Clinical Informatics Workforce Development in the United States

Army Medical Command (MEDCOM)

Colonel Nicole L. Kerkenbush, Defense Health Agency Health Information Technology Directorate, Deputy Director,

Solution Delivery Division, Chief Information Officer MEDCOM/OTSG G-6

Objectives

To provide an overview of our Comprehensive Workforce

Development Approach

To describe the Clinical Informatics Workforce Development

Project, Outcomes and Lessons Learned

To discuss how the US Army MEDCOM’s Workforce

Development approach can be applied in other organizations

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A Day in Army Medicine • 41,986 clinic visits • 374 patients admitted • 1,214 patient beds occupied • 26,600 dental procedures • 5,879 immunizations • 64 births • 12,494 radiology procedures • 54,048 outpatient pharmacy prescriptions • 50,420 laboratory procedures • 1,961 veterinary outpatient visits • $23.2 million-worth of food inspected

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Mission: The CMIO will be the premier advocate for clinical information systems for providers and serve as the liaison between the healthcare community and Army Medicine leadership.

Mission Essential Task List: • Establish and maintain trust among the healthcare provider community • Advocate for improving provider/user satisfaction by improving meaningful use of

information systems, with focus on improving the Department of Defense Electronic Health Record (EHR)

• Improve business and clinical information systems by engaging the user population, the information management governance bodies, and the program management offices

• Improve business and clinical processes by leveraging systems, best practices, training, and business intelligence tools in the daily workflow of providers and users

Army Medicine CMIO

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Informatics Core Business Units Business Process Management

Clinical Business Intelligence Clinical System Training

System Integration

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Informatics Implementation for Transformation

Strategy

Leadership CMIO Organization

Areas of Focus for Transformation

Enterprise Organization

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Typical Strategic Workforce Components Workforce Planning Forecasting talent supply and demand

Role and Competency Design

Defining job roles and the knowledge, skills, and behavior requirements for success in those roles

Succession Management Clarifying leadership criteria, identifying critical positions and potential replacements for those positions, developing leadership bench strength

Talent Assessment Assessing individuals to identify top talent, clarify talent gaps, and identify career development and training priorities

Career Development Tools and processes for employees to develop and grow

Performance Management

Tools and processes for setting performance expectations, providing performance feedback and coaching, and evaluating and recognizing performance results

What is Strategic Workforce Development?

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7 7

Strategic Workforce Development Trends:

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In the Past • Disparate workforce development

initiatives. • Off the shelf competency models,

generic and high-level • Hero leadership • Siloed, parochial interests • Exec compensation contracts • Product excellence • Inconsistent work habits • Creative-centric • Training mindset • Closed decision-making • Sycophantic • Compliant • Protective of exclusivity, imbred points

of view • Managing through intimidation

Today • Cohesive workforce strategy that builds off

of each component and ties back to the business.

• Customized competencies based on business strategy, behavioral based

• Team performance • Collaborative alliances • Total rewards • Customer intimacy • Adaptable work styles • Market-centric • Curious to learn • Transparent decision-making • Constructive confrontation • Accountable • Appreciation for diversity, inclusive voices • Leading through appreciation/recognition

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Aligned and Interdependent

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Organization Organizations are rebuilding to efficiently get work done and realize the full capability and creativity of its workforce Organization Design & Restructuring Business Process Improvement Governance & Operating Model

Talent Ensuring they have the right people, in the right roles at the right time, with the right motivation to deliver results Strategic Workforce Planning Competency Development Succession Planning Talent Development Performance Management Engagement and Retention Compensation & Rewards

Strategy Clarifying and communicating strategy from the board-room to front line employees Strategy Clarification Strategy Alignment

Leadership Building strong leadership teams with the right knowledge, skills and abilities to execute with focus and discipline Leadership Models Leadership Development Leadership Alignment

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Acquisition

Programs, processes, and means by which the organization attracts and

selects individuals that align with the organizations’ talent needs and enables

them to fulfill their mission

Onboarding

Programs, processes, and means by which the organization ensures

individuals are oriented and integrated into the organization

Learning & Development

Programs, processes, and means by which the organization ensures that

individuals have the skills, competencies, and behaviors necessary to be successful

PRO

GR

AMS

FOU

ND

ATIO

NA

L

Talent Management Principles

Performance Management

Programs, processes, and means by which the organization measures

individuals’ contributions and ensures they are rewarded for contributions that

are meaningful to the organization

Retention

Programs, processes, and means by which the organization ensures individuals are emotionally and

rationally involved in, motivated by, and committed to their work

Succession Planning

Programs, processes, and means by which the organization develops a

cadre of leaders that are capable to assume key clinical informatics

leadership roles

Role Profiles & Competency Models

STRATEGIC WORKFORCE DEVELOPMENT

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Demand for Clinical Informatics Workforce Development

• Growing the Informatics Workforce identified as a key priority for the MEDCOM Chief Medical Information Officer in 2008

• The CMIO role was designated at various organizational levels, however roles, responsibilities, competencies and experience vary tremendously

• MEDCOM AHLTA Provider Satisfaction (MAPS) program established common roles and position descriptions, as well as foundational competencies for Clinical System Trainers and Clinical Workflow Analysts

• Key deliverables: Workforce Development Strategy that addresses Recruitment, Retention, Competency & Learning Development, Career Development and Succession Planning for this highly specialized career field

• Take away Message: Very few organizations are doing this work in Clinical Informatics. The focus is on education & training of entry level Health IT practitioners, not comprehensive workforce development

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Workforce Development Project Plan

Key Artifacts - Job Family / Role Profiles - Competency Model - Performance Metrics

Key Artifacts - Operational Plan - Final Report - Marketing Collateral

Key Artifacts - Proof of Concept Plan - Gap Analysis - WFD Strategy & Plan

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Workforce Development Approach and Timeline

Role profiles for key informatics roles

What competencies, technical skills, and experiences are

critical to success at the AMEDD?

What does a career path in informatics look like at the

AMEDD? What does it take to progress?

Role profile assessment

Where do we have gaps in the competencies and technical

skills that we know are critical to success? What is the nature of those gaps (e.g., systemic,

role-specific)?

Where do we have strengths that we need to better

leverage?

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Overall CST Competency Rankings/Proficiencies

Target Proficiency

Employee Score

Manager Score

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

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0.5

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1.5

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2.5

3

3.5

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4.5

Overall CST Competency Rankings/Proficiencies

Target Proficiency

Employee Score

Manager Score

Workforce Development Strategy

What steps are we going to take to close the gaps that

we’ve identified through the assessment?

What will our key talent

programs (e.g., acquisition, learning & development, career

planning, and succession) need to entail?

Where is it critical that we

leverage the current contract work?

FY11 Implementation Plan

What is the detailed plan (tasks, timeline, deliverables) for

implementing the Strategy?

Where is it critical that we leverage the current contract work?

FY12

Detailed talent program designs

What exactly is the AMEDD doing to support informatics workforce

development? What processes and tools are now available to support

acquisition, learning & development, career planning, and succession?

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Job Family Matrix (Current State)

Clinical Business Intelligence Training & Support Systems Integration Business Process Management Strategic Leadership

Clinician Consultant TrainerImplementation Management &

Implementation Support SpecialistsPractice Workflow and Information Management Redesign Specialists Clinician Consultant

Info

rmat

ics P

ositi

ons

- Chief, CBI Branch*- Deputy Chief, CBI Branch* (Operations and Program Management)- Data Analysts**- PI Analysts- BPM Specialists

- Chief, T&S Branch*- Deputy Chief, T&S Branch* (Operations and Program Management)- Training Specialists

- Chief, CSI Branch*- Deputy Chief, CSI Branch* (Operations and Program Management)- Informatics Specialists (Program Managers)- IT Specialists

- Chief, BPM Branch*- Deputy Chief, BPM Branch* (Operations and Program Management)- BPM Specialists

- CMIO*- Deputy, CMIO (Operations and Program Management)

Mat

rixed

Po

sitio

nsIn

form

atics

Po

sitio

ns - Regional CST Lead- Regional CST

- Regional CWA Lead- Regional CWA

- Regional CMIO- Deputy CMIO- Program Manager

Mat

rixed

Po

sitio

ns - Data Analysts- Clinical Operations (Process Improvement, Patient Safety, Outcomes)

- Regional IT Specialist - Regional LSS Liaison

Info

rmat

ics

Posit

ions - CST Supervisor

- Senior CST- Junior CST

- CWA Supervisor- Senior CWA- Junior CWA

- CMIO- Deputy CMIO^- Informatics Nurse^

Mat

rixed

Po

sitio

ns - Data Analysts- Clinical Operations (Process Improvement, Patient Safety Coordinator)

- Clinical Champions- Super Users

- LSS Liaison

Red text - role does not currently exist

*Single incumbent role**Contract role^Not visible at all MTFs

AMEDD Informatics Job FamilyAMEDD

Capabilities:

Industry Alignment:

OTS

GRe

gion

MTF

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Clinical Business Intelligence Training & Support Systems Integration Business Process Management Strategic Leadership Telehealth Functional Support

Clinician/ Practitioner Consultants TrainersHealth IT Sub Specialist

Implementation ManagersImplementation Support Specialists

Practice Workflow SpecialistInformation Management Redesign Specialists

Clinician/ Public Health Leader Clinician/ Practitioner ConsultantHealth Information & Exchange Specialist

Clinician/ Practitioner ConsultantsResearch & Development Specialist

Health Information & Exchange Specialist

Info

rmat

ics P

ositi

ons - Chief, CBI Branch*

- Deputy Chief, CBI Branch*- IT Specialist/ Data Analyst- Performance Improvement Analyst^- BPM Specialist-Data Architect^

- Chief, T&S Branch*-Deputy Chief, T&S Branch- Training Specialist

- Chief, CSI Branch*- Deputy Chief, CSI Branch* - Clinical Informatics Specialist^- Health Systems Specialist^- IT Specialist

- Chief, BPM Branch*- Deputy Chief, BPM Branch*- BPM Specialist- Human Factors Engineer^

- CMIO*- Portfolio Manager^- Program Manager^- Acquisition Planning Officer^- Informatics Consultant/ Advisor^- Change Management Specialist^

- Telehealth Project Manager (SME/Consultant/ Liaison)- Telehealth Program Director

- Clinical Informatics Specialist- System Integrator- Health Systems Specialist-Technical Writer-Research Grant Writer

Mat

rixed

Pos

ition

s^^

- IT Specialist/ Data Analyst (PA&E)- IT Specialist (HA PA&E)

- Functional System Trainers (HP&S)- Technical Writer

- Project Director USAMITC - Human Factors Engineer (AMEDD Research Lab)

- CMIO USAMITC - Telehealth Program Director (TATRC)- Telehealth Program Director (TMA)

- Pharmacy Informatics Specialist-Laboratory Informatics Specialist-Logistics Informatics Specialists-Radiology Informatics Specialist-Pathology Informatics Specialist-Patient Administration Informatics Specialist-Public Health Informatics Specialist-Biomedical Informatics Specialist-Health Facility Planning Liaison-AR/NG Informatics Specialist

Info

rmat

ics P

ositi

ons

- IT Specialist/ Data Analyst^ - Regional Clinical Systems Trainer/ Supervisor- Regional Clinical Systems Trainer 2- Technical Writer^

- Integration Specialist^- Health Systems Specialist^- IT Specialist^

- Regional Clinical Workflow Analyst/ Supervisor- Regional Clinical Workflow Analyst 2- Human Factor Engineer^

- Regional CMIO- Regional Deputy CMIO- Portfolio Manager^- Program Manager^- Systems Integrator^

- Regional Telehealth Program Director- Telehealth System Administrator- Functional Consultant/ SME

- Clinical Informatics Specialist- System Integrator- Health Systems Specialist

Mat

rixed

Pos

ition

s^^

- IT Specialist/ Data Analyst- IT Specialist/ Data Analyst (Clinical Operations)- IT Specialist/ Data Analyst (Process Improvement)- IT Specialist/ Data Analyst (Patient Safety)

- Functional Systems Trainer (RMC/ Clinical Operations)

- Regional IT Specialist - Regional LSS Liaison - Telehealth Project Director - Regional Telehealth Program Director- Telehealth System Administrator- Functional Consultant/ SME

- Pharmacy Informatics Specialist-Laboratory Informatics Specialist-Logistics Informatics Specialists-Radiology Informatics Specialist-Pathology Informatics Specialist-Patient Administration Informatics Specialist-Public Health Informatics Specialist-Biomedical Informatics Specialist-Health Facility Planning Liaison-AR/NG Informatics Specialist

Info

rmat

ics P

ositi

ons

- IT Specialist/ Data Analyst^ - Clinical Systems Trainer/ Supervisor- Clinical Systems Trainer 1- Clinical Systems Trainer 2

- Integration Specialist^- Health Systems Specialist^- IT Specialist^

- Clinical Workforce Analyst/Supervisor- Clinical Workflow Analyst 1- Clinical Workflow Analyst 2

- CMIO- Deputy CMIO- Project Manager^

- Telehealth Program Director - Telehealth System Administrators

- Clinical Informatics Specialist (MD, Nurse, MS (70E))

Mat

rixed

Pos

ition

s^^

- IT Specialist/ Data Analyst- IT Specialist/ Data Analyst (Clinical Operations)- IT Specialist/ Data Analyst (Process Improvement)- IT Specialist/ Data Analyst (Patient Safety)

- Clinical Informatics Specialist/ Nurse - Clinical Champions- System Super Users

-Chief, Information Management- Clinical Informatics Specialist/ Nurse

- Telehealth System Administrator - Pharmacy Informatics Specialist-Laboratory Informatics Specialist-Logistics Informatics Specialists-Radiology Informatics Specialist-Pathology Informatics Specialist-Patient Administration Informatics Specialist-Public Health Informatics Specialist-Biomedical Informatics Specialist-Health Facility Planning Liaison-AR/NG Informatics Specialist

Med

ical

Tre

atm

ent F

acili

ty

AMEDD Informatics Job Families Matrix - Future State

AMEDD Role

Industry Role

OTS

GRe

gion

al M

edic

al C

omm

and

Job Family Matrix (Future State)

KeyBold*^

^^

Full role profile to be created for this rolePartial role profile (exclude proficiency) to be created for this Job summary to be created for this roleOut of scope for Informatics Workforce Development ProjectOut of scope for Informatics Workforce Development Project

Role Profile Assessment and Gap Analysis • Online survey for employees and managers to assess skills, competencies, behavioral indicators of

assigned role profile – The assessment was launched on August 10, 2012 and closed on August 23, 2012 – 80% of those invited to participate in the “pilot” completed the assessment

• The output of the assessment was used to create a targeted Clinical Informatics Workforce Development Strategy that leverages the identified strengths and closes the gaps

– Individually identified data is being kept anonymous and confidential and will only be shared in an aggregate report

• Assessment was limited to a focused “pilot” within Western Region, and participation was broadened to

other individuals across the AMEDD when additional data was needed. The table below provides additional details on the assessment data sources for each role:

Strategic Leadership Clinical Systems Trainer Clinical Workflow Analyst

Deputy CMIO (MTF)* CST 1 (MTF) CWA 2 (MTF)

CMIO (MTF)* CST 2 (MTF) CWA Supervisor (MTF)

Deputy CMIO (RMC)* CST Supervisor (MTF) CWA 2 (RMC)

CMIO (RMC)* CST 2 (RMC) CWA Supervisor (RMC

CST Supervisor (RMC)

Western Region data collected AMEDD-wide data collected

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Gap Analysis Methodology • Blended scores were calculated for each competency and technical skill for every employee where

assessment data (manager, employee, or both) was provided based on the following parameters: – In cases where both manager and employee scores were provided, a blended score was calculated with a 60%

weight applied to the manager ratings and a 40% weight applied to the employee ratings for each competency/technical skill

– In cases where only manager or employee scores were provided, that individual score was used as the blended score for each competency/technical skill

• Average blended scores were compared to the target proficiency level for each competency/technical

skill and for each role. The gaps were then calculated, and placed into one of the following categories:

Yellow

Gap is less than .25 below the target proficiency level, indicating a moderate

gap exists

Green

The blended score is at or above the target proficiency level, indicating no gap

exists

Red

Gap is greater than or equal to .25 below the target proficiency level, indicating a

strong gap exists

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Clinical System Trainer Assessment Results Competencies

• Competency gaps primarily exist at the Training Supervisor level • The competency gaps among the Supervisory roles primarily fall within the functional competencies, with the exception of Teamwork, which is a

foundational competency

• Strengths in People Management and Talent Development will be critical to leverage as the Workforce Development Strategy is implemented

CST 1 (MTF) (n=13)

CST 2 (MTF) (n=18)

CST Supervisor (MTF) (n=1)

CST 2 (RMC) (n=6)

CST Supervisor (RMC) (n=5)

(0 gaps) (0 gaps) (4 gaps) (0 gaps) (4 gaps)

Communication (0 gaps)g g g g g

Learning Agility (0 gaps)g g g g g

Results Orientation (0 gaps)g g g g g

Teamwork (2 gaps)g g y g y

Adult Learning (2 gaps)g g r g r

Organizational Agility/Acumen (2 gaps)g g r g r

Relationship Building (2 gaps)g g y g r

People Management (0 gaps)n/a n/a g n/a g

Talent Development (0 gaps)n/a n/a g n/a g

Foun

datio

nal

Func

tiona

lSu

perv

isory

Note: data points for the CST Supervisor (MTF) role are limited, and therefore caution should be exercised when drawing conclusions based on the data.

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Clinical System Trainer Assessment Results Technical Skills

• There are more gaps in technical skills than in the competencies

• The presence of significant Clinical Systems gaps is surprising given that the primary purpose of the training role is to train end-users on the clinical systems

• The gap in Essentris was expected as CST’s transition to the Essentris training support role

CST 1 (MTF) (n=13)

CST 2 (MTF) (n=18)

CST Supervisor (MTF) (n=1)

CST 2 (RMC) (n=6)

CST Supervisor (RMC) (n=5)

(4 gaps) (3 gaps) (4 gaps) (4 gaps) (6 gaps)

MS Excel (1 gap)g g g g r

MS Power Point (3 gaps)g g r r r

MS Project (2 gaps)r g r g g

MS Word (0 gaps)g g g g g

MS OneNote (0 gaps)g g g g g

AHLTA (2 gaps)r g g g r

ESSENTRIS (5 gaps)r r r r r

CHCS (4 gaps)g y r r r

Dragon (0 gaps)g g g g g

Asutype (0 gaps)g g g g g

ICDB/Carepoint (3 gaps)g y g y r

Data flow between entities (0 gaps)g g g g g

Function-specific

Database management (1 gap)y g g g g

MS O

ffice

Clinic

al Sy

stems

Note: data points for the CST Supervisor (MTF) role are limited, and therefore caution should be exercised when drawing conclusions based on the data.

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Learning & Development - FY12/13 This section of the Strategy is focused on the programs, processes, and means by which we will ensure that individuals have the skills, competencies, and behaviors necessary to be successful Key highlights of this strategy element: •Use the role profiles to develop career maps and life cycle models that provide employee with an understanding of career opportunities at the MEDCOM and what is needed to progress •For each of the competencies and technical skills captured in the role profiles, create a development actions library containing “Practice”, “Read”, and “Study/learn” actions that one can take to support their development in the specific area (see below)

– Actions will be highly specific and applicable to what we do at the MEDCOM

– Use of different development tools will vary depending on role/level

– Will coordinate with the AMEDD Center & School and other existing training and development programs to ensure we are aligned and to leverage existing programs

•Refresh the role profile assessment on either a rolling 12 or 24-month cycle •Create individual development plans

Practice

Read

Study/learn

Mentoring

Coaching

Practical, applied, and mainly on-the-job steps an

individual can take to build a competency or technical skill

Readings and reference material that highlight best

practices and effective approaches

Self-study courses, classroom training (internal

or external to MEDCOM), certifications, etc.

Self-initiated relationship with a colleague who has

particular expertise/strength in a competency or technical

skill

MEDCOM-assigned/ sponsored external, professional coach

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Learning & Development Program • Employees required to complete solutions in the Top 3 Competency &

Technical Skills Gaps • Four (4) hours per month to complete solutions; many of which are

“practice” solutions • Employees can choose to complete one or all solutions for the competency

or technical skill gaps, based on individual competency gaps and development plans

• Employees will maintain a written record of completed solutions using Tracking Form—still pending completion of the tracking feature in SharePoint

• Complete an enterprise-wide Competency Assessment after 1 year

Comp Gap #1

Comp Gap #2

Comp Gap #3

Tech Gap #1

Tech Gap #2

Tech Gap #3

CMIO Resource Management

Teamwork Talent Management

N/A N/A N/A

CWA Change Management

Project Management

Organizational Agility

Excel BPA Clinical Data Flow

CST Adult Learning Teamwork Relationship Building

Essentris CHCS PowerPoint

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Training

• Delivered via Defense Connect Online (DCO) & VOIP • Recorded and stored via SharePoint • Training Packages available via SharePoint

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Acquisition - Future Implementation This section of the Strategy is focused on the programs, processes, and means by which we will attract and select individuals that align with our talent needs and enable fulfillment of our mission

Key highlights of this strategy element: •Over time, role profiles will be developed for every key clinical informatics role at the MEDCOM – use the 2016 role matrix to document the evolution

•Meet our acquisition needs through the approach at right:

– Includes three rounds of selection screening post identification of the candidate list

– Flexible to whichever role we are hiring for (e.g., individual contributor, leadership role)

– Easily customizable and can be streamlined, as necessary – Selection tools based on the competencies, technical skills,

and experiences in the role profiles

Offer Letter

Round 1 Selection

Initial Screening Interview

Round 2Selection

Hiring Manager/Stakeholder Interview(s)

Round 3Selection

Assessment Day

Review &Calibration

CandidateList

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Onboarding – Future Implementation This section of the Strategy is focused on the programs, processes, and means by which we will ensure individuals are oriented and integrated into the clinical informatics workforce and MEDCOM, more broadly Key highlights of this strategy element: • More consistent onboarding approach for our new hires that supports them in five key

areas (below left) and follows a pre-defined schedule and set of tools (below right)

RoleLearn the key

responsibilities, performance objectives,

critical competencies and skills for the role and

how it fits within MEDCOM and

contributes to results

IndustryGain health IT

industry information pertinent to the new

role

CultureLearn the written and

unwritten rules of MEDCOM/local office

culture and how things get done

RelationshipsBuild networks and

develop positive internal and external

relationships

Leadership*Establish expectations and competencies for being an informatics

leader within MEDCOM

*Applies to roles requiring people management responsibility that is either of a formal reporting nature or project-based.

Timeline Individual Contributor Supervisor/Manager/Sr. Leader*

Pre-start date • Risk assessment • Onboarding plan

• Risk assessment • Onboarding plan

Week 1 • MEDCOM orientation • Team introductions • Role and objectives clarity

• MEDCOM orientation • Team introductions • Role and objectives clarity

Months 1 to 3 • Learn-the-organization plan • Onboarding mentor

• Learn-the-organization plan • Global leadership model &

course(s) • Onboarding mentor

Months 3 to 6 • Key stakeholder review • Onboarding mentor

• Key stakeholder review • Onboarding mentor

Months 6 to 12 • Onboarding mentor • Onboarding mentor

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Succession Planning - Projected FY13

This section of the Strategy is focused on the programs, processes, and means by which we will ensure the MEDCOM has a cadre of leaders that are capable to assume key clinical informatics leadership roles Key highlights of this strategy element: •Deploy a four-step approach (see right) •Initially, focus on the leadership roles (see below) and aim to have three individuals ‘groomed’ for each leadership role

•Individuals on succession lists receive targeted development: – Leadership training

Action learning

MTF RMC OTSG

• CMIO • Deputy CMIO

• Regional CMIO • Regional Deputy CMIO

• CMIO • Chief, BPM Branch • Deputy Chief, BPM

Branch • Chief, CSI Branch • Deputy Chief, CSI Branch • Chief, T&S Branch • Deputy Chief, T&S

