Health Data Management’s coverage of a report from eHealth Initiative that health information exchanges are shunning graduates of the Office of the National Coordinator’s health I.T. training programs generated considerable reader comment for and against the programs. Here’s a range of opinions, including those from some graduates:

From Monica S: I graduated from the ONC HIT program as an implementation specialist and project manager. I am suspicious that employers don't consider this training as legitimate. On top of that I am HIT PRO-certified which is also proving to be meaningless. This is very frustrating.

From John R: I took these courses and hate to report that they are not very well done. They are written at a 9th or 10th grade level at best. The reason why HIEs and the health care market place in general cannot seem to fill the open positions is the insistence that someone have 2+ years experience in health care. I run across daily so-called HIT professionals that cannot spell “cat” even if you spot them the “c” and the “a,” and they continue to be hired over truly qualified individuals without health care experience. For some reason health care experience counts more than other industry experience.  Healthcare does have its own unique challenges, but these can be taught.

From Kel M: The wariness of health care employers regarding ONC HIT Workforce training (six months or fewer) certificates is warranted. The components of each program- such as "Networking & HIE" and "Configuring EHR" merely tried to make a silk purse out of a pig's ear by repurposing “book-learning" as "ebook-learning" but with vastly fewer working hyperlinks. Throughout the Implementation & Support Specialist training, the trainee encountered disjointed content, homophones, extensive "assumed knowledge" by the developers, undefined acronyms and a focus solely on using the VA VistA for hands-on EHR discussion and configuring exercises. Other systems, those implemented by 95 percent of the nation's providers, were relegated to a few slides in MS PowerPoint presentations. Interoperability, data structure, data exchange standards, PHI security, and other technical implementation and support tasks were similarly "covered" in slides. Learning objectives for each component were replete with the hot buttons of "meaningful use" in the prefaces of the presentations but typically only two or three of the "buttons" could be unambiguously identified in the subsequent fewer-than-30 slide set (which was par for the course). One's appetite for the "meat" of HIT was strongly whetted, only to be unsatisfied and without direction by presentation end.

From Patti A: If you understood the constraints put on the developers as consumers of federal stimulus funds, maybe you would be less critical:

1) VistA was the ONLY system that was allowed to be used because you cannot use federal funds to advertise or advocate for a commercially available system. No commercial system is going to put their anonymized code/EHR out there for public consumption. If you don't understand this, I have a bridge for sale in Brooklyn.

2) The material was created to cover the entire spectrum from I.T. folks without health care knowledge to doctors who knew nothing about health I.T. How to you teach a cable guy and a surgeon the same thing and not lose either?

3) The material could not contain hyperlinks because not everyone who needs the training can afford an Internet connection (did someone forget the economic crises?), nor has the "last mile" effort extended connectivity to remote communities and low-resource areas. The material had to be fully self-contained. No links.

4) If you look at the training data, you will see that upwards of 40 percent of those taking training already have Masters or Doctoral degrees - i.e. clinicians coming back to school to train up. The domain expertise combined with HIT training is a value-add. Pay for consultants if you wish - but give me a nurse or a doc with HIT training any day. Heck, most of what I see in major hospitals are on-the-job-training folks who don't know workflow modeling from a paperclip. Finally, many of the community colleges had no materials at all related to HIT training. What they got (and what all of you can go download yourself - FREE- from the ONC website) are 20 three-credit courses that are fully transcripted, fully self-contained, and will run in flash (for those with no Internet and no teacher) or all of the raw files (PowerPoints with transcripts) that you can use as you please. Mix and match. The materials are designed like a textbook - teachers decide what to teach and how to teach it. It is an open resource for anyone to use, modify, adapt. It is a way to get the materials out there to seed the US--heaven knows we can all use more education. It is what the stimulus funding was for--to stimulate and to help retool workers who are getting a little long in the tooth and have not been raised on HIT.
Perchance we should all look at the glass half full instead of half empty?

From Sarah L: I oversee the ONC HIT training program at Lansing Community College. Employers may not realize that our average HIT student has a Bachelor's degree and 10+ years experience in health care or I.T. This training is meant to build upon previous education and experience, and is not the sole source of our students' knowledge. Our community college is fortunate enough to have a positive relationship with one of our HIEs. We have had 2 current employees go through the HIT training program. We also have had 2 of our HIT graduates get new positions with the HIE. I encourage other employers to look for graduates of the ONC HIT community college programs to fill their HIT employment needs.

From Troy M: After reading some of these posts, I think the entire training program is/was another government waste. Pattie A said, “If you understood the constraints put on the developers as consumers of federal stimulus funds, maybe you would be less critical,” but at the end of the day I am looking at the end result. The people do not have the knowledge needed. As for Sarah L, who said, "This training is meant to build upon previous education/experience and is not the sole source of our students' knowledge,” that is not the way the program is being sold. As far as people with 10 years of experience in the industry, they are in short supply and do not need the class. Please do not think I am attacking either of you, but the program itself has over-promised and under-delivered.

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