David Blumenthal, the National Coordinator for Health IT, sent an open e-mail detailing the ongoing process for defining "meaningful use" of electronic health records. In his e-mail, Blumenthal offered a preview of what healthcare providers should expect from forthcoming meaningful use standards. He also described how the government plans to help hospitals and physicians transition to EHR systems.
Staffing needs will change after medical practices adopt electronic record systems, and a variety of factors will come into play. They include practice size, scope and, most importantly, the practice's goals. What happens in terms of the number of staff will largely depend on the problems the practice is looking to address with automation, notes this article published by the American Medical Association.
The number of U.S. physicians and other medical professionals prescribing electronically is expected to more than double in 2009 due to higher Medicare payments tied to the technology's use. However, only one in four physicians and other prescribers who are office based are e-prescribing, up from 74,000 in 2008. And through the end of August, only 110 million of the more than 3.7 billion prescriptions dispensed annually by U.S. retail pharmacies were sent electronically, according to data released by Surescripts.
This report by CSC Healthcare Group highlights 10 barriers that hospitals must overcome to achieve meaningful use of EHRs, such as integrating decision support into CPOE, managing new types of electronic information, and sharing data with patients and other clinicians electronically. "Achieving meaningful use represents a huge clinical and operational change project on a compressed timeline,' write the report's authors, adding that they "believe that hospitals that learn from the experience of others and succeed on the top ten challenges defined in this white paper will be well on the way to achieving meaningful use."
For the first time in history, there are four distinct generations in the American workplace. Although no one learning style or preference is common to all members of a specific generation, there are some general characteristics that serve as guidelines for teaching strategies.
Be careful, however, not to stereotype learners. These characteristics and strategies are general suggestions to be adapted to the needs of individual learners.
Research findings indicate that each generation has particular attitudes, expectations, values, work ethics, communication styles, and motivators (Hammill 2005). Let's look at each generation, its characteristics, and teaching strategies that might be most helpful for its members.
The Veterans
Also known as Traditionalists, Veterans were born between 1922 and 1945 and personally dealt with two of the most significant events of the 20th Century: the Great Depression and World War II (Avillion 2008, Filipczak et al. 1999, and Hammill.)
The Veteran's view of family is that of a "traditional" nuclear family, consisting of two parents and their children within one household. They look upon education as a privilege (Avillion, Hammill) and view authority figures with respect. They are not likely to question them or express concerns directly, so you may not find they have concerns until you read their evaluations, so ask for feedback throughout the program. They prefer formal, businesslike learning environments (Avillion).
Teaching strategies for Veterans include:
Make sure learners are able to use equipment needed for the learning activity, especially for distance activities (such as computers, simulation tools, etc.) but don't assume they don't know how to use new technology.
Provide organized handouts that summarize the key points of the learning activity.
Explain how new skills relate to job performance
Encourage discussion.
Don't put Veterans "on-the-spot" by asking them to demonstrate unfamiliar techniques in front of others. Allow practice time in private.
Baby Boomers
Baby Boomers, the product of the post WWII baby boom, were born between 1946 and 1964. Baby Boomers saw the beginnings of changes in the family structure, from the traditional viewpoint of the Veterans to increased number of divorces and single-parent families (Avillion; Filipczak et al.; Hammill).
Boomers were usually doted on by their parents and grew up believing that they were entitled to the best the world has to offer. They believe that they are entitled to education, including higher education, and that they have a responsibility to change the world for the better (Avillion; Filipczak et al.)
Boomers have a passionate work ethic and desire for financial success. They value both teamwork and personal gratification in the workplace. Boomers are dedicated learners and initiated the self-help craze (Avillion; Hammill).
Boomers may come across as know-it-alls and do not respond well to authority figures. They respond best to educators who treat them as equals and share examples of their own experiences with learners. They value team work and personal gratification in the workplace and during learning activities (Avillion).
Baby Boomers are best motivated to learn if new knowledge and skills are designed to help them excel on the job and gain recognition (Avillion; Filipczak et al.; Hammill).
Consider these tips when planning education for Baby Boomers:
Incorporate team building activities, discussion, and icebreakers as part of learning activities.
Avoid extensive role-playing activities. Boomers do not usually like them.
Allow time for private practice of new skills since Boomers, like Veterans, don't like to display lack of knowledge in public.
Make information easily accessible. Remember that Boomers are the first generation to access the Internet and are fascinated with its use.
Generation X
Members of Generation X were born between 1965 and 1980. Referred to as the latch-key generation, Xers are accustomed to having both parents work outside the home and letting themselves in after school with their own keys (Avillion; Hammill).
Xers view education as a means to success. They are cautious about money, having seen their parents downsized, perhaps more than once. Accustomed to change in family and work status, this generation is comfortable with change. They like a balance between work and leisure, value flexibility, dislike close supervision, and prefer self-directed learning. Xers are born distance learners (Avillion; Filipczak et al.; Hammill).
Because they witnessed the downsizing of their parents, and perhaps grandparents, members of Generation X are not loyal to an organization. They do not automatically respect authority figures; you need to earn their respect. Instead, they are loyal to themselves and their own individual career paths (Avillion; Filipczak et al.; Hammill).
There are some distinct differences between how Boomers and Xers view work and education. Boomers invented the 60 hour work week while Xers insist on a balance between work and leisure. Boomers value the team concept at work and in learning, while Xers are perfectly content to pursue distance learning at a time and place convenient for them (Avillion; Filipczak et al.; Hammill).
Here are some tips for designing teaching/learning strategies for Xers:
Make learning activities fun. Xers value fun as part of work and learning.
Incorporate role-playing when possible. Xers enjoy role-playing scenarios and are not really worried about making mistakes in front of others as they learn.
Allow time for discussion. If the learning activity is conducted at a distance set up time for group meetings or online chats. Make use of e-mail as a means to answer questions and share information.
Earn Xers' respect by demonstrating expertise, and sharing your experiences with them. Be enthusiastic.
Xers like visual stimulation. They don't generally read as much as Baby Boomers and prefer visual illustrations over printed materials.
Generation Y
Members of Generation Y were born between 1981 and 2002 and are also referred to as members of the Echo-Boom Generation or Generation Net Avillion; Filipczak et al.; Hammill).
Generation Y's have grown up with technology and are completely comfortable with its frequent advances and changes. They equate education with the ability to find good jobs (Avillion).
They view downsizing as normal and have even less loyalty to organizations than Xers. They focus on what they do, not where they work (Avillion; Filipczak et al.; Hammill).
Here are some education tips for Y's:
Incorporate opportunities to interact with colleagues and educators.
Incorporate fun as well as structure in education. Provide information about objectives, goals, and schedules.
Establish a mentor program.
Provide written resources and ways to access journals, books, and other materials. Unlike, Xers, Y's enjoy and value the time that they spend reading.
Provide convenient distance learning opportunities, but make sure that you offer opportunities to collaborate and have discussions with each other and with educators.
Because you will be dealing with members of all four generations, plan varied activities that incorporate a variety of teaching/learning strategies. Be flexible and enthusiastic. All learners value educators who are sincerely interested in facilitating continuing education and the professional growth and development of their learners.
References
Avillion, A. E. (2008). A Practical Guide to Staff Development: Evidence-Based Tools and Techniques for Effective Education. Marblehead, MA: HCPro, Inc.
Hammill, G. (2005). "Mixing and managing four generations of employees." FDU Magazine Online. Retrieved September 1, 2009 from www.fdu.edu/newspubs/magazine/05ws/generations.htm.
Filipczak, B., Raines, C., & Zemke, R. (1999). "Generation gaps in the classroom." Training 36(11): 48-54.
This article was adapted from one that originally appeared in the October 2009 issue of The Staff Educator, an HCPro publication.
A Senate Finance Committee vote on healthcare reform will be pushed back to later this week, and perhaps into next week, as they await an estimate on how much the overhaul would cost. The Senate Finance Committee wrapped up work Oct. 2 on a reform bill, but committee Chairman Max Baucus (D-MT) promised his members that before voting they would have a "reasonable" amount of time to review the bill's price tag, as assessed by the nonpartisan Congressional Budget Office. That report will arrive later than expected.