East Carolina University
Academic Program Review
2016
Graduate Health Informatics Certificate Program
Graduate Health Care Administration Certificate Program
Graduate Health Care Management Certificate Program
In
The Department of Health Services and Information Management
Prepared by:
Dr. Xiaoming Zeng, Professor and Chair, Health Care Management Program Director
Dr. Pat Royal, Associate Professor and Health Services Administration Program Director
Dr. Robert R Campbell, Associate Professor and Health Informatics Program Director
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Executive Summary
Three graduate certificate programs -- Health Care Administration (HCA), Health Care Management (HCM)
and Health Informatics – from the Department of Health Services and Information Management (HSIM)
are included in this self-study for Academic Program Review. HCM is an optional certificate for students
enrolled in the MBA program within the College of Business. HCA and HI are stand-alone certificate
programs housed in HSIM. The HCA and HCM programs have similar courses in their curricula.
Purposes:
The goal of the HI certificate program is to equip students with the knowledge and skills needed for
employment and success in the emerging field of health informatics. The program is designed for health
care workers having no previous informatics training and for information technology workers having no
previous health care experience, seeking employment in health care as health informaticians.
The goal of the HCA Certificate program is to increase skill sets and position students for advancement
within management of a health care facility.
The goal of the HCM Certificate/MBA program is to prepare students for careers as managers in a variety
of health care organizations. As they progress through the program, students will acquire skills related to
the financial, legal, and logistical operation of a health care facility.
As the emphasis in healthcare continues to focus on population health, coordinated care, value-based
care, lean thinking, and patient-centered care, practical knowledge of health care management and
health informatics will position students for successful careers in healthcare. The training of the current
workforce will contribute to the regional transformation of Eastern North Carolina. Furthermore, the
three certificate programs are directly aligned with five guiding principles found in ECU’s 2014 Strategic
Plan: increasing opportunity, producing graduates ready to work and serve, developing leaders,
improving health, and keeping the commitment to diversity and inclusiveness. The HI and HCM programs
are unique in a sense that they are tied to a graduate degree program. HI graduates could transfer all
courses into MS HIIM program and HCM students could use the courses in the certificate as their
electives in the MBA program. All three certificate programs are offered in both face-to-face and online
formats; students potentially are able to complete the programs in a year; and job prospects for
graduates of each program continue on an upward trend.
Enrollment
From 2009 to 2015, enrollment in all three-certificate programs has followed an upward trend (Table 1).
TABLE 1 CERTIFICATE PROGRAM ENROLLMENT
2008 2009 2015
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Health Informatics 0 9 27
Health Care Administration 3 2 27
Health Care Management 21 15 33
Because many of the students enrolled in the three programs are working professionals, the majority of
them favor the distance education format, which provides them with the flexibility they need to fit their
educational needs into their busy lifestyles. Of the three programs, the HI and HCA certificates displayed
the most diversity, with 41% (HI-spring 2015) and 47.5% (HCA-spring 2015) of the enrolled students
indicating minority status. The majority of the HCM students (82% -spring 2015) identified themselves as
Caucasians. All three programs showed a preference for in-state female students, which is somewhat of
an outlier due to the fact that health informatics, is considered a technical field populated by a male
workforce. The number of graduates in all three programs has increased over the last seven years as is
evidenced below in Table 2.
TABLE 2. CONFERRED CERTIFICATES IN HI, HCA, AND HCM
2008 - 2009 2014 - 2015
Health Informatics 0 8
Health Care Administration 0 22
Health Care Management 13 16
Estimates for two-year completion rates hold at 31% for the HI program, and 51% for the HCA program.
Although the department does not track job placement data for the graduates of the three certificate
programs, data available from NCTower demonstrate that the average salary of HCA/HCM certificate
program graduates is potentially comparable to the average salary of graduates from the ECU MBA
program.
To increase student success, the department has taken the following steps:
1. Adjusted course sequence so students can complete the certificates within a one-year period.
2. Advisors from the MBA program are now counseling students in the HCM program.
3. An HI student completed an optional internship at the NC Hospital Association. The department
facilitated this internship opportunity in an effort to enhance the student’s employment
opportunities upon completion of the certificate program. The student is now working full-time
at Allscripts, a health care information technology company based in Raleigh.
4. Use Health Information Technology simulations to enhance experiential learning.
In the future, the department will consider implementing the following actions to increase student
success:
1. Increase the GPA admission requirement for the HI and HCA certificates to 2.75.
2. Add elective courses to the HI curriculum.
3. Report HI outcomes at the annual MS HIIM advisory meeting.
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4. Add electives to the HCA curriculum if the department’s Master in Health Administration program
is approved and established.
5. Work with IPAR to develop surveys to track student satisfaction and employment.
6. Meet regularly with MBA advisors to discuss student advising issues.
7. Request additional faculty line(s) to cover the increased teaching and advising load.
8. Include tuition surcharge to fund a position to coordinate advising in several graduate programs.
Curriculum and Learning Outcomes
All three certificate programs have short curricula (12-15 s.h.), with students matriculating on a rolling
basis and having the option to complete their plan of studies in one year by taking two classes per
semester. In the HI program, HIMA 6060 is a co-requisite for other courses in the curriculum.
