Quality improvement and patient-centered care—two concepts essential to the health reform effort—will require health IT. Current and future physicians must master the minimal competencies required to use health IT if the healthcare system is to reach its quality and cost containment goals, according to an article in the March edition of Health Affairs .
“Health IT is becoming integral to the practice of medicine. But, current medical education and professional development curricula do not systematically prepare physicians to use EHRs and the data these systems collect,” wrote Pierce Graham-Jones, project officer with the Beacon Community Program at the Office of the National Coordinator for Health IT (ONC), and colleagues.
The authors identified six near-term opportunities for integrating health IT training into educational and professional development programs:
- Improve integration of health IT into medical licensing board exams : “Testing on capabilities necessary to achieve meaningful use can be built into the clinical skills and the computer-based case simulation exams, both of which ask examinees to demonstrate their ability to practice medicine in a simulated clinical setting.”
- Include health IT requirements in accreditation of curricula : Just as testing boards should hold students accountable for learning to become meaningful users of health IT, accreditation bodies should hold medical schools and teaching hospitals accountable for providing the underlying knowledge and skills. “To ensure that curriculum changes are meaningful to the experience of medical students and residents, focused questions on health IT could be added to standardized undergraduate and graduate medical education surveys,” the authors wrote.
- Require meaningful use of health IT as a condition of licensure : Because licensure policy is set by state governments in a deliberate, multistakeholder process, license boards may be best served by waiting for accrediting organizations and specialty boards to integrate health IT into their requirements before acting themselves. To avoid exacerbating physician shortages, such requirements could be phased in over time, taking into account specialty-specific and geographic shortages.
- Integrate assessment of health IT capabilities into board certification : In addition to obtaining a license to practice medicine in a given state, physicians often take exams to become “board certified” in a particular area of medicine, noted the authors. The American Board of Medical Specialties already has taken steps to incorporate health IT training and skills assessment into maintenance of board certification for primary care physicians.
- Integrate use of health IT into continuing medical education : Attaining meaningful use requires significant expansion of many physician skills that are directly relevant to patient care. Attainment of meaningful use or a proxy learning activity could be designated to count for a certain number of category 1 continuing medical education credits.
- Use EHR-generated practice profiles to customize continuing medical education : EHRs allow for standardized capture of some data, such as patient demographics. Advanced use of EHRs may enable the development of standardized practice profiles and quality reports to support population health management and targeted improvement interventions, the authors wrote.
“We do not underestimate the challenges to effectively incorporating such training into the continuum of medical education and professional development,” noted the authors. “But mastering skills such as information management, quality improvement and population health management through the use of health IT will help physicians directly improve healthcare outcomes and successfully implement and practice innovative care delivery models.
“Universal and standardized training will be critically important in establishing important health IT competencies," the authors concluded. “The diverse organizations that standardize and regulate the professional development of physicians should move forward to achieve this goal.”