Wednesday, April 30, 2008

Is the HIMSS "Certified Professional in Healthcare Information and Management Systems" stamp substantive, or just alphabet soup?

This post might be subtitled "when spending millions on health IT, why spend thousands on true healthcare informatics education when you can get a 'Certified Professional' credential to hang on your office wall, cheap?"

Imagine your reaction to a web page for a major HC organization that said this:

Certification as an expert in medical devices available. No domain-specific, specialized educational requirements. Short multiple choice test where many wrong answers "forgotten" is only requirement. You will be identified as an elite member of the healthcare device team after receiving our certification. Send $xxx dollars to ...

Such a scam would likely invite a governmental investigation.

Electronic medical records and other clinical IT are, in fact, virtual clinical devices that happen to reside on computers.

Their impact on medical care and education can be profound, as pointed out in papers by Ross Koppel at Penn, Pamela Hartzband, M.D. and Jerome Groopman, M.D. at Harvard, and many others around the world such as at Bad Health Informatics Can Kill and my own growing aggregation of HIT stories at "Sociotechnologic Issues in Clinical Computing: Common Examples of Healthcare IT Difficulties."

Yet, the vendor-friendly organization HIMSS (The Healthcare Information and Management Systems Society) offers such a certification in health IT. HIMSS identifies itself as "the healthcare industry's membership organization exclusively focused on providing leadership for the optimal use of healthcare information technology and management systems for the betterment of healthcare."

Here are the details on their certification as a Certified Professional in Healthcare Information and Management Systems (CPHIMS):

The Healthcare Information and Management Systems Society (HIMSS) has launched a professional certification program for healthcare information and management systems professionals. An individual who meets eligibility criteria and successfully completes a qualifying examination is designated a Certified Professional in Healthcare Information and Management Systems (CPHIMS).

CPHIMS status provides both internal and external rewards. As a Certified Professional in Healthcare Information and Management Systems, you:

  • Distinguish yourself from your peers as certified in healthcare information and management systems;
  • Expand your career opportunities;
  • Signal that you have mastered proven, broad-based concepts through successful completion of the Certified Professional in Healthcare Information and Management Systems Examination;
  • Provide yourself with skills and tools to help you make a difference in your career, your organization, and your community;
  • Enjoy the pride of recognition of knowing that you are among the elite in a critical field of healthcare; and
  • Have a premier credential based on a sound assessment to distinguish yourself in an increasingly competitive marketplace.

Here are the eligibility standards:

  • Baccalaureate degree plus five (5) years of associated information and management systems experience*, three (3) of those years in healthcare.

  • Graduate degree plus three (3) years of associated information and management systems experience*, two (2) of those years in healthcare.

  • *Associated information and management systems experience includes experience in the following functional areas: administration/management, clinical information systems, e-health, information systems, or management engineering. [Is that vague and non-specific enough? - ed.]

And now, the certification instrument:

The CPHIMS credential is awarded to individuals who demonstrate eligibility for the Certification Program and who successfully complete a qualifying examination. The examination consists of 115 multiple-choice test items, presented during a 2-hour session. Scoring is based on 100 items pre-selected for desirable psychometric characteristics. The additional 15 test items are included as pretest items. Performance on pretest items does not affect a candidate’s score.

It is remarkable to me that there are no specific educational requirements relevant to HIT, such as a certificate in health informatics, informatics fellowship, or clinical medicine experience of any kind. In my humble opinion a 115-question multiple choice test does not qualify a person as an expert in anything. Further, it seems to me that any "15 test items" a test taker got wrong might simply be discarded, further diluting such a test's relevance at best, and a rather dubious manner of scoring an exam in healthcare at worst.

Also omitted is the calibre of one's "experience." What, exactly, did you do? Were you successful? Were you an asset? Or, did you set projects back? Did you contribute to failure?

I'd though the importance of formal education in healthcare had been resolved by the 1910-era Flexner Report. I guess I am mistaken.

The sequential FCC exams I took to achieve a ham radio license - a mere hobby - were far more exacting. And at the time there was an applied exam as well; I had to be able to receive Morse Code at twenty words per minute to achieve the "Extra class" license.

I won't even compare to medical board exams.

To this NIH postdoctoral fellowship-educated HIT professional, CPHIMS certification sounds more like a "credentials mill" operation than a legitimate eduational and certificational process.

An attempt to introduce such a certification process at any institution of higher education, such as the one in which I teach about clinical IT, would get laughed out of a Faculty Senate's Committee for Academic Affairs or similar curriculum-approval body. It might even harm the school's accreditation.

Could you imagine such a certification process for some other medical process or technology, e.g., fluoroscopy equipment or EKG machines?

Discouraging pursuit of formal informatics education increases HIT problems and delays, raises costs, and facilitate failures. Does the availability of "instant credentials" discourage acquiring a substantive health care informatics background, diluting the availability of true expertise in this difficult field?

Is such health IT certification somewhat of a fraud, a ploy to allow undereducated people an opportunity to add "alphabet soup" to their resume in order to secure positions in health IT, or is it legitimate certification?

I report, you decide.

-- SS


Nick said...

I'm in the trenches in the Healthcare IT world, at a major academic medical center. After some years in this industry, you know who is good at what they do and who is an impediment. Unfortunately, I see the impediments getting these as a way to say "look, I'm valuable!"

It's just a piece of paper that doesn't mean anything. They can get bent.

InformaticsMD said...

It's just a piece of paper that doesn't mean anything.

Do hospital IT hiring managers and CIO's agree? Since they are also a primary HIMSS consituent, I think they might like this "certification."

Anonymous said...

How is the CPHIMS credentialing exam different than any test individuals take throughout their life to achieve the next educational or professional milestone like SATs, MCATs, LSATs, GREs, Medical Boards, etc? I recently achieved CPHIMS certification and have formal HIT education (M.S. in Health Informatics) and almost 10 yrs HIT experience so I take slight offence to this post but agree that HIMSS could do a better job evaluating candidate's education and experience. They are constantly updating exam content but need to have better oversight on candidates sitting for the exam. However, I don't think it's a bad idea to have standardized criteria through which to evaluate professionals in industry as a way to validate knowledge of HIT practitioners.

InformaticsMD said...

Rita, not to impugn your own excellent educational credentials in any way, but CPHIMS and similar "alphabet soup achieved by short multiple choice exams" are different in that the exams are trivial.

100 questions for "certification"? That's risible.

Not to mention that the SAT, MCAT, LSAT etc. do not result in "certification."

Medical boards do, and they're just a bit more rigorous, with highly specific admission criteria.