Content Outline and Competencies:

I. History and Major Concepts of HIT  
   A. Discuss the importance of the American Recovery and Reinvestment Act of 2009. 
   B. Describe the key aspects of meaningful use. 
   C. Discuss principles of usability and design. 
   D. Define what is meant by clinical decision support (CDS) systems. 
   E. Discuss foundational elements of workflow analysis and process redesign.

II. Healthcare Roles and Environments.  
   A. Discuss the roles of various healthcare professionals and health information technologists. 
   B. Compare the major types and functions of different healthcare settings. 
   C. Discuss the language of healthcare. 
   D. Describe patient flow through the inpatient and outpatient settings. 
   E. Discuss professional behavior in the healthcare environment.

III. Healthcare Regulations, Ethical, and Cultural Issues 
   A. Discuss privacy, confidentiality, security issues, and related standards. 
   B. Discuss the major cultural issues in healthcare. 
   C. Identify the current challenges in healthcare quality. 
   D. Describe the role of a professional code of ethics in HIT. 
   E. Describe methods to ensure data security and confidentiality.

IV. The Electronic Health Record (EHR) and its Impact on Healthcare 
   A. Identify factors affecting the need for an EHR. 
   B. Define functional requirements of an EHR. 
   C. Discuss the purpose of EHR components. 
   D. Discuss the differences between EHRs, and personal health records (PHRs). 
   E. Discuss key issues in EHR development and implementation

V. Computing Concepts in Healthcare 
   A. Describe basic concepts, components, and use of HIS systems. 
   B. Describe hardware and software as it relates to healthcare. 
   C. Discuss the basics of computer networking. 
   D. Describe security concerns and safeguards. 
   E. Discuss the future of computing and its impact on healthcare.

Content Outline and Competencies:

I. Basic Computing Concepts and History
   A. List different types of computers and how they are used in
healthcare.
   B. Define the common elements of computer systems.
   C. Describe the various hardware and software options for typical
desktop, laptop, and server systems in the healthcare environment.
   D. Explain the development of computers and the Internet, including
healthcare systems up until the present time.

II. Internet and the World Wide Web
   A. Define the Internet and how to connect to it.
   B. Define the World Wide Web and how to access it with Uniform Resource
Locators (URLs) and search engines.
   C. Write effective search queries for Internet search engines, filter
the results, and evaluate credibility of information.
   D. Discuss Internet security and privacy concerns.
   E. List ethical issues for the Internet, including intellectual
property rights, copyright, and free speech.
   F. Examine online healthcare applications and discuss associated
security and privacy issues.

III. Computer Hardware and Architecture
   A. List the major hardware components of a computer.
   B. Describe how data is stored in memory and in secondary storage.
   C. Describe how data is represented in binary.
   D. Describe the function of the CPU.
   E. Describe how data is input/output from the computer.
   F. Describe how a computer system works together.
   G. Discuss specialized architectures and embedded systems used in
healthcare settings.

IV. Application and System Software
   A. Define application vs. system software.
   B. Cite examples of application software and the elements that comprise
them, focusing on healthcare systems.
   C. Describe the functions of operating systems and file organization.
   D. List different types of operating systems.
   E. Explain the purpose and usage of file systems.

V. Overview of Programming Languages and Concepts
   A. Define the purpose of programming languages.
   B. Describe the different types of programming languages.
   C. Explain the continuum of programming languages from machine code and
assembly languages through scripting languages and high level structured
programming languages.
   D. Explain the compiling and interpreting process for computer
programs.
   E. Discuss simple computer programs with variables, loops and
conditional statements.
   F. Discuss additional programming concepts such as objects and
modularity.

VI. Databases and the Structured Query Language (SQL)
   A. Define and describe the purpose of databases.
   B. Define a relational database.
   C. Describe the SQL language.
   D. Define the basic data operations for databases and how to implement
them in SQL, including data modeling and normalization.
   E. Design simple relational tables (and optionally implement them using
database software).
   F. Create simple querying statements for a database.

VII. Networks
   A. List and describe the various types of network communications and
network addressing.
   B. List and define the different types of networks.
   C. Describe different network topologies.
   D. List and describe different network standards and protocols.
   E. Describe wireless communication.
   F. List and describe network hardware.

VIII. Security
   A. List and describe common security concerns.
   B. Describe safeguards against common security concerns, including
firewalls, encryption, virus protection software and patterns, and
programming for security.
   C. Describe security concerns for wireless networks and how to address
them.
   D. List security concerns and regulations for health care
applications.
   E. Describe security safeguards used for health care applications.

IX. Components and Development of Large Scale Systems
   A. Describe the building blocks of a large scale system.
   B. Explain the initial design process/options for a large scale
system.
   C. Describe the evaluation process/criteria for including and selecting
existing software applications.
   D. Describe the process for new software development.
   E. Describe the different types of testing and when testing should
occur.
   F. Describe systems maintenance and explain the process of financially
supporting large scale systems over time.

X. Future of Computing
   A. Describe latest advances in technology.
   B. Discuss implications for healthcare systems, including potential
risks.

Content Outline and Competencies:

I. The OSI Model
   A. Explain the OSI representation of the various layers involved in
networking, including the general functions of each layer and their
interconnections.
   B. Explain the concept of the Application, Presentation, Session,
Transport, Network, Data Link, and Physical layers.
   C. Explain connection-oriented versus connectionless communication.
   D. Explain the use of network addressing including security
considerations and vulnerabilities.

II. Network Media and Hardware Communication Devices
   A. Select appropriate network media types to facilitate networking and
data exchange, taking into account access and regulatory requirements.
   B. Select appropriate hardware devices to facilitate networking and
data exchange, taking into account access and regulatory requirements.

III. National and International Standards Developing Organizations
   A. Explain why standards related to networking and health information
exchange are important, particularly in the current environment.
   B. Describe how standards are developed, who develops them, and how
they are selected and accredited.
   C. Explain the most common categories of standards.
   D. Demonstrate how to find, obtain, and use standards that are needed
to facilitate networking and health information exchange.

IV. Basic Health Data Standards
   A. Identify the set of standards necessary to establish semantic
interoperability.
   B. Describe the use, purpose, and interrelation among sets of
controlled vocabularies in use today.
   C. Explain data elements, attributes of data elements, and the creation
and purpose of the current standard.
   D. Explain how templates and archetypes facilitate networking and
information exchange.
   E. Discuss Clinical Data Architecture (CDA), Continuity of Care Record
(CCR), and Continuity of Care Document (CCD) standards and describe the
relationship among these standards.

V. The Electronic Health Record Functional Model
   A. Describe linking and aggregating data at all levels.
   B. Describe how data may be interchanged among heterogeneous settings
without loss of information.
   C. Describe the most recent messaging standards.
   D. Describe other data interchange standards including Digital Imaging
and Communications in Medicine (DICOM), the Institute of Electrical and
Electronics Engineers (IEEE), and the Integrating and Healthcare
Enterprise (IHE) initiative.
   E. Describe how model-based standards are created.
   F. Define the methodology development framework.
   G. Describe imaging standards.
   H. Describe standards for pharmacy services.
   I. Describe interface standards for medical devices.
   J. Describe claims and reimbursement standards.
   K. Describe the concept of profiling.
   L. Describe the use and value of implementation guides.

VI. Health Data Interchange Standards
   A. Analyze the fundamental structure and components of data.
   B. Explain the relevance of health data interchange standards for
health record mobility.
   C. Explain the relevance of document and imaging standards for health
record mobility.
   D. Explain the relevance of medical device standards for health record
mobility.
   E. Explain the concept of profiling and the role of IHE in defining
profiles.

VII. Standards for EHR Applications
   A. Identify and discuss a family of clinical decision support
standards, including Arden Syntax, clinical guidelines, and
"Info-buttons."
   B. Discuss single sign-on standards and the Clinical Context Object
Workgroup (CCOW) standard.
   C. Define and discuss regulatory and patient safety standards,
including reporting requirements.
   D. Describe bar code standards.
   E. Describe patient index, patient registeries, and record locating
standards.

VIII. Enterprise Architecture Models
   A. Explain the significance of Service Oriented Architecture in
networking and health information exchange (HIE).
   B. Explain the value of an enterprise architecture in networking and
HIE.
   C. Describe key elements of various service oriented architecture
platforms and infrastructure options.
   D. Explain regional healthcare networks - policy and implementation
strategies.
   E. Explain the concept of the NHIN.

IX. Privacy, Confidentiality, Security Issues, and Standards
   A. Discuss privacy, confidentiality requirements, and related
policies.
   B. Discuss how to implement the requirements.
   C. Define access control methods.
   D. Describe how to secure data storage and transmission using data
encryption, signatures, validation, non-repudiation, and integrity.
   E. Analyze access restrictions to data storage and retrieval (physical
and software).

Content Outline and Competencies:

I. Customer Service in HIT
   A. Describe the definitions of customer service.
   B. Identify customers' needs based on context.
   C. Discuss different metrics to measure customer service in HIT.

II. Professional Behavior in the Healthcare Environment
   A. Define contextual norms expected in healthcare organizations.
   B. Discuss the importance of dress, deportment, demeanor, and
grooming.

III. Overview of Communication Relevant to HIT
   A. Explain the purpose and goal of professional communication.
   B. Describe what is meant by effective and ineffective communication.
   C. Identify communication needs of common roles in healthcare.
   D. Describe the contribution of disability etiquette to professional
communication.

IV. Key Elements of Effective Communication
   A. Discuss the definition of communication.
   B. Discuss assumptions used in communication.
   C. Discuss the communication models from general to health-specific.
   D. Discuss variables used in communication.
   E. Define nonverbal communication.
   F. Describe how nonverbal communication functions in the human
communication process.
   G. Describe specific dimensions and give examples of nonverbal
communication.
   H. Discuss communication in paper-based and electronic formats.
   I. Discuss personal communication in the work setting.
   J. Discuss listening skills.
   K. Discuss diversity.

V. Regulatory Issues
   A. Describe the importance of and guidelines associated with infection
control.
   B. Relate protection of yourself and others to standard precautions.
   C. Explain the Health Insurance Portability and Accountability Act
(HIPAA) and related communication.

VI. Team and Small Group Communication
   A. Define group communication and tiered characteristics.
   B. Describe goals, norms, and cohesiveness of groups.
   C. List stages of team communication.
   D. Describe communication networks and sociograms.

VII. Conflict Resolution
   A. Describe dimensions of conflict.
   B. Define conflict.
   C. Explain approaches used in conflict resolution.
   D. Discuss conflict resolution styles.
   E. Describe communication strategies to resolve conflict.
   F. Discuss sources and strategies addressing technical implementation
conflict.

VIII. Ethical and Cultural Issues Related to Communication and Customer
Service
   A. Define ethics and ethical dilemmas.
   B. Differentiate between ethics and codified law.
   C. Discuss the utilitarian, individualism, moral-rights, and justice
approaches to ethical decision making.
   D. Describe the role of the medical ethics committee.
   E. Define culture and diversity.
   F. Describe the primary and secondary dimensions of diversity.
   G. Explain the potential benefits and costs of workforce diversity and
how diversity can be leveraged for better performance.
   H. Discuss the role of ethnocentrism and stereotypes in communication.
   I. Explain four major cultural differences and their effect on
communication.
   J. Discuss the major Equal Employment Opportunity laws.
   K. Define cultural competency and describe its role in addressing
health disparities.

IX. Personal Communication and Professionalism
   A. Describe appropriate use of personal communication devices in the
healthcare workplace.
   B. Discuss the impact of inappropriate use of personal communication
devices in the healthcare workplace.
   C. Identify the differences between personal and professional
communication.

Content Outline and Competencies:

I. Introduction to HIT Systems
   A. Define a system and relate systems concepts to HIT.
   B. Discuss specific examples of settings where HIT is used.
   C. Identify common components of a clinical HIT system.
   D. Demonstrate beginning level competency in maneuvering an HIT
system.

II. Functions of HIT Systems
   A. Identify the HIT functions that support a generic ambulatory patient
care process.
   B. Identify the HIT functions that support a generic inpatient care
process.

III. Information Exchange in HIT Systems
   A. Identify common elements in HIT information exchange.
   B. Explain the need for standards and why they exist.
   C. Define and differentiate between messaging standards and terminology
standards.
   D. Compare current efforts to facilitate health information exchange
between providers, communities, regions, and the nation including the
Nationwide Health Information Network and regional health information
exchanges.

IV. Effective HIT Systems
   A. Identify characteristics of an effective HIT system.
   B. Define and provide examples of how evidence-based practice can be
supported in HIT systems.
   C. Define and cite examples of usability, configurability, scalability,
and reliability in HIT systems.
   D. List and contrast different types of reports/queries required for
internal and external reporting.

V. Fundamentals of Usability in HIT Systems
   A. Define usability in relation to HIT systems.
   B. Explain the impact of HIT usability on user satisfaction, adoption,
and workarounds in error rates or unintended consequences.
   C. Provide alternatives to HIT usability bottlenecks.

VI. HIT System Facilitated Error
   A. Explain the concept of facilitated errors in HIT systems.
   B. Cite examples of situations where HIT systems could increase the
potential for user error.
   C. Analyze sources of HIT system facilitated errors and propose
realistic solutions.

VII. Privacy, Security, and Confidentiality in HIT Systems
   A. Explain and illustrate privacy, security, and confidentiality in
environments using HIT systems.
   B. Identify common threats encountered when using HIT systems.
   C. Formulate strategies to minimize threats to privacy, security, and
confidentiality in HIT systems.

VIII. HIT System Planning, Acquisition, Installation, and Training
   A. Conduct a basic user needs analysis for a given example situation.
   B. Create a plan for training users in a small office practice, a large
community clinic, or a single unit in an ambulatory care setting.
   C. Identify potential challenges that may emerge during installation
and generate potential solutions.

IX. Potential Issues with Adoption and Installation of an HIT System
   A. Identify frequently encountered challenges to adoption and
implementation of HIT systems.
   B. Design an action plan to address barriers to implementation of HIT
systems.
   C. Propose solutions to common problems in the implementation of HIT
systems.

X. HIT and Aspects of Patient-Centered Care
   A. Define patient-centered care.
   B. Propose HIT-enabled solutions/strategies to enhance patient
involvement in health and healthcare.
   C. Assess the effectiveness of HIT systems in supporting
patient-centered care.
   D. Perform self-assessment of personal beliefs related to HIT and
patient-centered care.

XI. HIT in the Future
   A. Recommend approaches for using HIT to enhance patient-centeredness.
   B. Propose strategies to increase patient access to their health
information.
   C. Suggest alternative designs for HIT for busy/mobile clinicians.
   D. Hypothesize how HIT may intersect with publicly available data to
improve health.
   E. List and predict applications of social networking for health.

Content Outline and Competencies:

I. Migrating to an EHR
   A. Determine appropriate committee members for planning EHR
implementation.
   B. Develop and apply criteria for selecting an appropriate EHR vendor.
   C. Define the steps in a basic strategic management plan.
   D. Develop a timeline for choosing and implementing an EHR.
   E. Discuss the components of contract negotiation.

II. Meaningful Use and Implementation
   A. Describe the five underlying healthcare goals to which all
meaningful use criteria map.
   B. Describe the process and purpose of EHR certification, the work of
the Certification Commission for Health Information Technology (CCHIT),
and other possible certifying bodies.
   C. Describe how the exchange of electronic health data relates to
meaningful use.
   D. Describe how clinical quality measures relate to meaningful use.

III. Clinical Decision Support
   A. Define what is meant by clinical decision support (CDS) systems.
   B. Discuss key factors in the development of CDS systems for clinical
and administrative use.
   C. Implement clinical decision-making tools, including computerized
provider order entry (CPOE).
   D. Implement CDS rules, alerts, and reminders.
   E. Given a case study, analyze the issues related to provider fatigue
in the context of alerts and reminders.

IV. Order Sets
   A. Define and describe an order set.
   B. Describe the benefits and costs associated with order sets.
   C. Demonstrate the ability to build order sets.

V. Data Entry Templates
   A. Create a document template.
   B. Create a shared template.
   C. Create a personal template.

VI. Health Summary and Clinical Reminder Reports
   A. View and create health summary reports.
   B. View and create clinical reminder reports.
   C. Describe how these EHR functions support quality care, patient
safety, and efficiency.

VII. Alerts/Notifications, Order Checks, and Reminders
   A. View and create alerts and notifications.
   B. View and create order checks.
   C. View and create reminders.
   D. Discuss the value of these EHR functions as CDS tools.

VIII. Data Infrastructure
   A. Discuss the concepts of data infrastructure including data
architecture, data sets, repositories, data dictionary, data standards,
and data types.
   B. Given a case study, produce a sample data dictionary.

IX. EHR Implementation in Specific Settings
   A. Discuss key issues in EHR development and implementation affecting
acute care.
   B. Discuss key issues in EHR development and implementation affecting
long term care including interchange of health information with acute
care.
   C. Discuss key issues in EHR development and implementation affecting
ambulatory care, including interoperability with acute care, application
service providers (ASPs), and community offerings for an EHR.
   D. Discuss key issues in EHR development in other health care settings
including physician practice, home health and hospice, behavioral health,
and health departments.

Content Outline and Competencies:

I. HIT System Elements
   A. Describe the use of client-server architecture to access and store
electronic health records (EHRs).
   B. Describe network needs to access and store EHRs.
   C. Identify application software and back-end data storage software in
an HIT system.

II. Software and Certification Requirements for System Selection
   A. Define commercial off-the-shelf (COTS) and in-house/homegrown
systems and describe their relative advantages and disadvantages.
      1. Identify financial benefits for initial creation, setup,
customization (flexibility), maintenance, and integration with existing
systems and processes.
      2. Identify personnel or consultant costs for creation,
customization, and maintenance.
      3. Estimate cost impact on internal staff, including hiring,
training, and lost productivity.
      4. Identify training costs for developers and users, including
development of training resources.
   B. Estimate costs and consider advantages and disadvantages of
purchasing versus licensing hardware and software.
   C. Discuss vendor documentation of system functionality and
requirements.
   D. Determine system compliance with the Certification Commission for
Health Information Technology (CCHIT) certification.
   E. Determine whether systems meet meaningful use criteria.
   F. Compare and rank vendor systems.
   G. Evaluate and select system based on requirements and certification
needs.

III. Functional and Technical Requirements for System Selection
   A. Identify twelve possible steps in choosing an EHR system.
   B. Gather functional requirements from institution and users.
   C. Document use-cases and relate them to functional requirements.
   D. Prioritize functional requirements, including grouping as essential
versus desired.
   E. Identify minimum and recommended software and hardware
requirements.

IV. Systems Analysis and Design
   A. Discuss aspects of systems analysis and design.
   B. Create a project plan for system design and implementation,
including data migration and conversion.

V. The SDLC Model
   A. Define the steps of the SDLC and the purpose and importance of
each.
   B. Choose a popular, commonly-known software application and describe
how it might have gone through the SDLC.
   C. Describe how and why an HIT software application would go through
the SDLC.
   D. Map a project plan to the SDLC model.

VI. System Security Procedures and Standards
   A. Identify regulatory requirements, including the Health Insurance
Portability and Accountability Act, for EHRs and integrate into a project
plan.
   B. Identify best practices for operating system and network system
security installation and patches and integrate into project planning.
   C. Identify and assess protection measures including access control,
firewalls, intrusion detection, and encryption.
   D. Discuss training for system users regarding the methods and
importance of security compliance.

VII. System Interfaces and Integration
   A. Determine and document system interfaces and integration
requirements.
   B. Describe pitfalls of installing a new application in an environment
of pre-existing applications.
   C. Present examples of interfacing modalities.

VIII. System Maintenance and Upgrades
   A. Identify and implement an effective troubleshooting procedure for
reporting, evaluating, fixing, deploying, and follow-up of errors,
problems, or limitations for the system.
   B. Develop the downtime schedule for maintaining and updating the
operating system, network, database, and client application.
   C. Develop a process for communicating requirements and supplying
updates among vendors, developers and users.
   D. Create a baseline for system performance measurement and comparison
for troubleshooting.

IX. Fault Tolerant Systems, Backups, and Decommissioning
   A. Discuss creating redundant and fault-tolerant systems for access and
data storage; thus, providing high performance and reliability.
   B. Describe backup and restoration of databases, applications, and
operating systems.
   C. Develop a plan for decommissioning systems and data.

X. Test Strategies and Plans
   A. Discuss the gathering of user feedback and developing a performance
baseline for system validation and testing.
   B. Document problems with their resolution status.
   C. Create, execute, and document a test plan.

XI. Pilot Testing and Full-Scale Deployment
   A. Discuss how to identify a pilot group and plan scope of a pilot.
   B. Discuss installation of a pilot system, training pilot users, and
making the pilot system available.
   C. Discuss gathering and prioritizing feedback from the pilot test and
potentially revising project plans.
   D. Develop and implement strategies for the following:
      1. Communicating deployment plan to end users and management.
      2. Technical support of deployment.
      3. Getting feedback from end users following deployment.
      4. Evaluating usage and capacity of system resources under
conditions of full deployment.
   E. Discuss deployment of a revised system.

Content Outline and Competencies:

I.    Human factors, design and usability 

   A. Define the concept of cognitive engineering.

   B. Describe the representational effect as it applies to human computer interaction and web design.

   C. Describe how humans process information and obtain skills.

1. Describe the Gestalt principles of perception and their relevance to human computer interaction and cognitive theory.
2. Describe the processes of memory and their relationship to web design.
3. Describe the cognitive constructs for mental representation.

   D. Explain how cognition and human performance models should inform iterative design processes.

   E. Distinguish between human factors and human-computer interaction (HCI) as they apply to usability.

   F. Explain how cognitive, physical and organization ergonomics are applied to human factors engineering.

   G. Describe how mental workload, selective attention and information overload affect usability.

   H. Describe the different dimensions of human error.

   I. Describe a systems-centered approach to error and patient safety.

   J. Evaluate methods for measuring mental workload and information overload.

   K. Describe how human factors analysis can be applied to the study of medical devices.

II. Data Gathering and Interpretation Methods Engineering

   A. Explain the role of requirements gathering in usability evaluation.

   B. Identify the uses, advantages and disadvantages of data collection methods used for requirements gathering.

   C. Explain how to conduct a workflow analysis.

   D. Identify contextual design principles as they apply to the healthcare setting.

   E. Describe the methods to interpret results of data collection.

III. Design and Usability Evaluation Methods

   A. Describe the importance of usability in relation to HIS.

   B. Evaluate common usability errors in HIS design. 

   C. Define Quality Improvement (QI) tools used to analyze HIS errors.

   D. Describe ways in which HIS facilitates error reporting.

   E. Describe usability evaluation methods.   

   G. Describe the usability testing environment, required equipment, logistics and materials.

IV. Processes of Commercial EHR Systems 

   A. Describe the most common commercial EHR systems used in ambulatory and inpatient care settings. 

   B. Describe functions and applications of KLAS ratings available on EHR Systems and apply the KLAS rating system to evaluate software selections for ambulatory and acute care EHRs.

   C. Describe and give examples illustrating how Certified Commission for Healthcare Information Technology (CCHIT) criteria are used for certification of EHR systems.

   D. State the benefits and stages of meaningful use and select illustrative examples in scenarios of EHR system use.

   E. Identify the role of governing bodies certifying commercial EHRs, including FDA oversight, the Joint Commission, and National Patient Safety Goals.

   F. Demonstrate concept knowledge of the request for proposal (RFP) process.

   G. Identify the key stakeholders involved in EHR selection and the roles they each play.

   H. Analyze the financial components that strengthen an EHR system vendor with examples of the project costs categories.

   I. Identify the key steps in the selection process for choosing an EHR system vendor and provide a summary of inpatient and ambulatory vendors.

V. EHR System Functionality

   A. Describe functionality of results review.

   B. Describe the functionality of computerized provider order entry (CPOE).

   C. Describe the functionality of documentation.

   D. Describe the functionality of messaging among different vendor systems.

   E. Describe the procedures for billing supported by different EHR systems.

VI. System and Database Architecture in Commercial EHRs

   A. Demonstrate concept knowledge of system and database architectures used in commercial EHRs.

   B. Describe the HIS landscape, including pharmacy and lab.

   C. Compare different EHR operating systems and databases.

   D. Explain how database architectures impact performance and extensibility.

   E. Articulate how system and database architectures impact security, auditing and performance monitoring.

VII. Vendor Strategies

   A. Describe the three types of interoperability.

   B. Describe vendor strategies for terminology and knowledge management and how these impact interoperability and data exchange.

   C. Describe processes and requirements for exchanging data with personal health records.

 VIII. EHR System Design 

   A. Explain how requirements translate into good design.

   B. Compare requirements analysis findings to usability designs.

   C. Describe Nielsen's heuristics and design principles.

   D. Evaluate whether an interface design exhibits good design principles. 

   E. Describe the principles of participatory and iterative design.  

   F. Explain how to design for safety.

   G. Differentiate technology input methods given different technology uses, user populations and contexts.

   H. Describe how information visualization can support and enhance the representation of trends and aggregate data.

IX. Vendor-specific Training and Go-live Strategies

   A. Describe characteristics of vendor-specific training and go-live strategies that would facilitate implementation of a new EHR system.

   B. Compare the advantages and disadvantages of "big-bang" and phased roll-outs.

   C. Identify staffing, command center and on-site consultant considerations in the EHR system vendor selection process.

   D. Compare vendor strategies for monitoring system usage and change management.

X. Mobile, Ubiquitous Computing and Medical Devices

   A. Describe the role of mobile and ubiquitous computing in healthcare.

   B. Define context-sensitive applications.

   C. Define the scope of medical devices in healthcare.

   D. Describe a human factors approach to the study of devices in healthcare.

   E. Compare and contrast examples of medical device usability issues and potential solutions.

   F. Explain the role of usability in mobile health devices and communication in healthcare.

   G. Evaluate methods of cognitive task analysis to medical device.

Content Outline and Competencies:

I. Company or Organization Description
   A. Describe the mission, vision, and goals.
   B. Provide a general outline of the organizational structure.
   C. Describe the roles of employees and workflow of the organization.
   D. Discuss the products and services of the organization.
   
II. Description of Work Activities
   A. Follow written and oral instructions.
   B. Manage time and resources effectively.
   C. Demonstrate effective written and oral communication.
   D. Participate in meetings and teams as assigned.
   E. Follow employer's rules, regulations and policies.
 
III. Workplace Skills
   A. Apply technical skills learned in coursework.
   B. Demonstrate analytical and problem solving skills.
   C. Demonstrate acquisition of new knowledge and skills.
   D. Perform industry related tasks as specified by intern supervisors.
   
IV. Professionalism and Ethics
   A. Demonstrate appropriate business behaviors and attire for assigned area.
   B. Demonstrate interpersonal skills appropriate to a business environment.
   C. Demonstrate and promote ethical standards of practice as per American 
Health Information Management Association (AHIMA).
   D. Demonstrate the principles of privacy, confidentiality and security with health information systems as per the Health Insurance Portability and Accountability Act (HIPAA).

Content Outline and Competencies:

I. Basic Terminology
   A. Describe basic terms such as disease, illness, health, and
healthcare.
   B. Describe the culture of healthcare.
   C. Explain cultural competence.
   D. Explain the concepts of "cultural safety", "safety culture", and
"just culture" as applied to organizations.
   E. Describe the multiple cultures that interact in healthcare
delivery.
   F. Explain "rich points" and their use in the study of culture.  
   G. Define acculturation and its relation to healthcare settings.

II. Health Professionals
   A. Contrast the different roles and requirements of health
professionals, including education, training, certification, and
licensure.
   B. Describe the different support roles, including technicians and
those involved in care coordination.

III. Healthcare Settings
   A. Differentiate the range of care delivery organizations, including
primary care, speciality care, tertiary care, inpatient and outpatient
facilities, long-term care hospitals, and long-term care facilities.
   B. Analyze the organization of healthcare delivery from the perspective
of a "continuum of care", such as ambulatory services, in-patient care,
long-term care, and end-of-life care.
   C. Compare the similarities and differences of community hospitals,
teaching hospitals, and community health clinics.
   D. Describe the various departments and services offered by an
outpatient clinic, community hospital, academic medical center, and
long-term care facility.
   E. Describe ways in which medical and/or information technology has
improved interdepartmental communication and consequently improved the
patient experience.

IV. Healthcare Processes
   A. Describe the classic paradigm of the clinical process.
   B. List the types of information used by clinicians in caring for
patients.
   C. Describe the steps of managing information during the interaction of
clients and patients.
   D. List the different information structures or formats used to
organize clinical information.
   E. Explain what is meant by the "hypothetico-deductive" reasoning
process.
   F. Explain the difference between observations, findings, syndromes,
and diseases.
   G. Describe multiple techniques or approaches used by the clinicians to
reach a diagnosis.
   H. Other than diagnosis and recommended treatment, list the major
factors that clinicians consider when devising a management plan for a
patient's condition.

V. Evidence-Based Medicine (EBM)
   A. Define the key tenets of EBM and its role in the culture of
healthcare.
   B. Construct clinical questions and critically appraise evidence in
answering them.
   C. Apply the key statistics of EBM for intervention studies, including
discerning relative and absolute risk.
   D. Describe the critical appraisal of other key clinical questions of
diagnosis, harm, and prognosis.
   E. Discuss the benefits and limitations to summarizing evidence.
   F. Describe how to implement EBM in clinical settings and its
limitations. 

VI. Nursing Care Processes
   A. Describe nursing assessment, intervention, and judgment.
   B. Discuss nursing roles in in-patient, out-patient, and long-term care
settings.
   C. Discuss the role of the nurse in patient education.
   D. Discuss invasive procedures performed by nurses.
   E. Discuss the nurse's role in medicating patients.
   F. Discuss the role of quality improvement.
   G. Describe the typical shift for a nurse, including the tasks and
roles during the course of the shift.

VII. Quality Measurement
   A. Describe the current state of healthcare quality in the United
States.
   B. Discuss how variations in healthcare from the ideal diminish
quality.
   C. Distinguish among structural, process, and outcome measures.
   D. Give examples of quality measures being applied in the current
healthcare environment, including those that are part of the meaningful
use criteria.

VIII. Professional Values and Medical Ethics
   A. Define traditions, ethics, and values for medical professionals.
   B. Describe the role of a professional code of ethics.
   C. Compare the professional codes of ethics for nursing and
physicians.
   D. Relate the professional code of ethics to the legal responsibilities
of physicians.
   E. Describe the purpose of Medical Practice Acts.
   F. Apply the tenets of the Health Insurance Portability and
Accountability Act's privacy and security rules in healthcare settings.
   G. Discuss bioethical issues and the government agency dealing with
bioethics.
   H. Describe Bernard Lo's clinical ethical decision making model.
   I. Compare and contrast ethical decisions concerning life and death.
   J. Discuss the populations that experience gaps in the quality of
healthcare received.
   K. Discuss the economic and regulatory definitions for the rationing of
care.
   L. Compare and contrast explicit and implicit rationing of care that
occurs in the United States.
   M. Describe the organizational and technological tools available to
protect privacy, confidentiality, and security.

IX. Socio-technical Factors
   A. Describe medical error and patient safety.
   B. Discuss error as an individual and as a safety problem.
   C. Compare and contrast the interaction and interdependence of social
and technical elements ("resistance to change").
   D. Discuss the impact of changing socio-technical processes on quality,
efficiency, and safety.
   E. Discuss the challenges inherent with adapting work processes to new
technology.

Content Outline and Competencies:

I. Analysis of Medical Terminology
   A. Discuss the four parts of medical terms.
   B. Recognize word roots and combining forms.
   C. Identify the most common prefixes and suffixes.
   D. Define directional and positional terms.
   E. Build, divide, spell and pronounce common medical words.

II. Body Systems
   A. Define and correctly pronounce medical terms associated with body
systems.
   B. Describe common diseases and conditions, laboratory and diagnostic
procedures, medical and surgical procedures, and medications.

III. Public Health
   A. Discuss terms used to define public health.
   B. Identify distinguishing features of public health.
   C. Discuss terms used to define health.
   D. Identify categories and factors that influence health.
   E. Identify terms commonly used as measures of health status.

IV. HIT, HIM, and EHRs
   A. Explain common terms, acronyms, and abbreviations used in HIT and
HIM.
   B. Discuss the American Recovery and Reinvestment Act of 2009 (ARRA).
   C. Describe portions of the Health Information Technology for Economic
and Clinical Health (HITECH) Act of 2009.
   D. Identify factors affecting the need for an EHR.
   E. Compare the advantages and disadvantages of the automated record
versus the paper record.
   F. Discuss the obstacles to implementation of a paperless record.
   G. Discuss the differences among EHRs, electronic medical records
(EMRs), and personal health records (PHRs).
   H. Define functional requirements of an EHR.
   I. Discuss the purpose of EHR components.
   J. Describe methods to ensure data security and confidentiality.
   K. Identify the hardware and software requirements for EHR
implementation.

V. Standarization
   A. Discuss the relevance of standardized terminologies to healthcare
practice and research.
   B. Describe the attributes of a terminology.
   C. Identify the difference between classification systems and reference
terminologies.
   D. Discuss the interest and involvement of the federal government in
terminology standards.
   E. Identify systems used to classify and document healthcare diagnoses,
interventions, and outcomes.

Content Outline and Competencies:

I. Fundamentals of QI and HIT
   A. Identify the current challenges in healthcare quality.
   B. Analyze the components of the healthcare system that have an impact
on quality.
   C. Explain quality and QI.
   D. Describe QI as a goal of meaningful use of HIT.
   E. Analyze the ways that HIT can either help or hinder QI.

II. Principles of Quality and Safety for HIT
   A. Describe the fallibility of people and systems.
   B. Describe the ways that every system is designed to achieve the
results it gets.
   C. Explain basic principles of safe design.
   D. Explain the ways that teams make wise decisions with diverse and
independent input.

III. Reliability and Culture of Safety
   A. Describe how ultra-safe organizations operate.
   B. Explain the importance of appropriately expressing perceived safety
concerns.
   C. Explain strategies to survive in a resistant culture.

IV. Human Factors in HIT Design and Complexity
   A. Define human factors and ergonomics and its objectives.
   B. Discuss the role of human factors and ergonomics in patient safety.

V. HIT Design that Support Teamwork and Communication
   A. Assess the impact of teamwork and communication on patient safety
and clinical effectiveness.
   B. Analyze ways in which HIT design can serve as a barrier to effective
communication.
   C. Describe ways in which HIT design can enhance teamwork and
communication.

VI. Decision Support for QI
   A. Define decision support, its importance, and why it is difficult to
implement.
   B. Compare decision support tools that improve quality.
   C. Appraise strategies for successful use of decision support tools.
   D. Analyze the benefits and shortfalls of alerts and clinical
reminders.

VII. Safe Workflow Design
   A. Assess decision-making requirements in healthcare.
   B. Construct a work process flow chart.
   C. Define ways of incorporating decision-making requirements into HIT
design.

VIII. HIT Implementation Planning that Maximizes Quality and Safety
   A. Critique an implementation team and the roles they play in ensuring
quality.
   B. Analyze effective implementation planning.
   C. Assess the quality implications of "big bang" versus staggered
approaches.
   E. Explain "go live" support strategies that minimize risk.

IX. HIT and Patient Safety
   A. Discuss the success of a simple checklist in improving central line
blood stream infections.
   B. Identify strategies for adaptive work that can be useful to HIT
initiatives.

X. HIT Design for Quality Reporting
   A. Explain the attributes of an effective reporting system.
   B. Appraise the importance of standardized and structured health
information.
   C. Describe how HIT facilitates data collection and reporting for
improving quality and safety.

