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Nationwide Health Information Network (NHIN) Workforce Study
(Report)
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Author(s): Altarum, Inc.; Principal Investigator: William A. Yasnoff, NHII Advisors. |
Organization(s): Altarum, Inc. |
For the past several years, the nation has been working to improve health care through the widespread implementation of electronic health records. One clear prerequisite for accomplishing this goal is the availability of a trained workforce to implement the developing Nationwide Health Information Network (NHIN). While it is generally acknowledged that the nation does not have a sufficient number of trained specialists for this purpose, no prior studies have produced any quantitative estimates of the workforce requirements. Accordingly, the current research was designed to further our understanding of NHIN workforce issues by collecting, assessing, and analyzing existing knowledge and data in this domain with the objective of producing an initial estimate of the number of people needed. This study gathered information through a series of four focus groups, five site visits, and direct communications with health information technology (HIT) vendors. The anticipated NHIN work was divided into three separate categories of activities for the purpose of assessing workforce: 1) electronic health records (EHRs) in physician offices; 2) EHRs in hospitals and other health care institutions; and 3) the health information infrastructure (HII) required in communities to link the various sources of records so that each patient's complete electronic record could be available. Assuming a 5-year time frame for NHIN implementation, results indicated that 7,600 (+/- 3,700) specialists are needed for installation of EHRs for the approximately 400,000 practicing physicians who do not have them already. For the hospitals needing EHRs (about 4,000), approximately 28,600 specialists are needed. Finally, about 420 people are needed to build the HII systems in communities to interconnect all these other systems. These data represent the first ever quantitative estimates of the workforce needed to implement the NHIN.
Tool: To assist in the further understanding and use of the results of this research, a workforce estimation tool was developed. This Workforce Estimation Tool is an Excel spreadsheet and allows for variable assumptions representing: 1) the time allotted for completing the NHIN, 2) the number of physicians needing EHRs, 3) the number of hospitals needing EHRs, and 4) the number of communities needing health information infrastructures. Values reflected in this tool as posted to ASPEs website are based on the ASPE workforce study with the calculations based on the study's assumptions. All variables may be changed by the user of the tool with new resultant estimates of workforce changing accordingly to each user's set of circumstances. The workforce tool description and an analysis of the ASPE study through the use of the tool serves as an example and is found in the final report.
Slides: The study results were presented to the American Health Information Community, EHR Workgroup on September 25, 2007. |
Published: September, 2007 |
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Executive Summary
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Well-Being of Children in Working Poor and Other Families: 1997 and 2004
(Report)
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Author(s): Richard Wertheimer, Kristin Anderson Moore, and Mary Burkhauser |
Organization(s): Child Trends |
When Congress reformed the welfare system in 1996, major goals of the legislation were to increase employment and income of needy families and to decrease child poverty. Another major goal was to improve child outcomes through increased parental employment and earnings along with other provisions of welfare reform. Our analysis finds that, between 1997 and 2004, the well-being of children in working poor families improved significantly for 10 of the 15 measures available in both years and remained stable for the remaining measures. In contrast, the well-being of children in non-working poor families improved significantly for only five measures and deteriorated significantly for four measures. Moreover, whereas the well-being of children in working poor families was not consistently better than the well-being of children in non-working poor families in 1997, by 2004, the well-being of children in working poor families was better than for children in non-working poor families for 12 of the 17 measures available for that year. These patterns held when social and economic factors are accounted for statistically. |
Published: September, 2008 |
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Research Brief
PDF Research Brief
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UI as a Safety Net for Former TANF Recipients
(Report)
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Author(s): Christopher J. O'Leary and Kenneth J. Kline |
Organization(s): W.E. Upjohn Institute for Employment Research |
This report analyzes whether former TANF recipients who lose their jobs apply for and receive unemployment insurance (UI) benefits and it describes the role of UI in TANF leavers' well-being and the types of employment deficits that might prevent their access to UI. This study uses newly available data linking information on both TANF and UI receipt to study the extent to which unemployed TANF leavers apply for and receive UI benefits, as well as the reasons they are denied. Analyses also examine how UI receipt relates to TANF cycling, as well as the relationship between TANF and UI caseloads. Data are part of the Administrative Data Research and Evaluation Project (ADARE), a consortium of states funded by the Department of Labor and managed by the University of Baltimore. The report uses longitudinal data from Florida, Michigan, Ohio, and Texas. |
Published: April, 2008 |
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Changes in Coverage in the Individual and Group Health Insurance Markets and the Effect of Health Status
(Report)
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Author(s): Bradley Herring, Xue Song and Mark Pauly |
Organization(s): Johns Hopkins University |
Although the vast majority of privately insured people in the U.S. obtain their coverage in the employment-based group market, about 17 million people under age 65 were insured in the individual health insurance market in 2006. About 47 million people, or 16% of the total U.S. population, were without health insurance coverage in 2006. Researchers know relatively little about how the group and individual markets actually function for those with chronic health conditions, and much of what we know is based on point-in-time analyses of insurance coverage. However, insurance coverage is actually very dynamic due to changes in employment and because eligibility for public programs typically depends on income and other criteria. This paper provides an in-depth look at the impact of health status on changes in coverage in these insurance markets using data from the Medical Expenditure Panel Survey. We also use these data to examine the effect of health status on changes in premiums in the individual insurance market. [38 PDF pages] |
Published: April, 2008 |
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Coming of Age: Employment Outcomes for Youth Who Age Out of Foster Care Through Their Middle Twenties
(Report)
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Author(s): Jennifer Macomber, Stephanie Cuccaro-Alamin, Dean Duncan, et. al. |
Organization(s): Urban Institute with subcontractors University of California Berkeley and University of North Carolina Chapel Hill |
A primary task for youth in transitioning to adulthood is sustaining employment to be self-sufficient. Studies of former youth who age out of foster care find that they generally experience unstable employment patterns and earn very low incomes between ages 18 and 20. However, less is known about whether these youths' initial patterns of employment instability and low earnings persist. This study linked child welfare, Unemployment Insurance (UI) and TANF administrative data to assess employment outcomes for former youth through age 24 in three states: California, North Carolina, and Minnesota. Descriptive, multivariate, and trajectory analysis techniques are employed to describe employment patterns. Findings indicate that low rates of employment persist through age 24; Low earnings persist through age 24 though few receive TANF benefits; and youth show four patterns of connectedness to the workforce that may provide insights to program planners considering how to best tailor services to youths' needs. |
Published: March, 2008 |
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Ten Key Findings from Responsible Fatherhood Initiatives
(Research Brief)
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Author(s): Karin Martinson and Demetra Nightingale |
Organization(s): Urban Institute |
This brief summarizes key findings from several important fatherhood initiatives that were developed and implemented during the 1990s and early 2000s. Formal evaluations of these fatherhood efforts have been completed, some quite recently, making this an opportune time to step back and assess what has been learned and how policy makers and program managers can build on the early programs' successes and challenges. The brief highlights lessons from: the Young Unwed Fathers Project, Parents' Fair Share (PFS), Welfare-to-Work Grant (WtW) Programs, Responsible Fatherhood Programs (RFP), and Partners for Fragile Families (PFF). |
Published: February, 2008 |
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Transitional Jobs for Ex-Prisoners:
(Report)
Early Impacts from a Random Assignment Evaluation of the Center for Employment Opportunities (CEO) Prisoner Reentry Program |
Author(s): Dan Bloom, Cindy Redcross, Janine Zweig, & Gilda Azurdia |
Organization(s): MDRC, Urban Institute |
This working paper presents one-year employment and recidivism outcomes for ex-prisoners assigned at random to the regular Center for Employment Opportunities (CEO) program or to basic job search assistance. The evaluation is part of the Enhanced Services for the Hard-to-Employ (HtE) Demonstration and Evaluation project, sponsored by the U.S. Department of Health and Human Services, with funding from the U.S. Department of Labor. |
Published: November, 2007 |
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Four Strategies to Overcome Barriers to Employment:
(Report)
An Introduction to the Enhanced Services for the Hard-to-Employ Demonstration and Evaluation |
Author(s): Dan Bloom, Cindy Redcross, Jo Ann Hsueh, Sarah Rich, and Vanessa Martin |
Organization(s): MDRC |
This first report in the evaluation describes the origin of the project, the rationale for the demonstration, the research design, and the four programs, as well as the characteristics of their participants. [This report is posted on the Administration for Children and Families (ACF) web site.] |
Published: October, 2007 |
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Partners for Fragile Families (PFF) Demonstration Projects:
(Report)
Employment and Child Support Outcomes and Trends |
Author(s): Karin Martinson, Demetra Smith Nightingale, Pamela A. Holcomb, Burt S. Barnow, and John Trutko |
Organization(s): Urban Institute with Subcontracts to Johns Hopkins University and Capital Research Corporation |
This report focuses on the characteristics of PFF participants and participants' employment, earnings, and child support patterns prior and subsequent to their enrollment in the program. Quarterly wage data from state unemployment compensation records were used to assess employment outcomes. State child support data on child support awards and payments were used to assess changes in participants' child support behaviors. From April 2000 through the end of 2003, nine states conducted PFF demonstrations, which were designed to help fragile families by helping fathers work with mothers in sharing the legal, financial, and emotional responsibilities of parenthood. Services were targeted at young, never-married, non-custodial parents. |
Published: September, 2007 |
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Assessing Child Support Arrears in Nine Large States and the Nation
(Report)
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Author(s): Elaine Sorensen, Liliana Sousa, and Simon Schaner |
Organization(s): The Urban Institute |
Despite record child support collections by state child support programs, considerable sums of child support go unpaid every year. This report provides a profile of state child support debt, examining who owes it and why it has grown so rapidly, based on analysis of state administrative data. Earnings data from the wage reporting system were used for a simulation of the collectability of child support debt. State child support policies on order establishment and arrearages were documented and analyzed to identify factors associated with greater accumulation of debt as well as state strategies for debt management. |
Published: July, 2007 |
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