The DNA of Allied Health Education and Practice. Dr. David D. Gale, Dean College of Health Sciences Eastern Kentucky University Richmond, KY 40475

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1 The DNA of Allied Health Education and Practice Dr. David D. Gale, Dean College of Health Sciences Eastern Kentucky University Richmond, KY 40475

3 Allied Health Professions are health care professionals that make up an estimated 30% of the total healthcare workforce and is distinct from medicine, dentistry, and nursing.

4 The term Allied Health was coined in1966 in response to Federal funding for these newly recognized professions. Thirteen deans met in Washington, D.C. and decided the funding parameters and the name for allied health.

6 v March 1: President s Message v March 2: H.R v March 17: S v March 30: HEW Secretary Testifies v June 23: Passes House v October 14: Senate Voice Vote v October 22: Money Appropriated v November 3: P.L

7 Appropriations 1967 $3,735, $8,000,000 Total $276,495,000 ( )

8 v ASAHP Founded in 1967 v $276,495,000 v (Equal to $1.29 billion in 2011 Dollars) v Zero Dollars v 1990 $737,000 v 2005 $5,500,000 v Zero dollars

11 information Welcome to Allied Health World, the premier resource for health care information. The professionals who developed this site interviewed experts in each respective field, learning the ins and outs of each career. Each healthcare category has specific and useful that is compiled all in one place; so you re not tasked with spending hours doing your own research. Your future in healthcare starts today!. START ACAREER IN PHLEBOTOMY SEARCH FOR PHLEBOTOMY TRAINING COURSES Combining medical technology and the human touch, the healthcare industry diagnoses, treats, and administers care around the clock, responding to the needs of millions of people from newborns to the terminally ill. Allied Health Professionals Survey conducted by AMA Organized Medical Staff Section

Health Care Careers e-letter April 2011 Coming soon: MedEdNews Dear Reader, Today, health care in general, and allied health in particular, face multiple challenges (and opportunities), all of which

15 Health Care Careers e-letter April 2011 Coming soon: MedEdNews Dear Reader, Today, health care in general, and allied health in particular, face multiple challenges (and opportunities), all of which call for a strong sense of unity and shared purpose. Otherwise, we risk moving off into multiple directions and losing the power of the whole. One key to unity? Organizations like these: Commission on Accreditation of Allied Health Education Programs National Network of Health Career Programs in Two-Year Colleges Association of Schools of Allied Health Professions Health Professions Network Another key is interdisciplinary and interprofessional education and practice. Towards that end, the AMA is combining four of its existing communications on medical education and health professions (this e-letter included) into one streamlined enewsletter, MedEdNews, which will debut in July. Stay tuned for more information! We welcome your comments on these and other health professions education issues at meded@amaassn.org. Best Regards, Fred Donini-Lenhoff, editor PS: Be sure to order your copy of the Health Care Careers Directory now!

United States Department of Labor DEFINITION OF ALLIED HEALTH Allied Health professionals are involved with the delivery of health or related services pertaining to the identification, evaluation and

16 United States Department of Labor DEFINITION OF ALLIED HEALTH Allied Health professionals are involved with the delivery of health or related services pertaining to the identification, evaluation and prevention of diseases and disorders; dietary and nutrition services; rehabilitation and health systems management, among others. Allied health professionals, to name a few, include dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, physical therapists, radiographers, respiratory therapists, and speech language pathologists.

Bureau of Labor Statistics Occupational Outlook Handbook, 2010-11 Edition Health Diagnosing and Treating Practitioners Health Technologists and Technicians Audiologist Chiropractors Cytotechnologist

17 Bureau of Labor Statistics Occupational Outlook Handbook, Edition Health Diagnosing and Treating Practitioners Health Technologists and Technicians Audiologist Chiropractors Cytotechnologist Dentist Dietitians and Nutritionists Occupational Therapist Physician Assistants Physicians and Surgeons Podiatrists Radiation Therapists Recreational Therapists Registered Nurses Respiratory Therapists Speech-Language Pathologists Veterinarians Athletic Trainers Cardiovascular Technologists and Technicians Clinical Laboratory Technologists and Technicians Dental Hygienists Diagnostic Medical Sonographers Emergency Medical Technicians and Paramedics Licensed Practical and Licensed Vocational Nurse Medical Records and Health Information Technicians Nuclear Medicine Technologists Occupational Health and Safety Specialists Occupational Health and Safety Technicians Opticians, Dispensing Pharmacy Technicians and Aides Radiologic Technologists and Technicians Surgical Technologists Veterinary Technologist and Technicians

18 BASIS FOR SELECTION 1989

19 US Department of Education

21 American Medical Association Council on Medical Education Role from

22 AMA COUNCIL 1930 s v American Occupational Therapy Association v American Society for Clinical Pathology v American Physical Therapy Association

23 AMA COUNCIL 1940 s v Health Information Administrator (1943) v Radiographer (1944)

24 AMA Committee Study of Paramedical Education (1957) Study of 50 Educational Programs study to direct services of his patients functioning in an ancillary role

25 American Medical Association House of Delegates (1969) v Defined Allied Health Professionals those who exercise independent judgment with their area of competence. In the AMA documents allied health was called ancillary and paramedical.

26 Study of Accreditation of Selected Health Educational Programs (SASHEP) SASHEP Sponsored by: Council on Medical Education, American Medical Association Association of Schools of Allied Health Professions National Commission on Accrediting Working Papers 1972

27 Dilemma #1: Should There be Accreditation? _The SASHEP study group concluded that: educational institutions and programs of study require some type of monitoring. SASHEP Sponsored by: Council on Medical Education, American Medical Association Association of Schools of Allied Health Professions National Commission on Accrediting

28 Dilemma #2 v What form of monitoring is appropriate? v How shall the monitoring be conducted? v Who should ultimately be responsible for the monitoring? v Who will finance this system? v No conclusions were reported.

29 Dilemma #3: The Functions of Accreditation: vthis issue was the most contentious who is in control? vother than the profession, where does authority to advise and decide what methods of control and selection be administered? vno conclusions or recommendations.

30 Dilemma #4: The Structure of Accreditation Until 1950 s if you wanted an accreditation group form it! The National Commission on Accrediting was formed to control this growth. --NOTED in this study professions become a monopoly in the public interest.. semi-professions were characterized by more control by administrative superiors and boards.

31 Dilemma #5: v Financing of Accreditation Only two short paragraphs on this topic!! v -- who should pay for this structure the professions, the schools, or state and federal government or gifts?

32 Dilemma #6: Validity of Accreditation v --NOTED in the study, the life cycle of regulatory agencies gestation, youth, maturity and old age. A sense of deterioration! v --needed is research on validity, available funding, and possible restructure of accreditation for health educational programs.

33 Dilemma #7: Expansion of Accreditation v Should expansion of other accreditation groups be controlled or restricted?

34 v --in 1960, Duvall, in the final report to the Committee to Study the Relationships of Medicine with Allied Health, reported that the physician must be the unifying force for the health care of America. v --medicine recognizes its unique competence can best be exercised in accrediting health educational programs on a basis of cooperation, coordination and collaboration.

35 Relationship of Accreditation to Licensure and Certification How can these two distinct functions be mutually modified so they may jointly and more adequately serve the purposes for which they are operated?

37 Accrediting Agencies Who Responded to Survey AANA American Association of Nurse Anesthetists aana.com ABHES Accrediting Bureau Health Education Schools abhes.org ACOE Accreditation Council on Optometric Education aoa.org ACPE Accreditation Council for Pharmacy Education acpe-accredit.org ADA American Dental Association ada.org ACOTE American Council for Occupational Therapy Education aota.org ARC PA Accreditation Review Committee Physician Assistant ada.org ASHA American Speech Language Hearing Association asha.org AVMA American Veterinarian Medical Association avma.org CAAHEP Commission on Accreditation of Allied Health Education caahep.org CAATE Commission on Accreditation of Athletic Training Education caate.net CADE Commission on Accreditation for Dietetics Education eatright.org CAHIM Commission on Accreditation for Health Informatics and Information Management Education cahim.org CAHME Commission on Accreditation for Health Care Management Education cahme.org CAPTE Commission on Accrediting in Physical Therapy Education apta.org CCNE Commission on Collegiate Nursing Education aacn.nche.edu CEPH Council on Education for Public Health ceph.org CPME Council on Podiatric Medical Education apma.org JRCERT Joint Review Committee on Accreditation in Radiologic Technology jrcert.org JRCNMT Joint Review Committee on Educational Programs in Nuclear Medicine jrcnmt.org NAACLS National Accrediting Agency for Clinical Laboratory Sciences naacls.org NLNAC National League for Nursing Accrediting Commission nlnac.org

38 Accrediting Agencies in Study Total Programs Agency Accredits 2008 Survey Site Visits Made a Year Programs not accredited -lack of meeting standards Programs placed on Probation Percentage Placed on Probation AANA % ABHES % ACOE % ACPE % ADA % AOTA % ARC PA % ASHA % AVMA % CAAHEP % CAATE % CADE % CAHIM % CAHME % CAPTE % CCNE % CEPH % CPME % JRCERT % JRCNMT % NAACLS % NLNAC % %

39 Programs ACOE ADA ACOTA ARC PA ASHA CAAHEP CAATE CADE CAHIIM CAPTE CCNE CEPH NAACLS NLNAC TOTAL AnesthesiaTechnologist/ Technician 7 7 Athletic Training Audiology Programs (Doctoral Level) Cardiovascular Technologist Clinical Lab Sc/Med Tech (BS) Clinical Lab Technologist/MAT (AS) Cytotechnologist Dental Assisting Dental Hygienist Dental Laboratory Technology Diagnostic Medical Sonographer DiagMolecular Sc(BS Minimum) 6 6 Dietitian/Nutritionist Electroneurodiagnostic Technologist Emergency Med Tech-Paramedic Exercise Physiologist 6 6 Exercise Scientist Genetic Counseling (ABGC) 25 Health Information Management Histotechnology Kinesiotherapist 6 6 Medical Illustrator 5 5 Medical Assisting Nurse Anesthetist (AANA) 111 Nursing (NLNAC) Nursing (CCNE) Occupational Therapy Optometric Technician 6 6 Orthotic and Prosthetic Practitioner 9 9 Pathology Perfusionist Phlebotomist Physicians Assistant Physical Therapy Polysomnographic Technologist Public Health (MPH) Respiratory Therapist Specialist in Blood Bank Technology Speech -Language Pathology Surgical Technologist TOTALS

40 Educational Preparation AnesthesiaTechnologist/Technician Athletic Training Audiology Programs Cardiovascular Technologist Clinical Lab Sc/Med Tech Clinical Lab Technologist/MAT Cytotechnologist Dental Assisting Dental Hygienist Dental Laboratory Technology Diagnostic Medical Sonographer DiagMolecular Scientist Dietitian/Nutritionist Electroneurodiagnostic Technologist Emergency Med Tech-Paramedic Exercise Physiologist Exercise Scientist Genetic Counseling Health Information Technician Histotechnology Kinesiotherapist Medical Illustrator Medical Assisting Certificate Associate Degree Bachelor's Degree Master s Degree Clinical Doctorate Research Doctorate Nurse Anesthetist Nursing Occupational Therapy Optometric Technician Orthotic and Prosthetic Practitioner Pathology Perfusionist Phlebotomist Physicians Assistant Physical Therapy Polysomnographic Technologist Public Health (MPH) Respiratory Therapist Specialist in Blood Bank Technology Speech -Language Pathology Surgical Technologist

Institutions of Higher Education tend to like their allied health programs even though they are expensive. The career ladder in the allied health profession is not available.

43 Institutions of Higher Education tend to like their allied health programs even though they are expensive. The career ladder in the allied health profession is not available. It works best in nursing, but only 10% more from the AD in nursing to the BSN in nursing. Each accreditation body operates in silos around the discipline with little regard for the education or awareness of other professions. Physician Assistants will require all programs to be at the Masters level by 2014 and the Physical Therapy community will require all programs to award the DPT by The clinical laboratory field has AD/BS/MS and a handful of clinical doctoral programs. However, there is a crisis in preparing enough doctoral prepared faculty and program directors for the programs. This profession has shortages but salaries have not risen.

44 The term Allied Health covers programs from one week bellybutton washers (Laparoscopic training) to PhD research post-doctoral education. By and large most allied health workers are educated in community or technical colleges. Professions are at the Baccalaureate or higher degree. There are presently 22 accreditation bodies in the health professions educating students in 7,706 programs. Eighty percent of the hospital patient record is from the laboratory, yet these workers are unable to discuss patient results with the patient. By and large the reimbursement system for the practice profession is flawed and fragmented. When the patient is in need of, for example, rehabilitation services, those professions should direct the patient care. More than 200 professions under one umbrella is just too many and paints a complex picture of who is under the umbrella!

45 vthird-party Accreditation in a peer review process vdevelop a National Accreditation Board

46 WHAT WE NEED TO KNOW What is the available work force in each profession including age, education, income, length of time in the profession. We need reimbursement mechanisms that appropriately reward practitioners for this highly demanding education. We need state practice acts that are current and relevant to the practice of that profession. We need an educational system(s) that works to assist our graduates to move up the educational ladder. Better articulation of the bodies of knowledge to support graduate education. AS MS Clinical Doctorate/Research Doctorate. We need an accreditation system that recognizes school of allied health rather than duplicating all materials for each program.

47 WHAT WE NEED TO KNOW We need additional and better prepared faculty for our programs. Some professions have been changed to graduate level entry, and the educational ladder for these is broken. Who will fix it? Most of the allied health programs that are commonly thought of as professional are at the graduate level, but others like respiratory therapy and dental hygiene primarily at the Associate Degree level.

48 End

Proposed Extended Hierarchy (High-Level) for Roles

Proposed Extended Hierarchy (High-Level) for Roles Extended Hierarchy (High-Level) for Roles Aide Assistant Behavioral Health Chiropractic Clerk Coordinator Counselor Dietary & Nutritional Service Dental Emergency Service Eye and Vision Services Hygienist