Branch • Chief, CBI Branch • Deputy Chief, CBI Branch

Identify Roles

Identify Candidates

Identify Development

Actions

Review Progress

1

2

3

4

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Retention - Future Implementation This section of the Strategy is focused on the programs, processes, and means by which we will ensure individuals are emotionally and rationally involved in, motivated by, and committed to their work Key highlights of this strategy element: •Methods for assessing the key elements of our Employee Value Proposition (EVP) – what we offer to employees in return for their efforts and contributions (see graphic below)

– Employee survey to assess each EVP element on two criterion: the relative importance that employees attribute to it and employee perceptions about how effective the MEDCOM is in meeting employee expectations

– Employee focus groups to follow up on key findings reported in the employee survey and gain more context for the gaps that exist

– Assessment of industry best practices to understand how our competitors fulfill their EVPs

•Annual review process led by CMIO and a leadership team of OTSG branch chiefs to:

– Review survey results and input from employee focus groups to identify key gaps in our EVP – Benchmark our Strategy to industry best practices – Recommend new or revised programs to the Strategy to address gaps

Employee Value

Proposition

Affiliation

Career

Direct Financial

Indirect Financial

Work Content

• Organization reputation• Title, level • Work environment• Social systems

• Organizational advancement• Personal growth• Training • Employment security

• Base pay• Incentives• Cash recognition• Premium pay

• Health benefits• Paid time off• Noncash reorganization• Retirement benefits

• Challenge• Autonomy• Meaningfulness• Feedback• Work schedules• Clarity of expectations

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Performance Management – Currently Out of Project Scope

This section of the Strategy is focused on the programs, processes, and means by which we will measure individuals’ contributions and ensure that they are rewarded for contributions that are meaningful to the MEDCOM

Of all of the elements of the Strategy, this section on performance management is the most forward-looking. Moving forward with changes in this area requires that we first get the other elements of the Strategy implemented and working effectively. As such, we’ve included this section so as to have an all inclusive Strategy; however, we do not expect to implement these changes until the other pieces of the Strategy are in place.

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What have we learned so far?

• Clear need and support for the clinical informatics capability

• Growing alignment around informatics strategy/vision and tactics

• A lot of effort around workforce development, but not all integrated and clear to the end-users

• Leadership development critical to the speed of evolution of clinical informatics

• Hunger for clarity around roles and responsibilities and how Army Medicine will support learning and development

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Opportunities & Challenges • Opportunities

– No one is doing this work in the private or federal sector—AMEDD is providing a best practice for Clinical Informatics and IM/IT

– Providing a systematic approach to operationalizing Workforce Development—can be used for other disciplines

– Publishable work to inform industry, which has focused on academic programs—debate about required competencies for HIT professionals

– Finally formalizing the role and creating processes and programs to grow talent • Challenges

– Socializing the Strategy and gaining unity around priority program design, implementation and sustainment

– Coordination of multi-site implementation over the next year—bandwidth of resources to support the project moving forward

– Competing priorities – Integrating Informatics WFD strategies into overarching IM/IT and MEDCOM

WFD/ Talent Management strategies – Sustainability of WFD programs

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The Road Ahead • Full implementation of the Strategy will take several years. The three-year timeline below

illustrates the major steps that will be taken to fully implement the Strategy by September 2014

October 2011 – September 2012 October 2012 – September 2013 October 2013 – September 2014

Phase III: Recruiting & Onboarding, Retention, and Success Planning Program Design & Implementation

Phase IV: Assessment Re-Boot, Workforce Development Strategy Refresh, Job Family Matrix Review, and Organizational Blueprints

Phase II: Role Profile Assessment and Rollout, Learning & Development/Career Development Program Design & Implementation

Phase I: Workforce Development Strategy

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Questions

Nicole L. Kerkenbush, MHA, MN, RN-BC COL, AN

Defense Health Agency Health Information Technology Directorate, Deputy Director, Solution Delivery Division and

MEDCOM/OTSG G-6 nicole.l.kerkenbush.mil@mail.mil Phone: 703-681-0124

Twitter: @OTSG_CMIO

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