Form 1 Performance Measures

HRSA-13-251

Rural Health Information Technology Workforce Program

Performance Measures

Goal:

Funded networks can focus on a variety of activities related to the recruitment, education, training, and retention of HIT specialists to include providing recruitment assistance and training support directly to enrolled HIT specialist students.

Tables/Categories:

1. Service Area

2. Demographics

3. Network

4. Sustainability of Program

5. Access to Education

6. Education and Training

7. Workforce Recruitment and Retention

Measures:

Table 1: SERVICE AREA

Instructions:

Information collected in this table provides an aggregate count of the number of counties within the service area which may or may not be the total population residing within the service area. Please indicate a numerical figure or DK for do not know, if applicable.

Number of counties

• End of the budget year number is the number of counties served by the end of the budget year.

• Denotes the number of counties served through the program. Please include entire, as well as partial counties served through the grant program. If your project is serving only a fraction of a county, please count that as one (1) county.

1	Number of counties: (If you serve a sub-county area please count this as (1)	End of budget year number
	Total number of counties served
	Number of counties providing students for the program
	Number of counties where the affiliated educational institution(s), apprenticeships, network member hospitals/clinics and/or other rural health care provider placements are located

Table 2: POPULATION DEMOGRAPHICS

Instructions:

Please provide the number of people in your service population by race, ethnicity, and veteran status. The number of people is the total potential trainee population targeted for the Rural HIT Workforce Program. The number of people in the target population would be the total number of trainees the network HIT workforce organization has access to as well as the total number of trainees enrolled in the educational programs and institutions where the network is actively recruiting.

If the number of people is zero (0), please put zero (0) in the appropriate section; do not leave any sections blank. There should not be a N/A (not applicable) response since all measures are applicable.

Number of people served through program by ethnicity (Hispanic or Latino/Not Hispanic or Latino). Hispanic or Latino origin includes Mexican, Mexican American, Chicano, Puerto Rican, Cuban and other Hispanic, Latino or Spanish origin (i.e. Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard etc.)

Population Demographics		Number
2	Number in target population by ethnicity:
	Hispanic or Latino
	Not Hispanic or Latino
	Unknown
3	Number in target population by race:
	American Indian/Alaska Native
	Asian
	Black or African American
	Native Hawaiian/Other Pacific Islander
	White
	More than one race
	Unknown
4	Number of veterans in target population

Table 3: NETWORK

Instructions:

Please identify the total number of formal member organizations in the consortium or network, as well as the types of member organizations by non-profit and for-profit status and organization type. Please indicate a number for each category.

Please also indicate the number of health care providers, professionals and critical access hospitals that are eligible for the Medicare and Medicaid EHR Incentive Program.

Network Size		Number
5	Number of non-profit member organizations in the consortium or network
6	Number of for-profit member organizations in the consortium or network
7	Total number of member organizations in the Consortium/Network
	Area Health Education Center (AHEC)
	Community College
	Community Health Center
	Critical Access Hospital
	Faith-Based Organization
	Federally Qualified Health Center (FQHC)
	Health Center Controlled Network (HCCN)
	Health Department
	Migrant Health Center
	Private Practice
	Regional Extension Center
	Rural Acute Care General Hospital
	Rural Health Clinic
	School District
	Social Services Organization
	University/College
	Urban Acute Care General Hospital
	Other – Specify Type:

Network Characteristics		Number
8	Total number of professionals in the network that are eligible for the Medicare and Medicaid EHR Incentive Program
	Number of eligible professionals that have received an EHR incentive payment
9	Total number of hospitals in the network that are eligible for the Medicare and Medicaid EHR Incentive Program
	Number of eligible hospitals that have received an EHR incentive payment
10	Total number of Critical Access Hospitals that are eligible for the Medicare and Medicaid EHR Incentive Program
	Number of eligible CAHs that have received an EHR incentive payment

Table 4: SUSTAINABILITY OF PROGAM

Instructions:

Please provide the following funding/revenue amounts:

• The annual program award based on box 12a of your Notice of Grant Award (NGA) or Notice of Award (NoA).

• The amount of annual revenue (if any) for the Rural HIT Workforce Program.

• The amount of additional funding secured to sustain the Rural HIT Workforce Program.

• Please indicate if you have a sustainability plan and select your sustainability activities.

If the total amount of additional funding secured is zero (0), please put zero in the appropriate section. Do not leave any sections blank.

Please identify the source(s) of revenue for sustainability and indicate whether you have developed a sustainability plan. Please identify the types of sustainability activities that the network/consortium engaged in during the respective budget year; please check all that apply.

11	Funding/Revenue:	Dollar Amount
	Annual program award
	Annual program revenue
	Additional funding secured to assist in sustaining the program for example value of in-kind services, additional grants, cash, etc.
	Does the network have a sustainability plan that has been approved by the network’s membership?	Y/N
12	Type(s) of sources of funding for sustainability:	Selection list
	Tuition
	Network Business Revenue
	In-Kind Contributions such as Financial Endowments
	Project Member Dues
	Fundraising
	Contractual Services
	Other – Specify Type:
13	HIT Sustainability Activities:	Check all that apply
	Consolidation of activities, services and purchases (with Network partners)
	Communication plan development
	Economic impact analysis
	Return on investment analysis
	Community engagement activities
	Business plan development
	Partnership with regional Workforce Investment Boards
	Organization bylaws
	SWOT analysis
	Sustainability plan
	Workflow analysis and redesign
	Other – Specify activity:
14	Will the Network/Consortium sustain beyond the HRSA/ORHP funding period?	Y/N
15	Will Network sponsored-HIT education and training program continue after HRSA/ORHP funding ends?	Y/N

Table 5: ACCESS TO EDUCATION

Instructions:

Please provide the following information about individuals enrolled in the program. In question 17 individuals may fall into more than one category.

	Category	Performance Measure	Data Type
16	Access to Education	Indicate the total number of individuals enrolled in the program	Number
17		Indicate the number of individuals enrolled in the program by type:	Number
		employed individuals
		unemployed individuals
		current health care staff
		local displaced workers
		veterans
		rural resident
		non-rural residents
		underrepresented Minorities and/or from Disadvantaged Backgrounds*
18		Indicate the number of individuals enrolled that currently have an Associates level degree or higher	Number

Table 6: EDUCATION AND TRAINING

Instructions:

In questions 20, 22, 24, 26 and 28 individuals may fall into more than one category.

19	Education & Training	Indicate the total number of individuals who completed the curriculum
20		Indicate the number of individuals who completed the curriculum by type:
		employed individuals
		unemployed individuals
		current health care staff
		local displaced workers
		veterans
		rural residents
		non- rural residents
		underrepresented Minorities and/or from Disadvantaged Backgrounds*
21		Indicate the total number of individuals who completed the CEHRT training
22		Indicate the number of individuals who completed the CEHRT training by type:
		employed individuals
		unemployed individuals
		current health care staff
		local displaced workers
		veterans
		rural residents
		non-rural residents
		underrepresented Minorities and/or from Disadvantaged Backgrounds*
23		Indicate the total number of individuals who completed the apprenticeship
24		Indicate the number of individuals who completed the apprenticeship by type:
		employed individuals
		unemployed individuals
		current health care staff
		local displaced workers
		veterans
		rural residents
		non-rural residents
		underrepresented Minorities and/or from Disadvantaged Backgrounds*
25		Indicate the total number of individuals who completed the certificate program
26		Indicate the number of individuals who completed the certificate program by type:
		employed individuals
		unemployed individuals
		current health care staff
		local displaced workers
		veterans
		rural residents
		non-rural residents
		underrepresented Minorities and/or from Disadvantaged Backgrounds*
27		Indicate the number of individuals who completed the program that have an Associates level degree or higher
28		Indicate the number of individuals who permanently left the program before completion by type:
		employed individuals
		unemployed individuals
		current health care staff
		local displaced workers
		veterans
		rural residents
		non-rural residents
		underrepresented Minorities and/or from Disadvantaged Backgrounds*
29		Select the competency exam the program has selected to assess HIT Specialist competencies:
		Healthcare Information Management Systems Society (HIMSS)
		American Health Information Management Association (AHIMA)
		Other (Please Specify)
30		Indicate the total number of individuals who passed the competency exam selected from above.
31		Select the Health Information Technology (HIT) curriculum focus of the program (select all that apply)
		Practice workflow and information management redesign specialists
		Clinician/practitioner consultants
		Implementation support specialists
		Implementation managers
		Technical/software support
		Trainers
		Other (Please specify)
32		Select the following professional competencies outlined by the Office of the National Coordinator (ONC) that aligns with the program’s HIT curriculum (select all that apply)
		Practice workflow and information management redesign specialists
		Clinician/practitioner consultants
		Implementation support specialists
		Implementation managers
		Technical/software support
		Trainers
		Other (Please specify)
33		Indicate if curriculum delivery mode is classroom based learning, distance learning (online, webinar) or Hybrid (mostly classroom) Hybrid (mostly distance learning).
34		Indicate if CEHRT training delivery mode is classroom based (on site), distance learning (online, webinar) or Hybrid (mostly classroom) Hybrid (mostly distance learning).
35		Select the type of curriculum development or enhancement activity conducted during the reporting period from the options below. You may select more than one option.
		Developed new course
		Developed new curriculum/program
		Enhanced existing course
		Enhanced existing curriculum/program
		Other (please specify)
36		Indicate the number of the EHR vendors used in this curriculum.

Table 7: WORKFORCE RECRUITMENT AND RETENTION

37	Workforce & Retention	Indicate the total number of individuals who are employed in the field of Health Information Technology as a result of the program	Number
38		Indicate the number of individuals who completed the program that currently employed in the field of HIT by setting:	Number
		rural hospital
		critical access hospital
		rural clinic
		rural Veteran’s Administration facility
		IT Vendor
		Health Center Controlled Network
		Regional Health Information Organization
		Other (Please specify)
39		Indicate the number of individuals who completed the program that are employed in the field of Health Information Technology within a network member facility	Number
40		Indicate the number of HIT specialists shared among two or more network members	Number
41		Select the areas where the HIT Specialists hired as a result of the ORHP funded program, implemented, expanded or strengthened the following technologies: (select all that apply)
		Telehealth
		Telemedicine
		Electronic health record
		Computerized physician order entry
		Electronic clinical operations
		Health Information Exchange
		Mobile health applications
		Equipment maintenance (telehealth, home monitoring, etc.)
		Patient/Disease Registry
		Other (please specify)
42		Indicate the number of targeted vacant Health Information Technology and/or HIT related positions located within the rural community.	Number
43		Indicate the number of targeted vacant Health Information Technology and/or HIT related positions located within the rural community that were filled during the reporting period.	Number
44		How many program completers** who were placed in a permanent rural position are still employed in a rural HIT specialist position?	Number
45		Indicate the number of network members that reached EHR meaningful use stage 1 due to the hiring of an HIT specialist from the ORHP funded program	Number
46		Indicate the number of network members that reached EHR meaningful use stage 2 due to the hiring of an HIT specialist from the ORHP funded program	Number

*Note: For a definition of disadvantaged, please go to http://www.hrsa.gov/loanscholarships/scholarships/disadvantaged.html

**Program completers are individuals who have completed the education, apprenticeship, training and successful passing of the competency exam.