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OCIO/OCMIO Informatics Workforce Development Project Phase II Planning Discussion February 3, 2012 Full Implementation of the Workforce Development Strategy is a Multi-year Process Completed the role profile assessment in December 2011 results to be shared during Informatics Workforce Development Project In Progress Review on 10 FEB Focus is now shifting to Phase II creation of the Learning & Development Program October 2011 September 2012 October 2012 September 2013 October 2013 September 2014 Phase II: Role Profile Assessment and Rollout, Learning & Development/Career Development Program Design & Implementation Phase I: Workforce Development Strategy 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 2 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Phase II Work Plan Oct 2011 Nov Dec 2011 Jan May 2012 Project Planning Role Profile Assessment Gain alignment around the project plan, key deliverables, etc. Identify the project governance structure Create and deploy role profile assessments Conduct assessment within ERMC, NRMC, SRMC, and PRMC Create gap analysis report and identify implications to the L&D plan priorities Review the assessment results June Sept 2012 L&D Design & Rollout Proof of Concept

Develop the detailed L&D plans Develop the detailed L&D plans for the remaining two job for Strategic Leadership/CMIO families job family Rollout the L&D plans to the Finalize the implementation regions strategy Collect feedback and revise, as Rollout the L&D plans to the necessary regions Collect feedback and revise, as necessary Key deliverables Key deliverables Key deliverables Role profile assessment results Detailed L&D plans for Project plan Strategic Leadership job family Governance structure and team report and list of L&D priorities Detailed implementation Project charter strategy 3 L&D Design & Rollout Remaining Job Families Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Key deliverables Detailed L&D plans for remaining job families White papers, executive summaries, and presentations for professional conferences, workshops and meetings Assessment Overview As part of the Clinical Informatics Workforce Development Project, an online assessment was conducted to determine the organizational strengths and gaps in competencies and technical skills for individuals occupying key clinical informatics roles. The output of the assessment will be used to create a targeted Clinical Informatics Workforce Development Strategy that leverages the identified strengths and closes the gaps. Assessment Scope Assessments were created for the following roles: Strategic Leadership Deputy CMIO (MTF) CMIO (MTF) Deputy CMIO (RMC) CMIO (RMC) 4 Clinical Systems Trainer CST 1 (MTF) CST 2 (MTF) CST Supervisor (MTF) CST 2 (RMC) CST Supervisor (RMC) Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Clinical Workflow Analyst CWA 2 (MTF)

CWA Supervisor (MTF) CWA 2 (RMC) CWA Supervisor (RMC) Assessment Overview Assessment Scope continued In August 2011, a pilot assessment was launched within the Western Region and select individuals across the AMEDD (e.g., other CMIOs, Regional lead positions) when additional data was needed The assessment was later expanded to the remaining AMEDD employee population in December 2011 Employees completed self-assessments for their current role and, when applicable, managers also completed assessments for the employees that they oversee Prior to completing the assessments, all participants were told that any data they provide would be kept anonymous and confidential and only shared in an aggregate report Assessment Participation The pilot assessment was launched on August 10, 2011 and closed on August 23, 2011 The second assessment was launched on December 7, 2011 and closed on December 16, 2011 For both of these assessments, we achieved an overall participation rate of 72% The remaining slides of this document provide detailed assessment results for the Clinical Informatics workforce 5 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Executive Summary of Findings Competencies 1. There are significant competency gaps across the informatics leadership roles, and these gaps are present in foundational, supervisory, and leadership competencies 2. For both the CWA and CST job families, the majority of the competency gaps were reported for the functional competencies for example, Powerpoint, Essentris, CHCS, sect. In fact, gaps in foundational competencies were only reported for the Supervisory roles (MTF and RMC). Gaps in Teamwork were reported for all Supervisory roles 3. There were no gaps reported in the supervisory competencies for the CWA or CST job families. It will be important to leverage the strengths in People Management and Talent Development as the Workforce Development Strategy is implemented 4. When reviewing the results for the CWA and CST job families by region, the findings are largely consistent with results for the entire workforce 6 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Executive Summary of Findings Technical Skills 1. For all roles, there are more gaps in technical skills than in competencies. This is to be expected since technical skills often require formal training and on-the-job experience 2. Gaps in technical skills primarily center around the Clinical Systems across all roles, and gaps in ESSENTRIS, ICDB/Carepoint, and CHCS were reported most frequently Moreover, there are significantly more gaps reported in Clinical Systems within the Strategic Leadership job family. 3. There appears to be a consistent gap across all CST roles for MS Power Point and CWA roles for MS Excel. These results were surprising since both these tools are integral to the CST and CWA roles, respectively 4. When reviewing the results for the CWA and CST job families by region, the findings are largely consistent with results for the entire workforce 7 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone

Strategic Leadership Assessment Results Competencies Deputy CMIO (MTF) (n=2) CMIO (MTF) (n=12) Deputy CMIO (RMC) (n=4) CMIO (RMC) (n=3) (8 gaps) (7 gaps) (1 gaps) (8 gaps) r y g y r g g g r r g y r r y r r r g r r r g r

g g g r r r g r r r g r Foundational Communication (3 gaps) Learning Agility (1 gap) Results Orientation (3 gaps) Leadership Supervisory Teamwork (4 gaps) People Management (3 gaps) Talent Development (3 gaps) Strategic Alignment/Mission Focus (1 gap) Resource Management (3 gaps) Change Management (3 gaps) Note: data points for the Deputy CMIO (MTF) role are limited, and therefore caution should be exercised when drawing conclusions based on the data. 8 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone There are significant competency gaps across the informatics leadership roles Gaps in the foundational competencies are relatively surprising given that these competencies are foundational to success in informatics in general, much less a requirement for a leadership position Strategic Leadership Assessment Results Technical Skills Deputy CMIO (MTF)

(n=2) CMIO (MTF) (n=12) Deputy CMIO (RMC) (n=4) CMIO (RMC) (n=3) (6 gaps) (5 gaps) (6 gaps) (6 gaps) g y g r g g g g g g g g r y r r r g r g r g r r r r

r r r r r r r y g r MS Offi ce MS Excel (2 gaps) MS Power Point (0 gaps) MS Word (0 gaps) Clinical Systems AHLTA (4 gaps) CHCS (2 gaps) ESSENTRIS (3 gaps) ICDB/Carepoint (4 gaps) MAPS Tools (4 gaps) Functio n- Clinical/business process analysis and specific reengineering (3 gaps) Note: data points for the Deputy CMIO (MTF) role are limited, and therefore caution should be exercised when drawing conclusions based on the data. 9 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Gaps are reported in all technical skills, with the exception of MS Power Point and MS Word Gaps in Clinical Systems-related technical skills are surprising given the role that informatics leaders play in helping to shape the evolution and use of these systems Strategic Leadership Assessment Results Implications for the Workforce Development Strategy Competencies Gaps reported in the foundational competencies should be addressed immediately. Going forward, the talent acquisition process will need to focus on selecting employees who demonstrate these competencies at the desired levels of proficiency. The current gaps reported in the supervisory and leadership competencies will need to be addressed through a targeted Learning and Development plan. These competencies can take time to develop and are often developed through a combination of targeted training and on-the-job experiences. Going forward, it will be important to identify employees (either individual contributors or supervisors) who have the potential to fulfill a leadership

role early in their careers and to ensure they are given opportunities to develop these competencies so they are prepared for the leadership role when the time comes. Technical Skills Since the majority of the gaps were reported in the clinical systems, MAPS tools, or clinical/business process analysis and reengineering, Learning and Development programs should focus on developing technical capability in these technical skills more so than in MS Office skills. 10 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Next Steps: Learning & Development Program Design For each of the competencies and technical skills captured in the role profiles, we will create a Learning and Development program comprised of 5 components (see below) Practical, applied, and mainly on-the-job steps an individual can take to build a competency or technical skill MEDCOM-assigned/ sponsored external, professional coach Coaching Self-initiated relationship with a colleague who has particular expertise/strength in a competency or technical skill Practice Mentoring Read Readings and reference material that highlight best practices and effective approaches Study/learn Self-study courses, classroom training (internal or external to MEDCOM), certifications, etc. When designing the L&D program, we will ensure that we create L&D actions that are highly specific and applicable to the MEDCOM and prioritized based on the biggest gaps (as identified in the assessment) The necessary mix of development tools for each role/level Alignment with existing AMEDD Center & School and other training and development programs, while leveraging existing training materials, when possible 11 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Learning & Development Program Design continued A Learning & Development library will be created to house the Practice, Read, and Study/Learn Learning & Development Actions for every role, competency, and technical skill in one central location Learning experiences are unique to each role (although they may apply to multiple roles) and are based on the competencies/technical skills listed in the role profiles Employees and their supervisors will be able to filter the L&D library by role, competency/technical skill and type of learning experience to create a development plan that is specific to their role, development needs, and learning preferences 12

Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Learning & Development Program Governance Structure, Roles, and Responsibilities Governance Council Primary responsibilities Oversees L&D project and deliverables Approves L&D content & curriculum Approves and monitors L&D program implementation & integration Determines L&D program resource requirements Working Group Primary responsibilities Prepares recommendations for GC review Finalizes Subgroup proposed L&D content & curriculum Recommends L&D program implementation & integration strategies Prepares preliminary resourcing COAs CMIO Subgroup CMIO (05/ GS14) LTC Angela Stone 13 Governance Council Governance Council Members Chief Medical Information Officer, MEDCOM 5 Regional Chief Medical Information Officers Informatics Consultant to TSG (Medical Corps) Informatics Consultant to TSG (Nurse Corps) Corps Specific Branch Proponency Officer (MC, ANC, Civilian), Director, AMEDD Personnel Proponency Directorate, Director, Talent Management Voting/Non-Voting Voting Member/Chair Voting Member Voting Member Voting Member Ad Hoc Membership as needed, with voting privileges at the discretion of the standing members on a decision by decision basis. CMIO (05) Working Group Senior Informatics Officer (05) CWA Subgroup Senior BPM Specialist (GS14) Subgroup Primary responsibilities Researches, evaluates, and drafts content and curriculum for specified roles Drafts L&D program implementation & integration strategies Evaluates and prepares recommendation on industry and DoD best practices Evaluates and prepares recommendations on

certification programs Evaluates and integrates content & curriculum across specified roles Informatics Workforce Development Project I Phase II Project Planning with LTC Stone CST Subgroup Senior Training Specialist (GS14) Ms. Kim Hermann-Do Ms. Michele McCormick CMIO Subgroup Lead Proposed Next Steps Work step 1. Identify 2 to 3 subgroup members to assist with the effort; consider individuals who: Lead Target completion date LTC Stone By 17 FEB LTC Stone & subgroup members By 9 MAR 3. Identify gaps in learning & development actions for the CMIO competencies and technical skills listed in the role profiles and ways to fill the gaps Axiom/TIAG By 23 MAR 4. Develop recommended learning & development plan, including recommendations for which elements would be required Axiom/TIAG & LTC Stone & subgroup members By 6 APR Are fulfilling a CMIO role today Have awareness and interest in the Workforce Development Project and talent management, in general Have knowledge of existing learning & development actions for CMIO roles 2. Identify existing learning & development actions for the CMIO competencies and technical skills listed in the role profiles Focus on Practice, Read, Study/Learn actions Axiom/TIAG to provide template for sub-team to document findings Will schedule two check-in calls with Axiom/TIAG to discuss progress, questions, etc. Need to schedule calls with

LTC Stone and subgroup to work through this Once work begins, we expect that the CMIO Subgroup will need to meet bi-weekly to achieve all of the objectives outlined above. 14 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone APPENDIX 15 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Competency Model Each assessment included the critical competencies identified for a particular role. Competencies comprised of the following four categories and varied by role/level: Leadership competencies define the knowledge, skills, and abilities that informatics leadership must have to drive the maturation of informatics and successfully execute the mission and vision throughout the AMEDD. Lea ders hip Supervisory Supervisory competencies are required for success in supervisory or lead roles. These knowledge, skills, and abilities enable supervisors to effectively execute the strategy defined by OTSG leadership at the regional and MTF levels. Functional Foundational 16 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Functional competencies are the specialized knowledge, skills, and abilities required to achieve results in a particular role. Training and development programs can enhance functional competencies and provide high impact for the organization. Foundational competencies provide the basic building blocks or necessary requirements for performing the roles and should be demonstrated by all employees. Selection efforts should determine whether or not threshold levels have been achieved. Clinical Systems Trainer Assessment Results Competencies CST 1 (MTF) (n=44) CST 2 (MTF) (n=69) CST Supervisor (MTF) (n=6) CST 2 (RMC) (n=7) CST Supervisor (RMC)

(n=5) (0 gaps) (0 gaps) (3 gaps) (0 gaps) (4 gaps) g g g g g g g g g g g g g g g g g y g r g g r g r g g g g r

g g y g r n/a n/a g n/a g n/a n/a g n/a g Foundational Communication (0 gaps) Learning Agility (0 gaps) Results Orientation (0 gaps) Functional Teamwork (2 gaps) Adult Learning (2 gaps) Supervisory The competency gaps among the Supervisory roles primarily fall within the functional competencies, with the exception of Teamwork, which is a foundational competency Organizational Agility/Acumen (1 gap) Relationship Building (2 gaps) 17 Competency gaps primarily exist at the Training Supervisor level People Management (0 gaps) Talent Development (0 gaps) Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Strengths in People

Management and Talent Development will be critical to leverage as the Workforce Development Strategy is implemented Clinical Systems Trainer Assessment Results Technical Skills CST 1 (MTF) (n=44) CST 2 (MTF) (n=69) CST Supervisor (MTF) (n=6) CST 2 (RMC) (n=7) CST Supervisor (RMC) (n=5) (3 gaps) (4 gaps) (4 gaps) (4 gaps) (6 gaps) g g g g r g y r r r g g r g g g g

g g g g g g g g y g g g r r r r r r g r r r r g g g g g g g g g g y r

g y r g g g g g g g g g g MS Excel (1 gap) MS Offi ce MS Power Point (4 gaps) MS Project (1 gap) MS Word (0 gaps) MS OneNote (0 gaps) AHLTA (2 gaps) Clinical Systems ESSENTRIS (5 gaps) CHCS (4 gaps) Dragon (0 gaps) Asutype (0 gaps) ICDB/Carepoint (4 gaps) Data flow between entities (0 gaps) Functionspecific Database management (0 gaps) 18 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone There are more gaps in technical skills than in the competencies across all roles The presence of significant clinical systems gaps, especially in ESSENTRIS and CHCS, is surprising given that the primary purpose of the training role is to train end-users on the clinical systems Further, it is worth looking into the gaps related to MS

Power Point, as this tool is integral to the training role Clinical Systems Trainer Assessment Results Implications for the Workforce Development Strategy Competencies Targeted Learning and Development plans will need to be put in place for the Training Supervisor roles to close the existing gaps. Based on the assessment results, it appears there is a capable cadre of trainers who have demonstrated proficiency in the functional competencies. It will be important to identify those trainers who have the potential and desire to assume a leadership role and ensure they are given on-the-job opportunities and formal training to acquire the additional Supervisory competencies required to progress in the clinical systems trainer job family. The role profiles will serve as a useful tool for both the development and selection of these employees. Technical Skills Because clinical systems knowledge is critical to a trainers ability to fulfill his/her role, steps need to be taken to close these gaps. Going forward, the acquisition process should select for individuals with clinical systems knowledge. Where this is not possible, the onboarding program should enable the individual to quickly establish their proficiency in these systems. Gaps related to MS Office applications (especially Power Point) should be also addressed and can be done so through targeted training programs and mentorship from individuals who role model this technical skill. 19 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Clinical Workflow Analyst Assessment Results Competencies CWA 2 (MTF) (n=37) CWA Supervisor (MTF) (n=4) CWA 2 (RMC) (n=4) CWA Supervisor (RMC) (n=4) (0 gaps) (7 gaps) (3 gaps) (2 gaps) g y g g g g

g g g g g g g r g y g y r g g r r g g y g g g r g y g r y g n/a g n/a g n/a g

n/a g Foundational Communication (1 gap) Learning Agility (0 gaps) Results Orientation (0 gaps) Teamwork (2 gaps) Functional Analytical Thinking (2 gaps) Change Management (2 gaps) Integrated Thinking (1 gap) Organizational Agility/Acumen (2 gaps) Supervisory Project Management (2 gaps) 20 People Management (0 gaps) Talent Development (0 gaps) Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Competency gaps primarily center around the functional competencies and are most noticeable for the CWA Supervisor role at the MTF level Strengths in People Management and Talent Development will be critical to leverage as the Workforce Development Strategy is implemented Clinical Workflow Analyst Assessment Results Technical Skills CWA 2 (MTF) (n=37) CWA Supervisor (MTF) (n=4) CWA 2 (RMC) (n=4) CWA Supervisor (RMC) (n=4) (6 gaps) (3 gaps) (10 gaps)

(2 gaps) r r r y g g g g g r r g g g r g g g g g g g g g r r r g g g y g y g

g g g g g g y g y g g g r r g g r g Clinical/business data repositories and mining tools (2 gaps) y g r g Clinical/business process analysis and reengineering (2 gaps) r g r g MS Excel (4 gaps) MS Offi ce MS Power Point (0 gaps) MS Project (2 gaps) MS Word (1 gap) MS OneNote (0 gaps) AHLTA (0 gaps) Clinical Systems

ESSENTRIS (3 gaps) CHCS (1 gap) Dragon (1 gap) Asutype (0 gaps) ICDB/Carepoint (2 gaps) Functio n-specific Data flow between entities (2 gaps) 21 Database management (1 gap) Informatics Workforce Development Project I Phase II Project Planning with LTC Stone Gaps exist across all roles but are most concentrated in the CWA 2 (RMC) role Gaps in functionspecific technical skills exist in individual contributor roles There appears to be pretty consistent gap across all roles for MS Excel; this is surprising given the importance of this tool for data analysis As was the case for the Trainer roles, there are fairly consistent gaps in ESSENTRIS across the roles Clinical Workflow Analyst Assessment Results Implications for the Workforce Development Strategy Competencies Gaps in the foundational and functional competencies for CWA Supervisors at the MTF need to be closed via targeted Learning and Development programs. Going forward, it will be important to identify employees who have demonstrated proficiency in these competencies and who have the potential to fulfill a supervisory role early in their careers. Learning and Development programs will then need to be put in place to help these employees further develop these competencies and prepare for the supervisor roles. The role profiles will serve as a useful tool for both the development and selection of these employees Technical Skills Because gaps were reported in MS Excel and ESSENTRIS for the majority of the CWA roles, Learning & Development programs will need to be implemented to help all CWAs develop their capability in these technical skills at the proficiency level necessary for their roles. Moreover, because a significant number of gaps were reported in various clinical systems and function-specific technical skills for the CWA 2 roles (MTF and RMC), Learning and Development programs will need to be implemented to help this CWA population develop their capabilities in these technical skills. 22 Informatics Workforce Development Project I Phase II Project Planning with LTC Stone

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