XI. Data Quality Improvement
   A. Discuss the impact of poor data quality on quality measurement.
   B. Identify ten attributes of data quality and key process
recommendations.
   C. Discuss common causes of data insufficiency.
   D. Describe how HIT design can enhance data quality.

XII. Error Reporting and Analysis
   A. Describe ways in which HIT facilitates error detection and
reporting.
   B. Explain how reporting errors help identify HIT issues.
   C. Assess HIT for unintended negative consequences.
   D. Examine common themes in HIT design deficiencies.
   E. Utilize QI tools to analyze HIT errors.

Content Outline and Competencies:

I. Concepts of Processes and Process Analysis
   A. Describe the purpose for process analysis and redesign in the
clinical setting.
   B. Describe the role of a workflow process analyst and redesign
specialist and contrast it with other roles such as technical support and
implementation management.
   C. Explain how health process analysis and redesign is related to
meaningful use.
   D. Analyze a healthcare scenario and identify the components of
clinical workflow.
   E. Analyze the responsibilities of each participant in the redesign
process and how the roles complement or overlap with one another.
   F. Describe how the workflow processes might differ based on the type
of healthcare facility.

II. Process Representation
   A. Articulate the value of process mapping.
   B. Describe standard process mapping symbols and conventions.
   C. Analyze an existing workflow process chart in terms of the
information that could be generated and the sequence of steps that are
being communicated.
   D. Choose the correct scope and detail level for a process map.
   E. Identify an appropriate process mapping methodology.
   F. Analyze a process map for a healthcare system or component using
correct symbols and conventions.

III. Process Diagrams
   A. Analyze context and data flow diagrams for a healthcare system or
component using appropriate Yourdon symbols and conventions.
   B. Identify a process flowchart for a healthcare system or component
using appropriate International Standards Organization (ISO) 5807 symbols
and conventions.
   C. Identify the correct scope and detail level for a process flowchart
and data flow diagram.
   D. Analyze a Gane-Sarson data flow diagram.
   E. Analyze Unified Modeling Language (UML) class, activity, and state
diagrams.
   F. Analyze an entity relationship diagram in crow's foot notation.

IV. Information Gathering
   A. Identify how the strategic goals and stakeholders for a given
healthcare facility can influence workflow processes in that facility.
   B. Evaluate an agenda for an opening meeting to discuss workflow
processes in a healthcare facility considering that facility's strategic
goals and stakeholders.
   C. Compare different types of knowledge and their impact on
organizations.
   D. Analyze a healthcare scenario according to Capability Maturity Model
Integration (CMMI) levels.
   E. Identify the workflow processes that are likely to be used by a
healthcare facility.
   F. Identify which workflow processes are essential to document and
analyze in order to best streamline the operations in a given healthcare
facility.
   G. Identify key individuals with whom an analyst should meet or observe
in order to gain an understanding of the nature and complexity of their
work.
   H. Develop questions to facilitate a productive discussion of the
information workflow, activities and roles within the facility.
   I. Describe ways to successfully overcome common challenges encountered
in knowledge acquisition.
   J. Explain how to choose an appropriate knowledge acquisition method.
   K. Given a set of diagrams and observations from an information
gathering meeting, draft a summary report.

V. Process Analysis
   A. Describe the purpose of process analysis.
   B. Describe skills and knowledge necessary for process analysis.
   C. Analyze a process analysis for a given clinic scenario.
   D. Create a draft summary report based on the results of a process
analysis.
   E. Identify desired electronic medical record functionality based on
the results of a process analysis.

VI. Process Redesign
   A. Describe the purpose, skills, and knowledge necessary for process
redesign.
   B. Identify common process problems that result in healthcare increased
cost, decreased safety, and lack of efficacy.
   C. Distinguish between first and second order process changes.
   D. Describe how meaningful use of information technology in healthcare
compensates for human weaknesses and leverages the strengths of
technology.
   E. Given a clinical scenario, choose an appropriate human-machine
division of tasks.
   F. Enhance clinical workflow by applying process redesign strategies to
common process problems.
   G. Use knowledge of common software functionality to inform a process
redesign for a given clinical scenario.
   H. Given results of a process redesign, draft a summary report.

VII. Process Optimization Decisions
   A. Discuss the planning and conducting of a decision-making meeting.
   B. Describe a walk-through of a decision-making meeting.
   C. Discuss how to communicate findings of a workflow process analysis
to healthcare facility decision makers.
   D. Evaluate the results of decisions made and actions identified during
an optimization meeting.

VIII. QI Methods
   A. Describe strategies of QI.
   B. Describe the role of leadership in QI.
   C. Describe opportunities for clinical improvement.
   D. Describe and recommend tools for QI.
   E. Compare quality improvement methodologies and tools and define
appropriate uses in healthcare.

IX. Change Management
   A. Describe how concerns expressed by participants in a process
analysis meeting may facilitate or impede proposed changes in workflow
processes.
   B. Describe strategies a workflow analyst can use to gain acceptance
for proposed workflow process changes.
   C. Identify appropriate change facilitation tools.
   D. Evaluate a change facilitation plan.
   E. Analyze various process change implementation strategies for a given
healthcare facility.

X. Process Change Implementation and Evaluation
   A. Evaluate a process change implementation plan for a healthcare
facility to identify management tracking and measurement opportunities.
   B. Discuss how to communicate process change in a healthcare facility.
   C. Discuss how to evaluate a recently implemented process.

XI. Sustained Quality Improvement
   A. Describe control strategies for clinical processes.
   B. Discuss how to create a sustainable and continuous improvement
plan.
   C. Describe a set of contingency plans to keep the practice running if
the electronic health record system fails.
   D. Evaluate proposed workflow processes to identify potential problems
and suggest changes to the redesign plan.

Content Outline and Competencies:

I. Health Informatics
   A. Define information management, information technology, and
informatics.
   B. Explain the basic theoretical concept that underlies informatics
practice.
   C. Define the meaning of health informatics as a field of study.
   D. Describe areas where health informatics may be applied.
   E. Identify trends and drivers of health informatics.
   F. State the roles and skills of professional health informaticians.
   G. Explain how health informaticians process data into information and
knowledge to support healthcare tasks that improve patient care.

