The North Carolina Health Professions Data System

1
The North Carolina Health Professions Data System

• Katie Gaul, Erin Fraher,
• Thomas C. Ricketts, Jessica Carpenter
• University of North Carolina at Chapel Hill

2
Overview of Todays Presentation

• The North Carolina Health Professions Data System
• Mission
• Background
• Data Collection, Cleaning, Reporting
• Organizational Issues
• External Data Sources
• WHY? Examples and Value of Work
• Wrapping Up

3
Our Mission

• To provide timely, useful data and analysis to
  support decision making for health professions
  policy in North Carolina and the United States
• To support research into health workforce issues
  and problems
• To train others in how to develop and maintain
  data systems in health workforce

4
HPDS 3 Main Product Lines
Maintenance of Licensure Data Files for HPDS
Special Projects Service to the State and the
Institution
Allied Health Workforce Studies
This function is the backbone of our work. It
takes substantial time and staff effort to
collect, clean, edit, and disseminate licensure
data. Sustaining maintaining this
infrastructure is challenging.
The HPDS often undertakes special research
projects at the request of the NC AHEC, UNC Board
of Governors (respond to legislation, make
presentations), licensure boards etc. This
service has increased the visibility of the Sheps
Center to important local sponsors and
policymakers.
Funded by the Duke Endowment and the NC AHEC,
research has focused on quantifying the supply
of, and demand for, allied health workers.
Findings highlighting the growth of allied health
employment have gained the attention of policy
makers. Staff in the Governors office, the
legislature, and other state agencies are working
to develop innovative ways to transition
unemployed individuals into allied health jobs.
5
North Carolina HPDS

• A collaboration between the Cecil G. Sheps Center
  for Health Services Research at UNC-CH and the
  health professions licensing boards.
• Data are provided voluntarily by the boardsthere
  is no legislation that requires this, there is no
  appropriation.
• Core funding provided by
• NC AHEC Program Office, data request fees,
  project cross-subsidies, and the UNC-CH Office of
  the Provost.

6
The System is Unique in the U.S.

• 30 years of continuous, complete data
• Comprehensive and voluntary collaboration with 12
  licensing bodies in North Carolina
• Data remain property of licensing board,
  permission sought for each new use
• System is independent of government or health
  care professionals

7
Categories of Health Professionals in Data System

• Certified Nurse Midwives (1985)
• Chiropractors
• Dental Hygienists
• Dentists
• Licensed Practical Nurses
• Nurse Practitioners
• Occupational Therapists (2006)
• Occupational Therapy Assistants (2006)
• Optometrists

• Pharmacists
• Physical Therapists
• Physical Therapist Assistants
• Physician Assistants
• Physicians (MDs and DOs)
• Podiatrists
• Psychological Associates
• Psychologists
• Registered Nurses
• Respiratory Therapists (2004)

8
HPDS Data Collected from Boards

• Base data from initial licensure/approval forms
• Updated data from renewals of licensure and
  approvals to practice
• Includes 100 of active professionals because
  licensure is required by law
• We develop a Snapshot of files as of October of
  each year (Orange Book)

9
Data Items Collected

• Demographic data
• Data elements that usually dont change
• Unique identifier
• Name
• Date and place of birth
• Race/ethnicity
• Gender
• Basic professional degree (degree conferred, name
  and location of institution attended, practice
  qualifications)

10
Data Items Updated

• Data elements that may change
• Home address
• Employment address
• Type of position
• Employment setting
• Clinical practice area/specialty
• Activity status (retired, active practice, not
  employed in profession)
• Average hours per week/employment status
• Highest degree
• Foreign language ability (available from select
  boards)

11
Additional Data Items Collectedfor Physicians
and PAs

• Primary, Secondary and Other practice location
• ZIP Code location
• Facility type
• Hours in clinical care (by location)
• Hours in primary care (by location)
• Provide prenatal care?
• Deliver babies?
• Hospital Privileges (2007)
• Licenses ever held in other states/countries
  (2007)

12
Licensure File Creation and Maintenance
(continued)
The entire process takes nearly a year from start
to finish
October
August
News Release
Review for changes
Trial Posts to web
Data come in
Edits, cleaning
Formatted initial analysis file
Data Book released
13
North Carolina Health Professions Data Book

• Annual Health Professions Data Book, produced
  since 1979, details state and county level health
  professions data current issue October 2007
  data
• Publications and research widely used by
  policymakers, educators, researchers, the media
  and health professionals as the official source
  of health professions statistics in NC
• Supported by the North Carolina Area Health
  Education Centers Program and the University of
  North Carolina at Chapel Hill Office of the
  Provost

14
North Carolina Health Professions Data Book

• Counts of active, licensed health professionals
• Population by age group and race
• Employment and income data
• Vital statistics (births, deaths, pregnancies)
• Infant mortality rates
• Hospital and facility data

Aggregated by state, county and regions (AHEC,
DHHS, Perinatal)
15
HPDS Organizational Issues
16
Infrastructure Hardware/Software

• Hardware
• High end personal computers which are regularly
  upgraded (every 2-3 years)
• Connected to Sheps Center servers allowing file
  sharing, storage of large files, automatic
  back-up
• Label writer for mailing data requests
• Cleaning and processing of licensure files is
  done on local desktop computer using SAS
• Archive licensure files kept on UNC mainframe

• Software
• Microsoft Access - track data requests, do file
  audits, invoicing, data book pages
• Microsoft Excel/Powerpoint - graphically present
  data
• Macromedia Dreamweaver - web development
• Adobe Acrobat - create PDF documents for website
• Quark or Adobe InDesign - desktop publishing
• Adobe Illustrator - format maps and graphics
• MapInfo or ArcGIS - create maps and do spatial
  analysis
• SAS or Stata - statistical analysis and
  programming

17
Dissemination

• State-Level (examples)
• State Legislators, Governors office, State
  Policy Makers
• Health Professions Schools
• All regional AHECs and their libraries
• North Carolina State Library
• North Carolina DHHS, Commerce
• North Carolina Hospital Association and other
  employers
• Professional Associations
• Duke Endowment and Kate B. Reynolds Charitable
  Trust
• North Carolina Institute of Medicine
• National-Level
• AAMC, other workforce centers, AHECs, and
  researchers
• Federal Bureau of Health Professions, HRSA, NAO
• Library of Congress
• Email listserv 2,298 members, sign-up available
  on website

18
Basic Cost Estimates
Stage Funding type Tasks Estimate This may vary
Design the System One-Time Explore available data, infrastructure, personnel, expectations design database and data collection analysis procedures Wide range depends on quality of data and current database format personnel
Implement the System One-Time Hire purchase infrastructure collect and audit data populate database identify and repair glitches launch website Wide range depends on quality of data and current database format personnel
Operations Ongoing Maintain files and collect new data publish Data Book and aggregate stats maintain website respond to requests for data 117,000 (North Carolina)
Special Projects Occasional Undertake special projects at the request of General Assembly and others tasks determined by nature of project Depends on scope of work and budget
19
Cost Estimate for Producing the Annual Data Book
Operating Costs
This is a general estimate of the costs to
produce the Data Book each year This does not
include funds necessary for infrastructure or
additional functions.
Fiscal Year 2007-2008
Personnel Time (salaries and benefits) excludes project cross-subsidies 113,300
Administrative (copying, postage, phone, supplies) 600
Publications (printing, dissemination) 2,900
Total 116,849
These estimates cover the production of the
annual HPDS Data Book and dont take into
account other projects that we design with the NC
AHEC Program and others.
20
Examples of Sources of Funding for Workforce
Research
Maintenance of Licensure Data Files for HPDS
Special Projects Service to the State and the
Institution
Allied Health Workforce Studies
Annual Contract Current Year, 116,849 NC AHEC
Program

• State, Federal Foundation Funding
• Development of Dental HPSA process (HRSA,
  450,000)
• Evaluation of the National AHEC Program (BHPR,
  239,467)
• Physician Workforce Study with NC IOM (Kate B.
  Reynolds 44,491)
• Rural Pharmacist Workforce Study (ORHP, 78,808)
• Supply of Psychiatrists in NC (NC AHEC, 30,000)
• Need for Assistance (NFA) process (BPHC, 90,000)
• SE Regional Center for Health Workforce Studies
  (HRSA, 1,000,000)

Multi Year Contract Total 2001-2007 262,476
(Duke Endowment and NC AHEC)
21
Data Request Revenue

• July 1, 2006 August 30, 2007
• 253 total data requests
• 6,536.29 Encumbered
• Average 5-10 contacts regarding requests per week
  (including all types and follow-ups on requests
  in process)
• Revenue supports publication of the annual Data
  Book and other publications, helps cover
  programming and administrative time, and helps
  purchase miscellaneous supplies software
• This is not typically a self-sustaining method to
  fund a data system

22
Data Sources
23
Examples ofSecondary Data Sources

• Supply and distribution of pharmacists in North
  Carolina HPDS data
• Number, type and location of pharmacies in NC NC
  Board of Pharmacy
• Population data Census, Claritas, State
  Demographer
• Volume and payer type for prescriptions dispensed
  in NC IMS Health
• Enrollments and graduations from NC pharmacy
  schools UNC-CH, Campbell
• Informal interviews
• Literature and internet searches
• National workforce data BHPr, AMA, APA, AANP

24
HPDS benefits from other data sets at Sheps

• Area Resource File (1994-present, intermittent
  files for previous years)
• HPSA/MUA file
• Claritas (1998-2000, 2003, 2005)
• AMA Masterfile (1981, 1986, 1991, 1996, 2000,
  2001, 2004, 2005, 2006)
• ADA Data (various)
• NC Hospital Discharge Data (1989-2005, except
  1995)
• NC Ambulatory Surgery Data (1997-2005)

25
Why?Examples and Value of Work
26
The Data System Can Help Answer Questions Like

• How many dentists are there in North Carolina?
  Where are they practicing?
• Are there too few psychiatrists in the state?
• Are we retaining health professionals trained in
  North Carolina?
• Will NCs supply of physicians keep pace with
  expected population growth?
• Does the ethnic and racial distribution of health
  professionals match the population?
• How well do the linguistic capabilities of
  practitioners match the language needs of North
  Carolinas citizens?

27
BUT it cant answer some types of questions for
lack of appropriate data

• When do physicians actually retire?
• Are fewer physicians delivering babies because of
  malpractice issues?
• Are we facing a psychiatrist shortage because
  reimbursement rates are too low?
• Where should we put the new (dentistry, pharmacy,
  satellite medical) school?
• Goal to provide data-driven, timely and
  objective analyses to inform the policy debate.

28
The Basics Describing the Workforce

• For example
• Supply of physicians is growing, but growth has
  slowed
• Average age of physicians is increasing slightly
• Gender is converging slowly for new physicians
• Newly licensed physicians were more likely to be
  female, be minority or be younger
• Of the physicians that left the file between
  2002-2003, 143 retired from practice and the
  average retirement age was 66
• 27 of active physicians in 2003 completed
  medical school in NC 35 completed NC residencies

29
Makes analysis simple

• Ongoing tracking stimulate attention and policy
  change
• Having the trend data readily available makes it
  unnecessary to do complex studies
• The data speak for themselves, and allows the
  stakeholders to feel some ownership in the data
• Stakeholders can do their own analysis by
  asking us questions of the data which we can
  answer
• Our data help people avoid doing large and
  complex (time-consuming) studies that cost a lot
  of money
• In some cases, the Medical Board will include
  survey questions on their licensure and renewal
  forms, making it easier to collect data with
  broad interest

30
Informing Policy Makers

• North Carolina General Assembly, 2003-2006
• Planning for potential new schools of
• Dentistry
• Pharmacy
• Optometry
• Plans for expansion of medical, dental schools
• Effects of malpractice insurance rate increases
• Effects of changes in license rules

31
Trends in the Supply of Dentists in North
Carolina, 1996-2005

• Policy Issue Dental access in rural NC
• Key Findings
• NC lags behind national supply
• Between 1996-2005, 33 of counties experienced
  decline in dentists per 10K pop, 26 of 33 were
  rural counties
• Aging dental workforce, especially in rural
  counties
• 87 of dentists are white
• Policy Response
• Legislature appropriated 89.6 million for new
  dental school at ECU and 96 million For
  expansion at UNC-CH

February 2007
32
The Supply and Distribution of Psychiatrists in
North Carolina Pressing Issues in the Context of
Mental Health Reform

• Policy Issue State decentralizing mental health
  serviceswill there be an adequate supply of
  psychiatrists?
• Key Findings
• Overall supply adequate, distribution is a
  problem
• 44 counties qualify as mental health professional
  shortage areas
• Of 19 counties that qualify as primary care
  HPSAs, 11 have shortage of psychiatrists
• 43 counties have no child psychiatrists
• Policy Response
• Legislature gave 500,000 of recurring funding to
  AHEC to address maldistribution and supply. Pilot
  efforts focus on mid-levels, residents and
  tele-psychiatry, consultation models.

January 2006
33
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34
NC AHEC, Sheps, NC IOM The Primary Care and
Specialty Physician Taskforce

• HPDS data revealed in 2003 that rate of growth of
  physicians per10,000 population slowed
• At same time, supply of primary care physicians
  did not keep pace with population in many rural
  counties
• With funding from Kate B. Reynolds, NC IOM
  convened taskforce to examine issue
• Nurse practitioners, physician assistants and
  certified nurse midwives included

35
The Primary Care and Specialty Physician
Taskforce Supply Projections

• Key Findings
• Despite rapid growth of NPs and PAs, NC provider
  supply will not keep pace with population
• NC IOM made 32 recommendations to the legislature
  to address supply, diversity and maldistribution
• Final report released June 2007 available at
  http//www.nciom.org

105
.75 FTE, faster growth
100
95
Ratio Relative to 2004 Level
90
85
.5 FTE, slower growth
80
2004
2006
2008
2010
2012
2014
2016
2018
2020
2022
2024
2026
2028
2030
Year
36
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37
Wrapping Up
38
Giving Back to the Boards

• Health Professions Licensing Boards
• Consult on new or modified questions on licensing
  forms
• Language ability (Pharmacy, Nursing, Medicine)
• Race (Pharmacy)
• Activity status (Physical Therapy)
• Help evaluate online registration (Medical Board,
  Nursing)

39
Lessons Learned

• Data driven workforce analyses necessary to
• Monitor longitudinal trends in supply and
  distributionestablish benchmarks. Are we worse
  or better off?
• Identify emerging workforce issues
• Challenge anecdotal evidence
• Be perceived as objective in politically charged
  policy debates
• Justify funding requests
• Tackle discrete policy-relevant and manageable
  size projects
• Disseminate results in short policy briefs with
  lots of pictures (maps are good)

40
Health Workforce Planning The Future

• Workforce issues are not going away
• Federal workforce research funds have been cut
  and there are limited national data
• Responsibility falls on individuals statesmost
  policy levers are at state-level

41
Moving Forward

• We (HPDS) are starting to shift from classic
  workforce studies (assign physician to place,
  counts by county, look at distribution, etc.) to
  more in-depth analyses
• Involves merging administrative and other
  databases onto our licensure files to capture
  more detailed information
• Dr. John Doe is not just a surgeon at ABC
  Hospital Dr. Doe does this many of these
  particular procedures on these types of patients
  per year, and has shifted from doing general
  surgery to more specialized surgical procedures

42
Recommendations

• Start small and make a big impact
• Expand later
• Get a good team together - people with different
  skill sets who work well together and can learn
  from each other
• What youre looking to do will inform state
  policy look for some state money to fund this
  (dont depend solely on federal funding sources)
• Stay objective and maintain credibility

43
Contact Us
Erin Fraher, Director erin_fraher_at_unc.edu (919)
966-5012
Katie Gaul k_gaul_at_unc.edu [phone]
Tom Ricketts tom_ricketts_at_unc.edu [phone]
Jessica Carpenter jmcarpen_at_unc.edu [phone]
Cecil G. Sheps Center for Health Services
Research University of North Carolina at Chapel
Hill 725 Martin Luther King Jr. Blvd, CB
7590 Chapel Hill, NC 27599 HPDS Main Line (919)
966-7112, nchp_at_unc.edu
44
HPDS Websitehttp//www.shepscenter.unc.edu/hp

• County- and region-level data
• Historical health professions trends (1979-2006)
• Practitioner per 10,000 population ratios and
  maps
• Data definitions
• HPDS publications, press releases
• Powerpoint presentations
• Data request instructions
• General information about the HPDS frequently
  asked questions
• Sign-up for HPDS listserv
• Links to NC licensing boards, other national and
  state health workforce sites, other useful
  statistics sources

45
Extra Slides
46
Overview

• The North Carolina Health Professions Data System
• Background
• Organizational Issues
• Data Sources
• Special Reports and Projects
• Allied Health
• WHY? Examples and Value of Work
• Wrapping Up
• Contact Information

47
The Cecil G. Sheps Centerfor Health Services
Research

• Founded in 1968 is one of the oldest and largest
  health services research centers in the nation
• Is an organizational unit of the University of
  North Carolina at Chapel Hill in the Health
  Affairs Division
• 14 million annual budget (2006)
• Employs or houses 170 staff including senior
  faculty, research fellows, analytic staff,
  fellows and graduate students
• Over 130 research fellows based in other academic
  departments, state and federal government,
  private industry and other countries are
  affiliated with the Sheps Center

48
Data Request Process

• Receive requests by
• Email
• Fax
• Phone
• Informational Requests
• Non-Sheps Data refer to appropriate source (if
  possible)
• HPDS Data request procedures
• HPDS General Information
• Requests tracked in contact database (MS Access)
• Requestors name contact information
• Detailed description of request
• Output type
• Due date date sent

49
Data Request Process

• Two types of data requests
• Off the shelf data and publications
• Aggregate statistics found on HPDS website or
  Data Book (e.g. How many RNs are active in Durham
  County?)
• Requests for Publications (Data Book, fact
  sheets)
• Requests requiring data processing
• Aggregate statistics not found in HPDS
  publications (e.g. How many family practice
  physicians in the state provide obstetric
  deliveries?)
• Individual level data
• Mailing lists (e.g. Regional MS Society sending
  educational fliers to local physicians Companies
  advertising CE programs to psychologists)
• Analysis files for research

Permission sought from board to release
individual level data
50
Data Requests Requiring Processing

• Requests tracked in contact database (MS Access)
• Requestors name contact information
• Detailed description of request
• Output type
• Due date date sent
• Fees
• Health Professions Data Book
• 20.00 per book, plus postage
• Mailing lists (name, address, county, specialty)
• 4.50 per 100 names for electronic files
• 100 minimum, non-profit organizations 200
  minimum, for-profit organizations
• 600 maximum
• Analysis files (including the above plus
  additional demographic and practice
  characteristics)
• 7.00 per 100 names for electronic files
• 200 minimum, non-profit organizations 300
  minimum, for-profit organizations
• 700 maximum, non-profit organizations 800
  maximum, for-profit organizations
• Requests requiring programming
• 50.00 per hour for substantial requests (else
  free)

Discounts given for AHECs, students, UNC System,
North Carolina State Agencies, and at the
Directors discretion
51
Organizational Issues Personnel
Center Director
Deputy Director Research
Deputy Director Operations
Deputy Director Policy Analysis Tom Ricketts, PhD
Director Program on Primary Care Health
Professions
Associate Director Health Policy Information
Director NC Rural Health Policy Analysis
Associate Director Policy Analysis
Director Health Professions Erin Fraher, MPP
50
Associate Director Data Mgmt Information
Services
Programmer
Research Associate
100
Data Coordinator
Programmer
100
Research Associate
Research Assoc
Programmer
Programmer
50
10
Graduate RA 10hrs
Graduate RA 20 hrs
52
HPDS Benefits from Sheps Center Infrastructure
Computer and Data Management Support
Executive
Other Research Areas
Administrative Support
Health Professions Data System
Business and Financial Support
Programming
Media and Communications
Information and Library Services
53
Infrastructure Cartography and Geographic
Analysis Capabilities

• Maps with HPDS data are prepared using
  cartographic software that provides a Geographic
  Information System (GIS) interface such as ESRIs
  Arc Suite (ArcView, ArcInfo, ArcGIS, ArcIMS),
  and MapInfo
• MapInfo / ArcView - Data System has benefited
  from availability of cartographic software and
  expertise through the NC Rural Health Policy
  Research and Analysis Program.
• There are three licenses for MapInfo in the
  Center.
• The Center may shift over to ArcView because UNC
  has an unlimited number of licenses.
• Rural program buys Claritas products for ZIP to
  county coding and address matching.
• Other GIS products are used as needed

54
Infrastructure Library Services

• Sheps employs two full-time librarians who
  oversee the Centers library holdings
• Librarians conduct customized bibliographic
  research from electronic sources for researchers
• Librarians manage a Rural Policy collection,
  which includes over 11,000 items related to rural
  health, primary care, health policy dated back to
  1978
• Rural policy collection regularly deposits and
  cross-references items from the Federal Office of
  Rural Health Policy (OFRHP), General Accounting
  Office (GAO), the Office of Management and Budget
  (OMB), the Congressional Budgeting Office (CBO),
  Medicare Advisory Payment Commission (MedPAC) and
  the Bureau of Health Professions (BHPr)

55
Infrastructure Dissemination

• Center normally employs two full-time Information
  and Communication Specialists, who assist in the
  development written and published material these
  positions are currently vacant
• Provide copy editing, prepare fact sheets, and
  respond to short term queries for information
• Center employs two full-time web masters with
  distributed responsibilities
• Press releases and Press events are managed in
  collaboration with the UNC Office of Public
  Affairs

56
Electronic Dissemination

• Email listserv
• Updates to website
• New publications and news items
• Sent to key policy makers, educators,
  researchers, employers, etc.
• Sign-up available on the HPDS website
• 2,298 people on the list

57
HPDS 3 Main Product Lines
Maintenance of Licensure Data Files for HPDS
Special Projects Service to the State and the
Institution
Allied Health Workforce Studies
This function is the backbone of our work. It
takes substantial time and staff effort to
collect, clean, edit, and disseminate licensure
data. Sustaining maintaining this
infrastructure is challenging.
The HPDS often undertakes special research
projects at the request of the NC AHEC, UNC Board
of Governors (respond to legislation, make
presentations), licensure boards etc. This
service has increased the visibility of the Sheps
Center to important local sponsors and
policymakers.
Funded by the Duke Endowment and the NC AHEC,
research has focused on quantifying the supply
of, and demand for, allied health workers.
Findings highlighting the growth of allied health
employment have gained the attention of policy
makers. Staff in the Governors office, the
legislature, and other state agencies are working
to develop innovative ways to transition
unemployed individuals into allied health jobs.
58
The Basics Benchmarking

• Benchmark to US practitioner-to-population ratio
• Benchmark to neighboring states
• Problems
• What is an active practitioner?
• Counting bodies vs. calculating FTEs
• Dealing with missing data?
• Allocating individuals with more than one
  practice location and out-of-state locations
• Allocating individuals based on in primary care
• Difficulty in quantifying a shortage, how many
  practitioners is too few?

59
Health Professions Data System Recent Products

• Special reports
• Trends in Licensed Health Professions in North
  Carolina, 1979-2005
• Fact Sheets
• Physician Medical and Residency Training Fact
  Sheet, 2005, 2003, 2001,1999,1997,1995
• Allied Health Job Vacancy Tracking Reports (Apr.
  2007, Aug. 2006, Apr. 2005)
• Trends in the Supply of Dentists in NC, 1996-2005
• The Supply and Distribution of Psychiatrists in
  North Carolina Pressing Issues in the Context of
  Mental Health Reform
• Trends in the Supply of NPs and PAs in NC,
  1990-2001

60
Trends in Physicians Delivering Babies
2000 2001 2002 2003 2004
OB/GYNs 919 937 954 960 981
OB/GYNs Delivering 651 701 742 750 748
OBs 70.8 74.8 77.8 78.1 76.2
FPs 2,173 2,224 2,293 2,327 2,040
FPs Delivering 212 227 228 232 205
FPs 9.8 10.2 9.9 9.9 10
61
Osteopaths, relatively few, but growing fast in
numbers
400
350
300
250
Number of DOs
200
150
Growth rate of gt10 per year
100
50
0
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
62
Evaluation
63
Medical Student Tracking(Class of 1996)
North Carolina Medical Students-Retention in
Primary Care 1996 Graduates
Primary Care Family Medicine, General
Pediatric Medicine, General Internal Medicine,
Internal Medicine/Pediatrics, and
obstetrics/gynecology.
Sources
64
Medical Student Tracking(Class of 2002)
North Carolina Medical Students-Initial Choice of
Primary Care 2002 Graduates
Primary Care Family Medicine, General
Pediatric Medicine, General Internal Medicine,
Internal Medicine/Pediatrics, and
obstetrics/gynecology.
Sources
65
Informing Policy Makers NC AHEC Special
Requests

• Provide research support to Central NC AHEC
  office
• Rural Curve
• Retention of physicians who do NC/AHEC residency
• Other miscellaneous requests

66
Allied Health Studies
67
HPDS 3 Main Product Lines
Maintenance of Licensure Data Files for HPDS
Special Projects Service to the State and the
Institution
Allied Health Workforce Studies
This function is the backbone of our work. It
takes substantial time and staff effort to
collect, clean, edit, and disseminate licensure
data. Sustaining maintaining this
infrastructure is challenging.
The HPDS often undertakes special research
projects at the request of the NC AHEC, UNC Board
of Governors (respond to legislation, make
presentations), licensure boards etc. This
service has increased the visibility of the Sheps
Center to important local sponsors and
policymakers.
Funded by the Duke Endowment and the NC AHEC,
research has focused on quantifying the supply
of, and demand for, allied health workers.
Findings highlighting the growth of allied health
employment have gained the attention of policy
makers. Staff in the Governors office, the
legislature, and other state agencies are working
to develop innovative ways to transition
unemployed individuals into allied health jobs.
68
The State of Allied Health in NC

• Policy Issue Making link between allied health
  workforce vacancies and economic development in
  rural NC
• Key Findings
• Between 1999-2005, overall employment in NC grew
  by 0.2 compared to 20.2 growth in health care
  jobs and 45.8 increase in allied health
  employment
• Allied health comprises 37 of all health care
  jobs
• 8 of top 10 fastest growing professions (across
  all employment sectors in are in allied health)
• Policy Response Pending
• We have requested funding for continued
  monitoring of allied health workforce

May 2005
69
Manufacturing and Health Care Social Assistance
Employment, NC, 1995-2005
900
822, 995
800
Manufacturing
700
568,835
600
Employment (thousands)
500
491,637
400
Health Care Social Assistance
300
332,446
200
100
0
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Year
Source North Carolina Employment Security
Commission, 2006.
70
Healthcare and Allied Health Jobs Grew, Overall
Employment Remained Stagnant
Total State, Healthcare and Allied Health
Employment, North Carolina, 1999-2005
1999 2005 Growth (1999-2005)
Total N.C. Employment 3,801,670 3,809,690 0.2
Healthcare Jobs 251,550 302,270 20.2
Allied Health Jobs 76,590 111,630 45.8
Source Bureau of Labor Statistics. Occupational
Employment Statistics. State Cross-Industry
Estimates 1999-2005. URL http//www.bls.gov/oes
/. Accessed 06/28/2006.
71
North Carolinas Fastest Growing
OccupationsPercent Change in Employment,
2002-2012
Rank Occupation Projected Openings Change
1 Medical Assistants 4,950 60.9
2 Occupational Therapy Aides 30 60.0
3 Dental Hygienists 2,590 53.9
4 Dental Assistants 3,120 53.0
5 Social and Human Services Assistants 5,110 48.4
6 Medical Record Tech. 2,620 48.3
7 Physical Therapist Assist. 720 47.7
8 Fitness Trainers 2,780 47.6
9 Respiratory Therapy Tech. 330 47.1
10 Respiratory Therapists 1,170 46.8
http//eslmi23.esc.state.nc.us/projections/Employm
entOutlook.asp?versionaopengpAreaType01Area00
0037PeriodID06
72
Health Care Jobs in North Carolina, 2005
Other, 3
Physicians, 5
LPNs, 5
Allied Health Professions, 37
RNs, 24
Total Health Care Jobs 302,270
Nurse aides, orderlies and attendants, 26
Note "Other healthcare occupations" includes
chiropractors, dentists, optometrists, and
pharmacists. Source U.S. Bureau of Labor
Statistics, Occupational Employment Statistics
(2005). URL http//www.bls.gov/oes/.
73
Job Vacancy Tracking Reports

• Purpose Estimate workforce demand for selected
  allied health professions
• Method Monitor weekly job listings in newspaper
  and online sources
• Data Latest data collected for twelve
  professions during 10 week period (September
  24-November 26, 2006)
• Results
• Number of vacancies
• Distribution of vacancies by region and
  profession
• Types of employers advertising vacancies

April 2007 August 2006 April 2005
74
Medical Assistants Employed in North Carolina,
2002-2006
Medical assistants are growing at nearly double
the projected growth rate
Source North Carolina Health Professions Data
System with data from the Employment Security
Commission
75
Licensure File Creation and Maintenance

• Files are received annually from Boards,
  effective Oct. 31
• Applications analyst programmers clean and edit
  files
• Compare new files to previous year to look for
  changes in variables
• Code individuals to counties based on ZIP code
  data
• There are checks in place to flag inconsistencies
  which we then investigate, but otherwise we do
  not verify the accuracy of each record
• Generate tables of summary statistics for review
  by Data Book Coordinator

76
Licensure File Creation and Maintenance
(continued)

• File audit
• Aggregated totals by variable are compared to
  previous years by state and county
• Programmers scrutinize files where strange
  patterns are detected
• Final review by HPDS staff and approval for
  release
• Feedback to Boards
• Tables of aggregate statistics by geographic
  region are returned to boards for their reference
• HPDS sends feedback to boards on potential data
  collection issues, trends in the data

77
Licensure File Creationand Maintenance
October
Files received from Boards, effective Oct. 31
Compare variables received to previous years
variables
Applications analyst programmers clean and edit
files
Code individuals to county based on ZIP code
Release Data Book, Post data to web
The entire process takes nearly a year from start
to finish
August
Feedback to Boards
Generate tables of summary stats for review
File Audit compare, investigate
Final review, approval for release