APPENDIX D

Healthcare Professional and Workforce Roles

This appendix provides descriptions for the many roles that are related to healthcare information technology, such as those working as healthcare professionals and in supporting positions, as well as those working in the field of healthcare information technology.

In the United States, professional roles are recommended by professional organizations to be added to the Standard Occupational Codes (SOC) from Bureau of Labor Statistics (BLS). If the BLS recommends a code, it is listed in the Bureau of Labor Statistics Occupational Outlook Handbook BLS/OOH. The majority of terms in this appendix are taken from the Bureau of Labor Statistics OOH. (Bureau of Labor Statistics. Accessed on March 12, 2017, from www.bls.gov/oes/current/oes_stru.htm#31-0000.)

There are several new categories, such as Health Information Technology and Management, Health Informatics Practitioners, Medical Records, and Health Information Technicians, that are in review for SOC and are slated for inclusion in 2018 if accepted.

When no SOC exists or there is no term in the OOH (for example, CNIO, CMIO, and CCIO), professional organizations who have defined the terms are noted. These definitions are posted on the organization’s web site for public comment, then published in professional journals. These references are provided where appropriate.

In other instances, the profession codes are listed in specific domain areas, yet their roles are critical in the planning, implementation, evaluation, and training in healthcare information technology. These codes have a separate reference where needed.

Healthcare Professional Roles

Audiologists

Assess and treat persons with hearing and related disorders. May fit hearing aids and provide auditory training. May perform research related to hearing problems.

Chiropractors

Assess, treat, and care for patients by manipulation of spine and musculoskeletal system. May provide spinal adjustment or address sacral or pelvic misalignment.

Dentists

Examine, diagnose, and treat diseases, injuries, and malformations of teeth and gums. May treat diseases of nerve, pulp, and other dental tissues affecting oral hygiene and retention of teeth. May fit dental appliances or provide preventive care. Specialties include orthodontists and prosthodontists.

Dieticians and Nutritionists

Plan and conduct food service or nutritional programs to assist in the promotion of health and control of disease. May supervise activities of a department providing quantity food services, counsel individuals, or conduct nutritional research.

Genetic Counselors

Assess individual or family risk for a variety of inherited conditions, such as genetic disorders and birth defects. Provide information to other healthcare providers or to individuals and families concerned with the risk of inherited conditions. Advise individuals and families to support informed decision making and coping methods for those at risk. May help conduct research related to genetic conditions or genetic counseling.

Nurses

Registered Nurses

Assess patient health problems and needs, develop and implement nursing care plans, and maintain medical records. Administer nursing care to ill, injured, convalescent, or disabled patients. May advise patients on health maintenance and disease prevention or provide case management. Licensing or registration required.

Licensed Practical and Licensed Vocational Nurses

Care for ill, injured, or convalescing patients or persons with disabilities in hospitals, nursing homes, clinics, private homes, group homes, and similar institutions. May work under the supervision of a registered nurse. Licensing required.

Clinical Nurse Specialists

Coming in 2018 if accepted by SOC.

Doctorly Trained Nurses

A relatively small percentage of nurses obtain doctoral or Ph.D. degrees from schools of nursing or other university departments. It is important for the reader to know that these highly trained nurses exist and that they occupy a wide variety of roles in healthcare. As there are no standard definitions of these roles that the authors know of, we present only the title and corresponding acronym/credential of the main types of doctorly trained nurses here:

•   Doctor of Nursing (DN)

•   Doctor of Nursing Practice (DNP)

•   Doctor of Nursing Science (DNS or DNSc)

•   Doctor of Philosophy (Ph.D. or DPhil)

Nurse Anesthetists

Administer anesthesia, monitor patient’s vital signs, and oversee patient recovery from anesthesia. May assist anesthesiologists, surgeons, other physicians, or dentists. Must be registered nurses who have specialized graduate education. (Authors’ note: This role is also known as Certified Registered Nurse Anesthetist [CRNA].)

Nurse Midwives

Diagnose and coordinate all aspects of the birthing process, either independently or as part of a healthcare team. May provide well-woman gynecological care. Must have specialized, graduate nursing education.

Nurse Practitioners

Diagnose and treat acute, episodic, or chronic illness, independently or as part of a healthcare team. May focus on health promotion and disease prevention. May order, perform, or interpret diagnostic tests such as lab work and X-rays. May prescribe medication. Must be registered nurses who have specialized graduate education.

Medical Records and Health Information Technicians

Compile, process, and maintain medical records of hospital and clinic patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the healthcare system. Process, maintain, compile, and report patient information for health requirements and standards in a manner consistent with the healthcare industry’s numerical coding system.

Optometrists

Diagnose, manage, and treat conditions and diseases of the human eye and visual system. Examine eyes and visual system, diagnose problems or impairments, prescribe corrective lenses, and provide treatment. May prescribe therapeutic drugs to treat specific eye conditions.

Pharmacists

Dispense drugs prescribed by physicians and other health practitioners and provide information to patients about medications and their use. May advise physicians and other health practitioners on the selection, dosage, interactions, and side effects of medications.

Physicians and Surgeons

Anesthesiologists

Physicians who administer anesthetics prior to, during, or after surgery, or other medical procedures.

Family and General Practitioners

Physicians who diagnose, treat, and help prevent diseases and injuries that commonly occur in the general population. May refer patients to specialists when needed for further diagnosis or treatment.

Internists, General

Physicians who diagnose and provide non-surgical treatment of diseases and injuries of internal organ systems. Provide care mainly for adults who have a wide range of problems associated with the internal organs. Subspecialists, such as cardiologists and gastroenterologists, are included in “Physicians and Surgeons, All Other.”

Obstetricians and Gynecologists

Physicians who provide medical care related to pregnancy or childbirth and those who diagnose, treat, and help prevent diseases of women, particularly those affecting the reproductive system. May also provide general medical care to women.

Pediatricians, General

Physicians who diagnose, treat, and help prevent children’s diseases and injuries.

Psychiatrists

Physicians who diagnose, treat, and help prevent disorders of the mind.

Surgeons

Physicians who treat diseases, injuries, and deformities by invasive, minimally invasive, or non-invasive surgical methods, such as using instruments, appliances, or by manual manipulation. Specialties include colon and rectal surgeons, neurological surgeons, orthopedic surgeons, plastic surgeons, etc.

Physician Assistants

Provide healthcare services typically performed by a physician, under the supervision of a physician. Conduct complete physicals, provide treatment, and counsel patients. May, in some cases, prescribe medication. Must graduate from an accredited educational program for physician assistants.

Podiatrists

Diagnose and treat diseases and deformities of the human foot.

Therapists

Exercise Physiologists

Assess, plan, or implement fitness programs that include exercise or physical activities such as those designed to improve cardiorespiratory function, body composition, muscular strength, muscular endurance, or flexibility. Excludes fitness trainer.

Occupational Therapists

Assess, plan, organize, and participate in rehabilitative programs that help build or restore vocational, homemaking, and daily living skills, as well as general independence, to persons with disabilities or developmental delays.

Physical Therapists

Assess, plan, organize, and participate in rehabilitative programs that improve mobility, relieve pain, increase strength, and improve or correct disabling conditions resulting from disease or injury.

Radiation Therapists

Provide radiation therapy to patients as prescribed by a radiologist according to established practices and standards. Duties may include reviewing prescription and diagnosis; acting as liaison with physician and supportive care personnel; preparing equipment, such as immobilization, treatment, and protection devices; and maintaining records, reports, and files. May assist in dosimetry procedures and tumor localization.

Recreational Therapists

Plan, direct, or coordinate medically approved recreation programs for patients in hospitals, nursing homes, or other institutions. Activities include sports, trips, dramatics, social activities, and arts and crafts. May assess a patient condition and recommend appropriate recreational activity.

Respiratory Therapists

Assess, treat, and care for patients with breathing disorders. Assume primary responsibility for all respiratory care modalities, including the supervision of respiratory therapy technicians. Initiate and conduct therapeutic procedures; maintain patient records; and select, assemble, check, and operate equipment.

Speech-Language Pathologists

Assess and treat persons with speech, language, voice, and fluency disorders. May select alternative communication systems and teach their use. May perform research related to speech and language problems.

Veterinarians

Diagnose, treat, or research diseases and injuries of animals. Includes veterinarians who conduct research and development, inspect livestock, or care for pets and companion animals.

Technicians

Medical and Clinical Laboratory Technologists

Perform complex medical laboratory tests for diagnosis, treatment, and prevention of disease. May train or supervise staff.

Medical and Clinical Laboratory Technicians

Perform routine medical laboratory tests for the diagnosis, treatment, and prevention of disease. May work under the supervision of a medical technologist.

Healthcare Support Roles

Aides, Assistants, and Similar Roles

This major group comprises the following occupations: Home Health Aides, Psychiatric Aides, Nursing Assistants, Orderlies, Occupational Therapy Assistants, Occupational Therapy Aides, Physical Therapist Assistants, Physical Therapist Aides, Massage Therapists, Dental Assistants, Medical Assistants, Medical Equipment Preparers, Medical Transcriptionists, Pharmacy Aides, Veterinary Assistants and Laboratory Animal Caretakers, and Phlebotomists.

Medical and Health Services Managers

Plan, direct, or coordinate medical and health services in hospitals, clinics, managed care organizations, public health agencies, or similar organizations.

Healthcare IT Workforce Roles

Top Executives

Plan, direct, or coordinate activities in such fields as electronic data processing, information systems, systems analysis, and computer programming. Includes Chief Medical Information Officer, Chief Nursing Information Officer, and Chief Clinical Information Officer. The following are not official SOC codes in the DOL classification but are defined by the professional association AMIA:

Chief Medical Information/Informatics Officer (CMIO)

In hospitals or health systems, a physician charged with helping to assure the success of clinical information systems, representing a clinician’s perspective, and participating in system selection, implementation, evaluation, and user training. (https://www.amia.org/glossary)

Chief Nursing Information/Informatics Officer (CNIO)

In hospitals or health systems, a nurse charged with helping to assure the success of clinical information systems, representing a clinician’s perspective, and participating in system selection, implementation, evaluation, and user training. (https://www.amia.org/glossary)

Chief Clinical Informatics Officer (CCIO)

CCIO was recently added to the healthcare leadership teams to complement the CIO. While the CCIO term is still rarely used, the term encompasses the more commonly used Chief Medical Informatics Officer (CMIO) and Chief Nursing Informatics Officer (CNIO) as well as the seldom used Chief Pharmacy Informatics Officer (CPIO) and Chief Dental Informatics Officer (CDIO). The term Chief Health Informatics Officer (CHIO) is sometimes used synonymously with CCIO implementation, evaluation, and user training. (https://academic.oup.com/jamia/article/23/2/435/2572493/The-Chief-Clinical-Informatics-Officer-CCIO)

Computer and Information Systems Managers

Computer and information systems managers, often called information technology (IT) managers or IT project managers, plan, coordinate, and direct computer-related activities in an organization. They help determine the information technology goals of an organization and are responsible for implementing computer systems to meet those goals. (https://www.bls.gov/ooh/management/home.htm)

Computer and Information Research Scientists

Computer and information research scientists invent and design new approaches to computing technology and find innovative uses for existing technology. They study and solve complex problems in computing for business, medicine, science, and other fields.

Computer Hardware Engineers

Computer hardware engineers research, design, develop, and test computer systems and components such as processors, circuit boards, memory devices, networks, and routers. These engineers discover new directions in computer hardware, which generate rapid advances in computer technology.

Computer Network Architects

Computer network architects design and build data communication networks, including local area networks (LANs), wide area networks (WANs), and intranets. These networks range from small connections between two offices to next-generation networking capabilities such as a cloud infrastructure that serves multiple customers.

Computer Programmers

Computer programmers write and test code that allows computer applications and software programs to function properly. They turn the program designs created by software developers and engineers into instructions that a computer can follow.

Computer Systems Analysts

Computer systems analysts study an organization’s current computer systems and procedures and design information systems solutions to help the organization operate more efficiently and effectively. They bring business and information technology (IT) together by understanding the needs and limitations of both.

Database Administrators

Database administrators (DBAs) use specialized software to store and organize data, such as financial information and customer shipping records. They make sure that data are available to users and are secure from unauthorized access.

Information Security Analysts

Information security analysts plan and carry out security measures to protect an organization’s computer networks and systems. Their responsibilities are continually expanding as the number of cyberattacks increases.

Network and Computer Systems Administrators

Computer networks are critical parts of almost every organization. Network and computer systems administrators are responsible for the day-to-day operation of these networks.

Software Developers

Software developers are the creative minds behind computer programs. Some develop the applications that allow people to do specific tasks on a computer or another device. Others develop the underlying systems that run the devices or that control networks.

Web Developers

Web developers design and create web sites. They are responsible for the look of the site. They are also responsible for the site’s technical aspects, such as its performance and capacity, which are measures of a web site’s speed and how much traffic the site can handle. In addition, web developers may create content for the site.

Project Managers

A project manager facilitates the planning, scheduling, and controlling of all activities that must be done to meet a project’s objectives. (Chapter 11 of this book)

Systems Analysts

Computer systems analysts study an organization’s current computer systems and procedures and design information systems solutions to help the organization operate more efficiently and effectively. They bring business and information technology (IT) together by understanding the needs and limitations of both.

Computer Support Specialists (Application Specialists)

Computer support specialists provide help and advice to people and organizations using computer software or equipment. Some, called computer network support specialists, support information technology (IT) employees within their organization. Others, called computer user support specialists, assist non-IT users who are having computer problems. (https://www.bls.gov/ooh/computer-and-information-technology/computer-support-specialists.htm)

Operations Research Analysts

Operations research analysts use advanced mathematical and analytical methods to help organizations investigate complex issues, identify and solve problems, and make better decisions. (https://www.bls.gov/ooh/math/operations-research-analysts.htm)

Director of Analytics

The Advanced Analytics Director is responsible for managing projects from discovery to implementation, growing patient and staff engagement, and developing new products in healthcare IT. (https://www.indeed.com)

Hardware Engineers

Computer hardware engineers research, design, develop, and test computer systems and components such as processors, circuit boards, memory devices, networks, and routers. These engineers discover new directions in computer hardware, which generate rapid advances in computer technology. (https://www.bls.gov/ooh/architecture-and-engineering/computer-hardware-engineers.htm)

Electrical Engineering Technicians

Electrical and electronics engineering technicians help engineers design and develop computers, communications equipment, medical monitoring devices, navigational equipment, and other electrical and electronic equipment. They often work in product evaluation and testing, using measuring and diagnostic devices to adjust, test, and repair equipment. They are also involved in the manufacture and deployment of equipment for automation. (https://www.bls.gov/ooh/architecture-and-engineering/electrical-and-electronics-engineering-technicians.htm)

Quality Control Inspectors

Quality control inspectors examine products and materials for defects or deviations from specifications. (https://www.bls.gov/ooh/production/quality-control-inspectors.htm)

Technical Writers

Technical writers, also called technical communicators, prepare instruction manuals, how-to guides, journal articles, and other supporting documents to communicate complex and technical information more easily. They also develop, gather, and disseminate technical information through an organization’s communications channels. (https://www.bls.gov/ooh/media-and-communication/technical-writers.htm)

Computer Support Specialists

Computer support specialists provide help and advice to people and organizations using computer software or equipment. Some, called computer network support specialists, support information technology (IT) employees within their organization. Others, called computer user support specialists, assist non-IT users who are having computer problems. (https://www.bls.gov/ooh/computer-and-information-technology/computer-support-specialists.htm)