II. Hardware and Software
   A. Describe the major hardware components of a computer and major types
of software used in computer systems.
   B. Describe the major types of network configurations.
   C. Define the concept of an information system in general and
characteristics of an information system and a health information system
in particular.
   D. Describe the different types of information systems in terms of
their ability to support the requirements of a healthcare enterprise.
   E. Describe various types of technologies that suppport health
information systems.
   F. Examine the challenges presented by emerging trends in information
technology, social media, and global communication.
   G. Identify the advantages and disadvantages of using the Internet as a
platform for healthcare applications.

III. EHRs
   A. State the similarities and differences between an electronic medical
record (EMR) and an electronic health record (EHR).
   B. Identify attributes and functions of an EHR.
   C. Describe the perspectives of healthcare providers and the public
regarding acceptance of or issues with an EHR.
   D. Explain how the use of an EHR can affect patient care safety,
efficiency of care practices, and patient outcomes.
   E. Discuss how health information exchanges (HIEs) and the Nationwide
Health Information Network (NHIN) impact healthcare delivery and the
practice of healthcare providers.
   F. Outline issues regarding governmental regulation of EHR systems such
as meaningful use and qualified EHRs.
   G. Summarize how the Institute of Medicine's Vision for 21st Century
Health Care and Wellness may impact health information systems.
   H. Identify how ongoing developments in health informatics can affect
future uses and challenges related to health information systems.

IV. CPOE
   A. Describe the purpose, attributes, and functions of CPOE.
   B. Explain ways in which CPOE is currently being used in healthcare.
   C. Discuss the major advantage of CPOE adoption.
   D. Identify common barriers to CPOE adoption.
   E. Identify how CPOE can affect patient care safety, quality,
efficiency, and outcomes.

V. CDS Systems
   A. Describe the history and evolution of CDS.
   B. Describe the fundamental requirements of a CDS system.
   C. Discuss the importance of clinical practice guidelines and
evidence-based practices and how these affect CDS systems.
   D. Describe the challenges and barriers to building and using CDS
systems.
   E. Discuss the legal and regulatory barriers in the distribution of CDS
systems.
   F. Identify future directions for CDS systems.

VI. Patient Monitoring Systems
   A. Describe the purpose, attributes, and functions of patient
monitoring systems.
   B. Discuss the primary applications and how automation can improve the
quality of patient care.
   C. Analyze how the integration of data from many sources assists in
medical decision making.
   D. Discuss how telehealth supports clinical care.
   E. Discuss the effectiveness and economic benefits of telehealth.
   F. Examine the role of smart technology and links to health information
systems.

VII. Medical Imaging Systems
   A. Examine the purposes, processes, and management issues related to
the use of imaging systems in healthcare.
   B. Explain the economic and technological factors that must be
considered in the adoption of digital displays by radiology departments.
   C. Describe the major challenges with imaging systems faced by
healthcare institutions and informaticians.
   D. Describe the future of imaging systems.

VIII. Consumer Health Informatics
   A. Describe the emergence of personal health records and their
implications for patients, healthcare providers, and health systems.
   B. Discuss the benefits and challenges of consumerism in the ongoing
development and use of health information systems.
   C. Explain how current and emerging technologies, including the
Internet, have impacted and may continue to affect consumer health
informatics.
   D. Describe the role of genomics in consumer health informatics.

IX. Administrative, Billing, and Financial Systems
   A. Describe the strategies used by healthcare organizations to ensure
integration of front-end clinical data collection and back-end billing
functions.
   B. Discuss the critical requirements needed in integrated billing,
financial, and clinical systems.
   C. Explain how automation tools (such as scheduling system support
tools) are being integrated with health information systems.
   D. Describe the core elements of a master patient index and the current
trends in establishing a national or universal patient identifier.
   E. Discuss data analysis and trends, especially as related to the
improvement of patient care.

Content Outline and Competencies:

I. The EHR Training Environment
   A. Discuss the role and competencies of a trainer. 
   B. Explain why people resist change and discuss methods to overcome resistance. 
   C. Select strategies to facilitate change based on analysis of the learners and environment. 
   D. Define the levels of learning per Bloom’s Taxonomy. 
   E. Describe the characteristics of adult learners that impact training design.

II. Needs Assessment and Analysis 
   A. Discuss the recommended training cycle of the ADDIE ISD model 
   B. Identify instructional design problems for a variety of learners and training settings. 
   C. List a range of data collection methods for conducting needs assessments in healthcare settings. 
   D. Analyze learner, task, and situational characteristics. 
   E. Describe the special training needs and constraints in a healthcare setting.

III. Educational Design 
   A. Construct lesson plans using appropriate instructional methods and approaches. 
   B. Write measurable goals for a training program which meet the specific, measurable, attainable, realistic, and timely (SMART) criteria. 
   C. Write specific level learning objectives based on Bloom’s Taxonomy. 
   D. Select content for development based on the objectives and lesson plan. 
   E. Identify the appropriate instructional approaches established by the needs analysis.

IV. Educational Materials Development 
   A. Choose appropriate instructional media for a given lesson plan. 
   B. Create customized written materials utilizing principles of instructional design. 
   C. Create an effective PowerPoint presentation utilizing evidence-based design principles. 
   D. Create and customize content using appropriate activities for training objectives. 
   E. Discuss methods for continuing education and training utilizing various technologies.

V. Training Implementation 
   A. Discuss components of successful EHR training implementation. 
   B. Select super-users based on recommended criteria. 
   C. Describe the components of a super-user training Program. 
   D. Explain strategies for training implementation. 
   E. Demonstrate effective presentation skills using a variety of instructional tools and strategies.

VI. Training Evaluation 
   A. Design assessment instruments and procedures aligned with instructional goals/objectives. 
   B. Administer assessments as a component of training/instructional design. 
   C. Design a program evaluation tool that objectively measures a training program. 
   D. Discuss how data collection is analyzed and supports program improvement. 
   E. Specify revisions to training based on evaluations results.

Content Outline and Competencies: