IGPI: 5200 Cross-Sectional Study of the Health Informatics Job Market Using Text Mining and Keyword Analysis

Transcription

1 IGPI: 5200 Cross-Sectional Study of the Health Informatics Job Market Using Text Mining and Keyword Analysis Garrett Larson M.S. Health Informatics Student

2 Background What is Health Informatics? Health Informatics is a continually evolving field that recently exploded with interest due to the implementation of: 1. Meaningful Use Meaningful Use rules were part of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act. By adapting electronic health records (EHR) into their practice, physicians could each receive up to $63,750 by meaningful using these systems. This incentive was meant to encourage wide spread adoption of the EHR throughout the United States. 2. MACRA - The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law on April 16 th It essentially created/streamlined a program to provide financial rewards to clinicians who participate in the Merit Based Incentive Payments System (MIPS) and also provides bonus payments for participating in eligible alternative payment models (APMs). It is easy to define Informatics, this is the process of collecting, creating, storing, retrieving, and manipulating data and/or information. The definition becomes a bit more complicated when the word Health is introduced. The U.S. National Library of Medicine currently provides this definition: Health Informatics is the interdisciplinary study of the design, development, adoption and application of IT based innovations in healthcare services delivery, management and planning The American Health Information Management Association (AHIMA) is a well-known professional organization that offers several certifications for Health Informatics trained individuals. They currently provide this definition: Health informatics is a collaborative activity that involves people, processes, and technologies to produce and use trusted data for better decision making. AMIA is another well-known professional organization that represents Health Informatics professionals. AMIA also has organized a program whereby education programs can become officially accredited to provide Health Informatics education. They currently provide this definition: Health Informatics is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving and decision making, motivated by efforts to improve human health.

3 There does not seem to be a clear and sole definition to the term Health Informatics; the problem is further exacerbated by the fact that there are currently 300+ programs that offer varying levels of Health Informatics education currently in the United States. Each one of these programs have their own internal definition of Health Informatics. The Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) is attempting to standardize the education tract and by that fact, the definition of Health Informatics. They began an aggressive effort starting in January of AHIMA also recently began advertising a product they offer to experienced Health Informatics professionals and new Master s graduates; they state that becoming a Certified Professional in Health Informatics (CPHI) will identify your experience and Health Informatics knowledge to perspective employers. In order to become certified, a potential applicant must pass an exam. The current exam blueprint is summarized below: The CPHI exam blueprint is beginning to answer our question, but the certification only recently became available; its use is widely debated amongst Health Informatics professions and competing professional organizations. Both the exam and the CAHIIM accreditation process may yield a standard definition in the future, but a clear and concise statement still is not possible. Another way to answer the question is to look at what skills are required for Health Informatics professional upon graduation/certification. The sources that have been discussed previously will all provide different career paths or recommended skills sets. It has already been shown that no clear definition exists within amongst those stakeholders. Friedman provided some input into this topic in 2012 with his paper What informatics is and isn t. At the time he was able to show that Health Informatics is a cross-training of information between health domains and the realm of information science. So does this mean Health Informatics is simply computer science for the world of health? According to Friedman this is not a good comparison. How else might this definition problem be solved?

4 Methods and Results What skills does the Job Market expect from someone in Health Informatics? In order to solve this problem a new approach was developed using keyword analysis of current job market posting for Health Informatics. The keywords Health Informatics were queried into multiple job search platforms with the most recent 20 job postings (by date) extracted into a visual basic scripted Excel spreadsheet. This process was duplicated three times; a total of 14 keyword groups were eventually created. After it was demonstrated results could be easily repeated without human error, a fresh set of 100 job postings were extracted from the previously unused source of Google s job search feature in the Chrome browser. The exact search string used was: Health Informatics all locations. Of those; six were deemed to be duplicates and thus excluded. The Keyword results of n=94 were then analyzed and summarized below.

5 Data Management As expected the majority of the job summaries required skills related to collecting, creating, storing, retrieving, and manipulating data, 15 of the postings specifically requested applicants be familiar with databases. Keywords were designed to capture 14 business software programs. Proficiencies with Outlook , Power-Point, and other Microsoft Office tools were commonly noted. Overall the only unique standout was 12% (n= 11) of the samples requested experience with Tableau. No other Business Analytical software was mentioned more than once. Government Compliance and Regulation Keywords related to ensuring government compliance and reporting key metrics related to Meaningful Use and MACRA were present in nearly 50% (n= 46) of the sampled job summaries. This information highlights a growing need within the Health Informatics job market. Programming Skills Programming skills were requested in only 25% (n= 24) sample postings; of this group many indicated that the ability to learn a language would be sufficient. The language used by the Statistical Analysis System (SAS) was clearly the language of choice (when a specific language was mentioned). No other specific language skills stood out amongst this keyword group. Medical Information Systems Experience with Electronic Health Records (EHR) or other Medical Information systems were requested in 64% (n= 60) of the sampled postings. Half of these samples (n= 30) requested skills that would help the applicant provide end-user training in these systems. While no clear EHR system clearly stood out, both Epic (n= 10) and Cerner (n= 11) experience were the most requested systems that an applicant should be familiar with. Research 50% (n= 47) of the jobs sampled noted that the applicant would be expected to do some research. Qualitatively it was noted that this research ranged from academic to providing data for reporting compliance/quality measure use.

6 AHIMA Credentials The CPHA exam is still new and debated amongst Health Informatics stakeholders; but the job market is slowly seeking AHIMA related certifications for applicants in Health Informatics. 7% (n= 7) of the sample job summaries mentioned keywords within this group. This statistic will be watched closely over the next few years. Education Level Overwhelmingly the sample job postings requested the applicant have specific education related to Health Informatics (n= 74). The minimum degree for 55% (n= 52) of the sampled posting was either a Bachelor of Arts or Bachelor of Science. Summary What does the job market define Health Informatics as? Using the results from this limited study; A Health Informatics employer would define the ideal candidate as: A health data analyst comfortable with health information systems; for the purposes of training end-users and to maximize both Meaningful Use and MACRA measures within the organization.

7 Discussion/Qualitative Observations The ideal candidate discussed previously would genuinely have a dominant position in the current market, but this does not yet define Health Informatics. Almost all of the job postings collected are looking for an employee that can process data. What does this mean though? An exhaustive attempt to quantify the data skills required was made in this research. The majority of the records only listed generic responses related to data such as data, analytics, or data science. Ten records did have the keyword SQL within the posting text; upon qualitative review, the majority of these were using the term SQL to merely discuss relational databases. There was not a clear link to the structured query language that is SQL. An attempt to capture keywords related to NoSQL, Hadoop, Apache, Lamp, MySQL and even specific Oracle SQL was made. None of these attempts provided useful results to review. Why was it difficult to obtain this information? There are several possibilities: 1) The methods used to capture the data keywords in the study were flawed While the technique used could undoubtedly be improved in future research queries and a larger sample population, each job posting was also qualitatively reviewed, and the lack of specific data keywords was verified. 2) The employer is not concerned with past data skills; they expect to train the applicant in whatever it is they are using. Data science is a skill that continually evolves. It is rational to assume that employees would need company-specific training upon employment. Perhaps the job postings are vague for this reason. 3) Whoever wrote the job posting does not know what they need; human resources may have been told to "hire a Health Informatics professional" to solve health data problems within the organization. This is the most likely scenario based on the qualitative analysis of 94 job postings. As noted previously, Meaningful Use and MACRA have opened up new opportunities within the healthcare system. Based on the qualitative review of this study, it is believed that many of the job postings were made by people unfamiliar with what Health Informatics is. This evidence is backed up by the fact that n= 30 of the job postings requested that the applicant be able to train health information system users. The majority of this training was specific to maximizing quality measures. The postings for this cross-sectional study were extracted on 17 Feb 2018; there have been hundreds of new postings since that time. This research should be continued to help future job applicants focus on needed skills within the marketplace. In the end, the market may be the only one to answer the question, What is Health Informatics?

8 References AHIMA. (2018). Health Informatics. Retrieved from AHIMA: Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). (2018). Retrieved from CAHIIM: Friedman, C. P. (2013). What informatics is and isn't. JAMIA, Haux, R. (2010). Medical informatics: past, present, future. International Journal of Medical Informatics, Hochman, M. (2018). Electronic Health Records: a Quadruple Win, a Quadruple Failure, or Simply Time for a Reboot? Journal of General Internal Medicine, In Hoyt, R. E., & In Yoshihashi, A. (2014). Health informatics: Practical guide for healthcare and information technology professionals. Morrrisville: Lulu.com. Kulikowski, C. A., Shortliffe, E. H., Currie, L. M., Elkin, P. L., Hunter, L. E., Johnson, T. R., Williamson, J. J. (2012). AMIA Board white paper: definition of biomedical informatics and specification of core competencies for graduate education in the discipline. Journal of the American Medical Informatics Association : JAMIA, Office of the National Coordinator for Health Information Technology. (2018, March 16). Meaningful Use and MACRA. Retrieved from HealthIT.gov: U.S. National Library of Medicine. (2018, May 1). Health Informatics. Retrieved from Health Services Research Information Central: