling at NKU will be recruited through established relationships with high schools and marketing infrastructure, strategies and tools.This includes engagement with extracurricular activities/student organizations.

2. Students with an Associate Degree in Health Information Management or Health Information Technology degrees will be recruited through articulation agreements, marketing by NKU, visits and presentations by faculty to the Community Colleges.“2+2” programs will be formalized and other programs such as a “3+2” are also under discussion.

New undergraduate students will also be recruited the stakeholders such as hospitals, insurance companies, and vendors.  Marketing visits and, including are held annually at multiple healthcare organizations across the region and state by health informatics faculty. 

Students will be recruited as described in #2 above.  Selection will be based upon university criteria and administered by the Office of Admissions.

The primary feeders will be (1) high schools (2) 2-year schools with articulation agreements (3) 2 year schools and (4) hospitals and other stakeholders investing in human capital development.

Based upon enrollment projections of 30 per year for the first 5 years, and the assumption than 10 students will be through articulation agreements, 10 will be new students who select NKU for the program, and 10 are students who select the program but would have otherwise attended NKU, there are 20 net new students per year or 100 during the first 5 years.  This based upon the demand for workers in this field and the attraction to this major which is not replicated at other colleges of universities.

Northern Kentucky University has substantial experience in the areas of health informatics education, training, and student placement.  The following is a summary of the analyses undertaken to ascertain demand for the Bachelor of Science in Health Informatics.  This information is intended to supplement that available in the original proposal.

Experience with a Similar Program

In 2008, NKU launched a very successful Master of Health Informatics (MHI) program.  The number of students enrolled in this program has ranged from 70 to 120 per year since the program was launched.  The demand for graduates has been very high due to the reasons described in the proposal (primarily associated with healthcare reform and federal policies requiring the measurement of digital data collected through electronic health records and health information exchange).  To our knowledge the placement rate has been near 100% for our MHI graduates.  The program has also recently been rated 5^th in the nation for online health informatics programs.[1]

The BS in Health Informatics was designed based upon the lessons learned and expertise developed in the MHI program.  Based upon that experience, we have recognized that not all of the jobs in Health Informatics require a graduate level degree.  In addition, smaller practices and facilities in underserved regions or serving underserved populations cannot afford or attract students with graduate level credentials.  More significantly, while health informatics jobs require specialized knowledge of healthcare processes and organizations, and capability with specialized standards and technologies, many new and future positions can be filled with the education achieved with a B.S. degree.

On October 14, 2016, the Medicare Access and CHIP Reauthorization Act (MACRA) was implemented.  Under this law almost all clinicians will be required to collect and report data electronically and measure performance as required by the Centers for Medicaid and Medicare Services (CMS) or face between a 4 and 10 percent reduction in payments for Medicare.  Thus, even small practices will require technology and data expertise.  This also speaks to the growing demand for a well-trained, but affordable workforce.[2]

Thus, based upon our experience with our graduates, employers, and an understanding of industry trends, a need for workers with a Bachelors level credential has been identified.

Survey of Hospital System Chief Information Officers

In conjunction with the development of this proposal, a survey of the six large hospital systems in Northern Kentucky/Greater Cincinnati region was undertaken in 2015. The respondents (n=6) were the CIO’s for the systems.  All identified a need for workers and prioritized the following areas:

• System Integration/Interfaces

• Database Administrator

• Privacy and Security

• Data Quality/Compliance

• Healthcare Analytics

• Clinical Application Development

All of these skills will be taught within the proposed B.S. in Health Informatics.

Review and Approval from Advisory Board

The College of Informatics has an Advisory Board of prominent and senior executives for the Graduate Program in Health Informatics.  This includes a diverse group of healthcare professionals from across the Commonwealth and Northern Kentucky Region.  This group has affirmed the need for workers in Health Informatics at the Bachelors level and their oversight will be extended to this new program if it is approved.  The Advisory Board received an update on the program proposal on November 4, 2016 and approved its structure.

U.S Bureau of Labor Statistics and Online Jobs Postings:  State/Regional Forecasts

In examining third party sources for the demand for graduates of this program, the U.S Labor Department and the Kentucky Career Center both provide a source for the forecast for workers.  At this point, there is not a specific category for Health Informatics, but there is a similar category for Health Technology Specialist by the Bureau of Labor Statistics.  Also, it is possible to do keyword searches of online job databases by region for Health Information Technology.  The results for the Northern Kentucky region are in Table 1.

Table 1:  Health Technology Current Job Openings:  NKY Region[1]

The difference in these results is due to a broader geographic region and more sources for the Indeed.com estimate.  Both indicate a demand for workers.

Table 2 indicates the projected growth rate by the U.S. Bureau of Labor Statistics for Medical Records and Health Information Technology Specialists.

Table 2:  Projected National Growth Rate and Regional Employment[2]

Table 3 provides data on the projected growth rate for the occupation of Health Technologists and Technicians category from the Kentucky Career Center.  Once again, there is not a specific category for health informatics or health information technology but this serves as a reasonable proxy.

Table 3:  Commonwealth of Kentucky (2012 – 2022)[3]

Summary

The above body of data and information taken in conjunction with the national forecasts and trends included in the program proposal demonstrate a need for the Bachelors of Science in Health Informatics.

Health informatics is a rapidly developing field that involves the maintenance, collection, and analysis of data used in providing clinical care, for performance measurement and for reimbursement.  As a transdisciplinary program, Health Informatics builds upon several fields including information systems, computer science, communication, allied health, biology, pharmacology, physiology, and health information management. The rapid introduction of information technologies into the health system combined with payment and delivery reforms have greatly increased the use of technologies, data, and health information.  This proposed program builds directly upon a highly successful Masters Degree in Health Informatics offered within the submitting academic unit at NKU.

Health informatics is a distinct field.  Health informatics is the science that defines how health information is technically captured, transmitted and utilized.  A related field is health information management which is the practice of acquiring and protecting digital and traditional medical information.^[1]  Applied health informatics addresses the flow of health information in an electronic/digital environment and covers process, policy, technological solutions, and data analytics while health information management has had a focus on coding/reimbursement, data integrity, confidentiality, and information security.  These fields are complimentary and mutually supporting.

This program provides the knowledge and skills required from workers who are high in demand across the region, state, and nation.  Their role is critical to the modernization of healthcare and in supporting federal policy and organizational initiatives focused on the triple aims of better care for individuals, better health for populations and reducing per-capita costs.^[2]  Unprecedented changes in healthcare delivery, reimbursement, performance measurement, and data management are creating a great need for workers with specialized skillsets and the acquisitions of new skills by incumbent workers.   Central to healthcare reform is getting information (clinical, claims, analytic reports) to the right place at the right time for patient care, population health, measurement and analytics, and payments.

The healthcare industry was historically slow to adopt computerized systems and digital records, relying on paper records, fax machines and file rooms.  The federal government introduced incentives to encourage the adoption of electronic health records (EHR) and their use in defined “meaningful” ways.  These Meaningful Use requirements are the driving force for the implementation of technologies and processes in this evolving marketplace.  More than 83% of all physicians now use an EHR compared to 20% in 2004, and 77% of hospitals reached Stage 2 Meaningful Use requirements by the end of 2014.^[3]

The next phase enabled by Meaningful Use is linked to payment reform.  This is beginning to shape both care delivery and healthcare business processes.  The Centers for Medicare and Medicaid Services (CMS) has announced that by 2018, 90% of all payments will be through alternative risk-sharing or value-based payment models such as Accountable Care Organizations (ACOs) as opposed to historical fee-for-service payment models.   These and other types of “fee for value” models are very dependent upon Health IT, health information exchange (HIE), and informatics in order to meet their clinical and financial objectives and maintain sustainability.

Healthcare is a unique environment and workplace.  This curriculum focuses on the specialized skills and knowledge required from workers in health informatics   These include clinical and technical knowledge, compliance and coding, legal and ethical considerations, financial resources and payment models , project management, health system design, and a basic knowledge of the biological sciences.

The Health Informatics Program Committee will be responsible for assessing the program on the same schedule as other four-year degree programs at NKU are assessed, and for evaluating student learning outcomes.

The full program proposal will list the detailed matrix that maps courses and experiential components to program learning outcomes.  The quality of the program will be tracked by:

Graduation/completion rate data.

Employer surveys.

Graduate surveys.

Organizational partner reports or external capstone projects run through the Center for Applied Informatics.

A review/feedback process managed by the external Health Informatics Advisory Board

Full progam review on a standard five-year cycle according to Kentucky CPE criteria.

End-of-semester evaluations by the students.

The Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) is considering accreditating undergraduate programs in health informatics.  If that is the case, NKU would likely pursue accreditation.

Course level learning objectives

At least once per year

At the end of course term.

Various means (ie. faculty reporting & assessment).

Course learning objectives set by the faculty (confirmed by Advisory Council)

Each faculty is required to reflect and report course level “Closing the Loop” Assessment / Improvement narratives for each measure which will be aggregated at the program level for department curriculum / program assessment and renewal.

End of semester student evaluations and planned faculty peer reviews.

Faculty performace reviews, peer coaching and best practices development.

• Employer surveys.

• Graduate surveys

• A review/feedback process managed by the external Health Informatics Advisory Board