Furthermore, if a student does not have educational or professional experience in the health care field,
they will be required to take COHE 6000, which is also a co-requisite in the HCA program.
Overall, positive learning outcomes are evidenced by students in all three-certificate programs. However,
there were some weaknesses identified: primarily in students who struggled completing two writing
assignments, and students who experienced problems completing several database modeling exercises.
To ameliorate these programs, rubrics were created to measure students’ learning outcomes, instructors
received training on how to teach students to write well, and more exercises were built into course
instructional sequences in an effort to improve student-learning outcomes. Over the past year, learning
outcomes have improved in the areas of student writing and database modeling, with course instructors
continuing to monitor student outcomes in an effort to engender greater levels of achievement.
The department’s action plan for improving the certificate programs curriculum and pedagogy are as
follows:
1. Include more electives in program course offerings to provide more options to the students.
2. Continue to monitor the results from the student learning outcomes assessment plans to address
identified deficiencies.
3. To improve students’ overall educational experience and satisfaction, a social media page will be
created to engage all students enrolled in or who have graduated from each of the three
programs.
4. Invite students to attend graduation and meet with faculty.
5. Procure resources to hire a coordinator to advise students enrolled in the department’s
certificate and degree programs.
6. Work with IPAR to implement surveys to track student, graduate and employee satisfaction rates.
Faculty Resources:
Full-time faculty in the department are certified to teach in their area of specialization, which, in this case,
is either health informatics or health services administration. Given current faculty resources, along with
the support of adjunct faculty, resources are enough to deliver the curriculum. Full-time faculty are
charged with teaching between six and nine sections per year. In an ideal situation, the addition of one
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or two new faculty members would lower the average teaching load so that faculty members could focus
more on research, as this was one weakness identified in the self-study. However, recruiting and
maintaining faculty has become a challenge due to the relatively low salaries being offered in the College
of Allied Health Sciences.
In the future, strategies for recruiting and retaining quality faculty members will include:
1. Targeting new professionals who have recently obtaining their Ph.D.
2. To advertise open faculty positions by using diverse online and print resources.
3. Match faculty teaching and research interests to the courses that they teach to maximize
satisfaction.
4. Continue to recommend and nominate faculty for research and teaching awards.
5. Address the problem of salary compression whenever possible.
As a unit, in 2014 – 2015, the faculty in the department generated an equivalence of 18.47 FTEs, which
represents the work of 13 faculty members. Additionally, more SCHs have been generated in the past
seven years due to the addition of graduate programs and increased enrollment in each of the graduate
programs.
The teaching load per faculty member in the fall of 2013 was 2.88 sections. According to the CAHS
workload policy, full workload of a faculty member is equivalent to teaching 10 3-credit hour courses per
year. In other words, if a faculty member taught 10 3-credit hour courses in one year, the faculty member
would not be required to perform research or service activities. On average, HSIM faculty teach 8
sections per year. Program directors may have a 1-2 section reduction through the aid of course
reassignment. Junior faculty member(s) will have lower teaching loads in order to build their research
portfolio for tenure review. Currently, there are no graduate teaching assistants available to the
department.
Faculty within the HSIM department are committed to teaching. Six faculty members have received
college level awards, while 4 have received university level awards. Faculty member constantly upgrade
and revise their teaching pedagogy to improve student learning. Over the past 4 years, the department
has been the recipient of the BB&T leadership enhancement grant each year, which designates funds for
integrating leadership training in the classroom.
An area in need of improvement for the faculty is in research, especially externally funded research. In
general, the HSIM faculty have published more books than the combined average of 119 other health
sciences programs in the nation, but fewer refereed journal articles, citations and grants.
Faculty provides service at all levels from departmental to professional organizations. The department’s
faculty serve on various university committees, as members of faculty senate, and on search committees
for new faculty, deans, and library directors. At a national level, four faculty members serve as chairs of
program review committee for the Association of University Programs in Health Administration (AUPHA),
and one faculty member is a program site reviewer for the Commission on Accreditation for Health
Informatics and Information Management Education (CAHIIM).
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The action plan for sustaining the strengths of department faculty and addressing perceived weaknesses
includes the following steps:
1. Recruit faculty members who are oriented towards research.
2. Nurture junior faculty to develop a research agenda.
3. Provide start-up funding to new faculty members.
4. Educate current faculty on external grant opportunities.
5. Increase the weight of grants and journals in annual evaluations.
6. Consider adding the requirement of grant proposal submission to the department tenure and
promotion guidelines.
7. Encourage collaboration with established researchers on campus.
8. Reassign faculty time for preparing grant proposals.
9. Support requests for funding for presentations at conferences.
10. To free up faculty so they can focus on research and creative activities, request funding to hire
adjunct faculty to teach low-level courses.
Regional Transformation – Economic Development/Public Service
Over the past 7 years, the department has been involved in projects focusing on regional economic
development and public service:
Capstone internship
Service learning course
Patient Centered Medical Home (PCMH) project
ECU Physicians Portal Project
Health Informatics Job Fair and Symposium
Brody Redesigning Education to Accelerate Change in Healthcare (REACH) project.
Additional Resources
Although the current resources are adequate for the operation of the department, they are insufficient
for the growth of the department. We need additional resources to address needs for increased
enrollment, additional requirements on compliance and reporting, and to support faculty in research, as
pointed out in the self-study. Although the current classroom and office space is enough, continuing
support of the college educational technologist will be important to sustain the programs to provide
quality teaching.
Additional resources needed are graduate student assistants, a graduate program coordinator, and
support from IPAR in terms of data collection on the output and outcome of the programs in the
department.
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Full Report
Three graduate certificate programs – Health Care Administration (HCA), Health Care Management
(HCM), and Health Informatics (HI), administered by the Department of Health Services and Information
Management -- are included in this self-study for ECU Academic Program Review. Because of the concise
curricula of the certificate programs and similarity between the HCA and HCM programs, instead of
individual reports for each program; we report the three programs together in this self-study.
HCM is an optional certificate offered within the MBA program. The College of Business advises the
students, with all courses delivered by the HSIM faculty. HCA and HI are offered as stand-alone graduate
certificate programs. There are other certificate and degree programs in the department – MS in Health
Informatics and Information Management (MS HIIM), Graduate Certificate Program in Health Information
Management (HIM), and BS in Health Services Management (HSM). They are excluded from this self-
study because BS HSM and MS HIIM are either accredited or certified by external accreditors and HIM is a
new program just established within a year (HIM). Although what reported here is specific to the three
certificate programs, inevitably, some data at the department level will be reported since they are
pertinent to the questions addressed in the Academic Program Review.
History of the programs: The HCM program was originally offered by the Department of Community
Health (COHE). COHE merged with HSIM in 2008; therefore, HSIM started to teach the courses in HCM. In
2009, due to the increased demand from the students who would like to have a standalone certificate
program in health administration without formally enrolling into the MBA program, the HCA certificate
program was established. Most of the courses are shared between the HCA and HCM programs. Dr. Pat
Royal currently is serving as the program director.
The HI certificate program was established in 2009 with a grant from the UNC General Administration (GA)
to establish an online certificate program in health informatics within the UNC system. The rationale for
the program is to educate professionals about health informatics, particularly in the context of electronic
medical record implementation. The courses in the HI certificate program have been included in the
curriculum of the MS HIIM program, after the latter was established in 2013. Dr. Robert Campbell is
currently serving as the program director.
1. Program Purpose
1.1. Provide a clear and concise statement of the program’s purpose.
HI: The goal of the certificate program is to equip students with the knowledge and skills needed
for employment and success in the emerging field of health informatics. The program is open to
any student with an earned baccalaureate degree and an interest in pursuing a professional
career in health informatics.
The program is designed for health care workers who have no informatics training and for
information technology workers who have no health care experience and may wish to seek
employment in health care as health informaticians. The objective is to expand upon the
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student's current knowledge skills to make them more capable and well trained in the field of
health informatics. The students will acquire substantial knowledge and skills at the intersection
between health care and information technology.
In the case of current health care workers who have health care related degrees, exposure to
certificate courses should increase their skillset for practice in an information intensive health
care environment. For students with computer or information technology degrees, the
certificate courses will expose them to the uniqueness and complexity of the work processes
found in a health care environment.
HCM: The Health Care Management Certificate/within the MBA program includes information
on financial, legal, and operational issues in health care. The program will also focus on how
these issues differ from those found in other related industries. Students are prepared for
careers as managers in a variety of health care situations. The knowledge gained from this
certificate can be applied to hospitals, ambulatory care centers, long- term care facilities, health
research and clinical trials, home health care agencies, and health insurance companies.
HCA: The certificate was created to increase skill sets and position students for advancement
within the management of a health care facility. It is designed for health care workers who hold
non-administrative degrees and for administrative degree holders (Business or Public
Administration) who have no health care experience and may wish to seek employment in
health care.
Specifically, candidates who successfully complete the certificate should be able to have a better
understanding of the organizational structure of a health care facility. This includes knowledge
of how reimbursement systems function, the basics of third party payment, appreciation for
legal and regulatory constraints that affect the operation, management, and financing of health
care organizations, and an appreciation for the role information technology plays in managing a
health care facility.
1.2. Describe how the program’s purpose aligns to the University’s mission and strategic
initiatives.
ECU’s mission reads:
To be a national model for student success, public service and regional transformation, East
Carolina University:
Uses innovative learning strategies and delivery methods to maximize access;
Prepares students with the knowledge, skills and values to succeed in a global,
multicultural society;
Develops tomorrow’s leaders to serve and inspire positive change;
Discovers new knowledge and innovations to support a thriving future for Eastern
North Carolina and beyond;
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Transforms health care, promotes wellness, and reduces health disparities; and
Improves quality of life through cultural enrichment, academics, the arts, and
athletics.
The purpose of the three certificate programs is to prepare professionals who hold baccalaureate
degrees and desire to gain more knowledge and skills in either health care management or
informatics. With the increasing demand on population health, coordinated care, valued- based
health care, lean thinking, and patient centered care, knowledge and skills in the two areas of
management and informatics will ensure the success of the students.
All three-certificate programs are offered online, to provide flexibility to the students who are
working professionals. The HCM program is an optional certificate program within the MBA
program that allows students to gain in-depth management knowledge in health care while
completing their MBA degrees, which consequently, will help the students to succeed in the
health care industry. Most of the students are from the state of North Carolina and likely to stay
in the state to contribute to the economy of the state and region.
The three programs are associated with the following guiding principles of ECU’s 2014 strategic
plan:
Increasing opportunity – additional certificate training will increase the chance the students
will find employment and/or get promoted.
Produce graduates ready to work and serve – the graduates, with specialized knowledge will
be prepared to enhance their current knowledge and skill set, and contribute to the economy.
Develop leaders – the programs teach management and informatics in health, which are
factors in the changes taking place in health care. Graduates will be able to lead the process.
Improve health – one of the goals of health care management and health informatics is to
improve the process of providing health care.
Keep our commitment to diversity and inclusiveness – as discussed below in the Enrollment
section; all three programs have a diverse study body.
1.3. Articulate specific and unique features of the program that distinguish it from others.
HI: The HI program is offered in both face-to-face and online format. Since 2013, it has been used
as a “stepping stone” to MS in HIIM. GRE test will be waived as long as students earn a 3.5 overall
GPA in the certificate. All courses in HI can be transferred into the MS HIIM program if the
students are accepted into the program. Students favor such an arrangement because it eases
their anxiety of taking a standardized examination and provides an option to earn a certificate
first. The certificate meets the criteria for federal gainful employment disclosure.
HCM: HCM is offered as an optional certificate for MBA students in the College of Business.
About 20% of the ECU MBA student population chooses to pursue an optional certificate to
satisfy the elective requirement for their MBA program. These certificates are designed to
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provide a student with insight into a specific industry. The courses in the HCM do not include a
tuition surcharge, which lessens the financial burden placed on the student.
HCA: HCA is the only stand-alone certificate in Health Administration offered from the UNC online
program (online.unc.edu). The certificate specifically targets individuals who are already, at least
minimally, involved in health care; however, with continual changes in the health care system,
some of these individuals are lacking the current body of knowledge necessary to remain up-to-
date with current policies and regulations. The certificate can be completed in 3 semesters,
which appeals to many students – especially those who need specific courses for advancement
within their current place of employment. The certificate does accept individuals without health
care experience; however, these students are required to take a specific course that provides an
overall focus on health care. The certificate meets the criteria for federal gainful employment
disclosure.
1.4. Describe the external factors that impact the program’s enrollment and market demand of its
graduates based on statewide, national and/or professional studies
The Health care sector has experienced increased workforce needs while other industries such as
manufacturing have slowed down in hiring. The reasons for the workforce needs include an aging
society, the Affordable Care Act (ACA), increased public and private investment in health care,
and increased use of technology, especially health information technology.
According to the Bureau of Labor Statistics – the field of medical records and health information
technicians (http://tinyurl.com/o9stu6w) will have a 15% job increase from 2014 to 2024.
Employment change will be 29,000 news jobs (Please note there is no separate job title dedicated
to health informatics). The field of Medical and Health Services Management
(http://tinyurl.com/chnz7qm) will have a 17% increase in jobs from 2014 to 2024. The
employment change is 56,300. Both projections are considered above average.
Figure 1 shows the 10-year job trend using the key search phrase “Health Informatics” on
indeed.com – a popular job search website. It shows an increase of job listings from 0.03 to 0.08
when compared to other job postings on the website. Notably, the peak of job postings was circa
2011 when the Federal Government enacted the “Health Information Technology for Economic
and Clinical Health Act” that included incentives and penalties to stimulate the implementation of
Electronic Medical Record systems. Figure 2 shows the job postings using the key words “health
management administration”. It indicates an upward trend of the need for health care managers,
especially after the Patient Protection and Affordable Care Act was passed in 2009. More health
care managers and administrative staff members are needed to handle the additional number of
newly insured patients. The increased pressure on coordinating care for better value in health
care also stimulates the need for the current health care workforce to be retrained.
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FIGURE 1 JOB TREND OF THE KEYWORDS "HEALTH INFORMATICS"
FIGURE 2 JOB TREND OF THE KEYWORDS "HEALTH MANAGEMENT ADMINISTRATION"
2. Enrollment, Degrees and Student Success
Enrollment and Degrees Analysis
2.1. Describe the program’s enrollment trend over the last seven years.
Enrollment time series data from fall 2008 to spring 2015 are depicted in Figure 3. Because of
the increased societal demands as discussed above in 1.4, all three programs enjoyed
enrollment growth from the fall of 2008 to spring 2015.
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FIGURE 3 ENROLLMENT OF HI, HCA, HCM CERTIFICATE PROGRAMS
HI: The health informatics program enrolled its first student in the spring of 2009. It steadily
increased to 27 students by the spring of 2015. The peak of enrollment was in the fall of 2013
with 32 students. The majority (>96%) of students are part-time because most have a full- time
job and use the certificate program to gain additional knowledge to support their job duties. In
combination of full- time and part-time students, the full- time equivalent student numbers have
increased from 0.25 to 10.25. Currently, all of the students (100%) in the program reside in
North Carolina. The majority of the students (at least 89%) are DE only, which correlates with
the working professional profile of the students. In the spring of 2015, all students in the
program are DE. While health informatics is a technical area, surprisingly, the majority of the
students are female (>78%). This probably is because the working professionals in health care
have become more female dominated. The percentage of minority students has increased from
22% in the fall of 2009 to 41% in the spring of 2015. The majority of the students (93%) are 25
years or older.
HCA: The program began in the fall of 2008 with 3 students. The enrollment numbers for new
students in the spring of 2009 was 1 which was not surprising considering students were advised
to start either in summer or fall due to course sequencing. By the fall of 2009, 14 new students
had enrolled in the program. This trend (higher fall enrollments) continued until the peak
enrollment of 36 new students in the fall of 2012. After this date, the numbers of new students
started declining per semester, but the disparity between fall and spring became less so the
overall number of students admitted yearly was still fairly consistent with little growth when
compared to earlier years. In 2012, admission for summer enrollment was being tracked
separately and those numbers have been consistent with average admissions of around 13
students per summer. The total number of students who have been admitted to the certificate
program since 2008 is estimated to be approximately 320. This number does include returning
students. These students are typically counted as part-time students due to the nature of the
0
10
20
30
40
50
60
Fall2008
Spring2009
Fall2009
Spring2010
Fall2010
Spring2011
Fall2011
Spring2012
Fall2012
Spring2013
Fall2013
Spring2014
Fall2014
Spring2015
HI, HCM, HCA Enrollment
HCM HI HCA
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certificate program, meaning they can only take 2 courses each semester due to course
sequencing.
The majority of the students enrolled in the HCA certificate are distance education students.
Estimates hold that roughly 75% of the students apply as distance education students.
Additionally, the majority of the students reside in-state. Approximately 80% of the students are
in-state. The in-state distribution is 15.7% (Western NC and Charlotte Areas), 44.7% (Triad and
Triangle Areas) and 39.6% (Eastern North Carolina) while out of state student distribution is 20%
(Midwest), 40% (South) and 40% (Unknown).
The racial breakdown of the student population is: 52.5% White, 31.7% Black or African
American, 2.3 % Asian, 1.5% American Indian or Alaskan Native,1.5% two or more races, 1.1%
non-resident Alien, and 9.4% unknown (Note these percentages do not include the missing
numbers of summer students not captured in the data set)
The gender breakdown of the student population is 83.6% Female and 16.4% Male. The age
distribution is 1.5% (19-21 years old), 17.4% (22-24 years old), 30.2% (25-30 years old), 32.8%
(31-40 years old) and 18.1% (41-64 years old).
To be admitted into the HCA certificate, students are required to have a minimum GPA of 2.5
either in undergraduate or graduate course work. There are no other standardized tests
required.
HCM: The HCM program, as an optional certificate program for the MBA program, has had a
more stable enrollment over the last seven years. In the fall of 2008, there were 21 students
enrolled in the program. In the spring of 2015, there were 33 students in the program. The
program peaked around the fall of 2011 (53) and spring of 2012 (54). Similar to the other two
programs, HCM has more part-time students (55%-85%). The number of full- time equivalent
students has been between 42 in the fall of 2011 to 15.50 in fall 2008. In the spring of 2015,
HCM has 23.5 FTE students. Again, the majority of the students (>94%) are in-state due to in-
state tuition. Distance Education has become more popular among the students – the trend
became even more obvious after the spring of 2012 when the percentage of DE students
increased from 72% to 88% in the fall of 2012. Similar to the other two programs, HCM has more
female students (55%-70%). The majority of the students are Caucasian (61% -- 95%) other than
in the fall of 2010 when 44% of the students were minority and 39% were Caucasian. As
expected, the majority (>80%) of the students are 25 years or older.
2.2. Describe the trend regarding the number of certificates conferred each year.
Figure 4 shows the numbers of conferred certificates in all three programs from 2008 – 2015. It
clearly shows that the HCA and HI certificate programs have been steadily graduating more
students each year. For the HCM program, there was a sharp drop of conferred certificates from
2012-2013 to 2013-2014, which correlated with the drop of enrollment in the previous years.
Notably, not all certificate students apply for graduation once they completed all their course
work. Since 2013, some of the HI students continued their studies in the MS in HIIM program
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and did not apply for graduation from the certificate program. The implementation of
DegreeWorks will help to collect data that are more accurate on the number of certificates
conferred from these programs.
FIGURE 4 DEGREE CONFERRED
2.3. For graduate programs, describe the trend regarding completion rates (3 and 5 years for master’s;
7 and 10 years for doctoral programs) and time-to-degree of the students. What actions have
been taken to improve degree completion and time-to- degree?
We are not actively tracking data on the completion rates of the certificate programs. Data had
to be manually queried and calculated in order to estimate the completion rates of the programs.
For the HI and HCA programs, most of the students take one or two courses per semester as
part-time students. Many students may decide to stop taking courses in the curriculum without
notifying the program director. For the HCM program, because students are MBA students
taking the optional certificate program for their electives, tracking completion rate is not
applicable.
To examine the completion rates, we manually examined the registration records of the
students to calculate the completion rates of each term. Figure 5 shows the completion rates of
the HCA program from fall 2010 to summer 2015. The completion rate has improved over time
from 32% in fall 2010 to 50% in Summer 2015. The highest completion rate was 76% in the
spring of 2014. The completion rates were lower after that term because some students are still
taking courses. The overall completion rate of the HCA program during the period is 51%. Most
of the students finished the program within 2 years.
0
5
10
15
20
25
30
35
2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015
Certificates Conferred
HI HCM HCA
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FIGURE 5. HCA COMPLETION RATE
Figure 6 shows the completion rates of HI students from summer 2009 to summer 2014. The
completion rate has improved from 0 in summer 2009 to 40% in summer 2014. The highest rate
was 100% in the summer of 2012, but there was only 1 student in the cohort. Thirty-three
students out of the 96 enrollees have graduated from the program during this period. The
overall completion rate was 30/96 = 31.25%. Three students had completed all course work with
a passing GPA, but did not apply for graduation. Most of the remaining students have good
academic standing with a cumulative GPA > 3.0. Fifty-six students are considered inactive in
Banner with an average GPA of 3.45. On average, these 56 students completed 6.05 credit hours.
This confirms that many students use the certificate program to explore their options for future
career. Many have full time jobs and family commitment so they may just opt to discontinue
their study in the certificate program if they cannot maintain all their priorities.
FIGURE 6 COMPLETION RATE OF THE HI PROGRAM FROM SUMMER 2009 TO SUMMER 2014
0%
10%
20%
30%
40%
50%
60%
70%
80%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
HI Completion Rate
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Both HI and HCA are currently listed as programs that qualify for gainful employment. The
gainful employment initiative specifies that the programs may be completed in 30 weeks. This
will motivate future students to complete the certificate program in a timelier manner.
It is expected that including the Health Informatics certificate program as the feeder for the MS
HIIM program will also help to increase the completion rate of the HI program. Students will
have more motivation to complete the program and earn high GPAs in order to obtain admission
into the program and waive the GRE requirements.
Multiple extrinsic and intrinsic factor that may contribute to the low completion rates:
1) The programs are challenging. All courses are taught at the graduate level. Some students
were not prepared for the certificate program, especially for the technical and quantitative
courses;
2) Many students rely on financial aid. They might be financially challenged to complete the
certificate program;
3) With students disproportionally taking the courses online, it has made advising a challenge;
4) The number of courses are limited that students can choose in the certificate program
curriculum. If they receive a low grade in one course, it will be hard for them to maintain
their GPA above 3.0, as required by the graduate school.
2.4. Regarding the program size, is there a justification for expansion or contraction? What actions
have been taken that implement the University’s/College’s strategic initiatives regarding
enrollment management?
We deemed that all three programs are right-sized. Although the peak of the enrollment of the
HCA and HCM program around the fall of 2012 did create a challenge on teaching load and
course assignments, the total number of enrolled students in both programs has decreased since
then and stabilized around 27-33. We did not enforce enrollment caps or increased GPAs on the
applicants.
One reason for the decreased numbers in enrollment since 2012 may be attributed to the
implementation of the ACA and the increase in the ranks of health care administrators at health
care facilities throughout the United States.
The HI program has stabilized at around 27 students. Many of the students in the HI certificate
program have the intention to continue their graduate study in the MS in HIIM program. The
sizes for these programs are well justified and should not increase the pressure on the faculty’s
teaching load.
Student Success
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2.5. What is the 3-year trend regarding D/F/W rates in 1000- and 2000-level courses? Where
appropriate, how do the D/F/W rates in face-to-face courses compare to those in online courses?
What has the program done to address the courses with high D/F/W rates?
The D/F/W rates are only reported for undergraduate programs. Therefore, it is not applicable
for graduate certificate programs to report this data. Because the low number of students in
face-to-face sections, we are not able to compare the performances between the two different
delivery methods.
2.6. What is the job placement rate of the graduates? Does it meet faculty expectations?
We do not actively track the job placement for the current students for several reasons:
1) There are limited resources available for the programs to track graduates. No alumni survey
or employer survey for certificate programs are administered by IPAR so we have little data
to use for tracking the students. IPAR currently has an exit survey for students who graduate
from degree programs. The same survey could be potentially used for graduating students
from certificate programs.
2) Many students in the certificate programs are currently professionals seeking to gain
additional knowledge and skills about health care management and health informatics. They
are necessarily seeking employment after graduation.
3) Many students use the health informatics (since 2013) certificate program as a stepping
stone into the master’s program. All HI courses transfer to the graduate degree program. The
GRE requirement will be waived for admission into the MS HIIM program, if a student earns a
3.5 GPA or above in the HI certificate program. Therefore, it is not practical to track job
placement rates for those students.
According to NCTower.com (http://nctower.com/output/unc/9742/2012), data culled from 2011
– 2012 reported that 71% of the graduates from the HCA and HCM certificate programs found a
job within a year from graduation. The mean graduate salary is $61,408.
Data retrieved from NCTower.com report that 76% of the MBA students from ECU find
employment within one year of graduation. The mean annual salary of the graduates was
$52,794, therefore, the job placement of the HCM/HCA graduates is comparable the MBA
students. Faculty expectations, in terms of job placement for the certificate programs, have been
met by this limited data.
2.7. If applicable, what is the licensure pass rate of the graduates? Does it meet
faculty expectations?
There is no licensure requirement associated with any of the certificate programs.
2.8. What actions has the program taken over the past seven years to improve student success?
There have not been any specific actions to improve student success in terms of employment,
mainly due to the fact that no data has been collected in this area and to the nature of the
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certificate students. Student success would need to be defined before any actions could be be
taken. Certificate students are not necessarily expecting to enter the workforce, because, in
most instances, they are already gainfully employed. Success could be defined as promotions or
raises, but that type of data has not been collected. Additionally, success could be defined as
graduation in a specific time frame. However, due to the nature of the certificate program,
measurement of a specific period of time would not be generalizable across the student
population, since many to them enter the certificate with the realization that full- time work
schedules may preclude them from taking more than one course per semester. The following
examples highlight methods used to promote student success during their course of studies
within the program and after they graduate from the program.
We adjusted the sequence of the courses in the HCM and HCA certificate programs to ensure
students can complete the certificate program in one year. For example, we moved the
course COHE 6600 from the fall to the spring semester so students could finish the program
within a year when taking 2 courses per semester.
The MBA program handles advisement of students in the HCM certificate program.
We helped one student in the HI certificate program to participate in an internship at the NC
Hospital Association (NCHA) on data analytics, even though an internship is not required.
Now the student is an Application Support Consultant at the electronic medical record (EMR)
vendor Allscripts.
Throughout the courses offered in the certificate programs, an emphasis has been placed on
experiential learning, where students learn through reflection on doing. Investment and use
of Health Information Technologies such as NeehrPerfect and OpenEMR provide students
with hands on experience using some of the tools and applications they will use as employees
of a health care organization.
Action Plans
2.9. What actions does the program plan to take in the next seven years to increase enrollment and
student success? What resources are needed?
We will consider increasing the GPA requirement for admission from current 2.5 to 2.75.
Using Fall 2015 data, increasing minimum GPA to 2.75 will reduce the number of admissions
from 8 to 7 for the HI program and 12 to 10 for the HCA program. Although increasing
minimum GPA may decrease the admissions slightly, it will ensure that students admitted
into the program are better prepared for the rigors of graduate level education.
With more Health Informatics related courses available in the new MS HIIM program, we will
consider including additional electives in the HI certificate program so students can choose
courses that meet their interest. For example, privacy and security is an important topic in
health informatics, but currently, it is not part of the HI certificate program curriculum.
Because many students in the HI certificate program will apply for the MS – HIIM program,
outcomes from this program will reported at the annual MS – HIIM program advisory
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committee meeting. Feedback from the committee members will be solicited on how to
enhance the certificate program in terms of curricular and learning outcomes.
With the development of the potential MHA program and collaboration with the Department
of Public Health and Department of Health Administration at Appalachian State University,
we will consider adding more courses as electives for HCA or HCM students.
Since we are not tracking data such as student satisfaction or employer survey, we will work
with IPAR to discuss the possibility to track certificate program alumni through alumni
surveys or exit surveys for the graduates. However, current resources in the department will
prohibit us from administrating these surveys in house. The best strategy is to revise the
current IPAR survey for graduating students from degree programs and use it to collect
student satisfaction data from certificate program graduates.
We will have regular meetings with the MBA advisors to discuss issues and potential
improvements related to MBA students choosing the HCM program.
With the increase of enrollment numbers in the graduate programs, we would need to adjust
faculty teaching loads by hiring new faculty members or using additional adjunct faculty
members to teach in these areas. Currently, all full time faculty have been teaching at least 2
courses per semester (with the exception of summer) including both campus and distance
education sections, while relying minimally on adjunct faculty members. This scenario has
worked quite well over the past 3 years as opposed to some previous years (2011-2013)
where we were struggling to be able to provide the courses as needed due to higher
enrollment numbers. While hiring a new faculty member would not be out of the range of
possibilities, the number of students would need to remain consistent over a number of
years to predict a growing trend, which would substantiate a new hire.
One strategic action we may utilize in the coming 7 years is to consider the addition of a
tuition surcharge at the graduate levels. The workload of admitting and advising students,
along with the tracking and coordinating assessment and reporting outcomes for the
certificate programs and graduate degree programs is expected to increase over the next 7
years. With the potential addition of an MHA program, we need to have a dedicated staff
member to handle graduate student advising. The tuition surcharge will provide us the
resource to have that critical person to support the students. Similarly, the MBA program has
already applied a surcharge to their courses.
3. Curriculum, Learning, Outcomes and Student Satisfaction
The catalog page of the three certificate programs can be found here:
HI:
http://catalog.ecu.edu/preview_program.php?catoid=9&poid=2046&hl=%22health+informatics%
22&returnto=search
HCA:
http://catalog.ecu.edu/preview_program.php?catoid=9&poid=2045&hl=%22Health+Care+Admin
istration%22&returnto=search
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HCM:
http://catalog.ecu.edu/preview_program.php?catoid=9&poid=2057&hl=%22Health+Care+manag
ement%22&returnto=search
3.1. Based on degree requirements and the updated curriculum map, describe how course sequences,
including prerequisites, are used to introduce and reinforce student learning prior to students
being assessed.
Table 3 shows the courses in the HI, HCA, and HCM programs and the semesters they are
offering.
TABLE 3 COURSES IN HCA, HCM, AND HI
E: Elective F: fall S: spring SS: summer
HI: This certificate program requires successful completion of 15 s.h. from the following courses:
HIMA 6060 Health Informatics, COHE 6410 Electronic Medical Records, COHE 6420 Evaluation
Methods in Health Informatics, COHE 6430 Database Systems in Health Cares, COHE 6440 E-
Health Care Information Systems, and COHE 6450 Decision Support in Health Care. Students
having no previous experience in health care or who have not passed a graduate level course in
Health Care Delivery Systems must take COHE 6000 Health Care Systems and Problems as an
additional course. HIMA 6060 is offered in both fall and spring because it is an introductory
course serving as a co-requisite to the rest of the courses in the curriculum. The curriculum
content provides a solid foundation for students to gain knowledge about health informatics,
especially in the area of Electronic Medical Records system implementation. COHE 6420 is
offered in the fall semester, COHE 6410, COHE 6430 and COHE 6450 are offered in the spring
semester, and COHE 6440 is offered in the summer semester. A student can finish the
curriculum within a year if enrolled full- time.
HI HCA HCM Course F S SS
E X X COHE 6000 Health Care Systems and Problems X X X
X E COHE 6300 Health Law X
X COHE 6310 Health Care Accounting and Financial Management X
X COHE 6600 Management of Health Care Operations X
X COHE 6610 Financial Management of Health Care Organizations X
X E HIMA 6060 Health Informatics X X
X COHE 6410 Electronic Health Records X
X COHE 6420 Evaluation Methods in Health Informatics X
X COHE 6430 Database Systems in Health Care X
X COHE 6440 E-Health Care Information Systems X
X COHE 6450 Decision Support in Health Care X
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HCA: This certificate program has five required courses. The only course that may be substituted
is COHE 6000. For students without experience/education in health care, they must take a
different course (HIMA 6060) which is more introductory than 6000. Before proceeding to any
other courses, either one of these initial courses (6000 or 6060) must be successfully completed
or the student can take the first course as a co-requisite. For example, a student with experience
in health care can take COHE 6000 along with COHE 6310 in the fall semester. The following
spring semester, the courses offered (6600 and 6620) are higher level courses and build on the
knowledge from the previous semester. The final course 6300 is only offered in the summer
semester. When the program was created, we were using an attorney to teach 6300 (Health Law)
and he was only able to teach in the summer semester due to other workload issues. This trend
has continued which allows students to complete the certificate in 3 semesters.
HCM: This optional certificate is for MBA students who are interested in management in health
care. They can take the courses COHE 6000 Health Care Systems and Problems, COHE 6600
Management of Health Care Operations, COHE 6610 Financial Management of Health Care
Organization, and COHE 6620 Health Care Strategic Planning and Management. A student may
use COHE 6300 Health Law as a substitute with permission. COHE 6000 and COHE 6610 are the
prerequisite of the other courses. COHE 6610 is designed specifically for the MBA students
because they take finance and accounting courses from the MBA curriculum. Because the
certificate is part of the MBA program, students in the certificate may take one course a
semester to fulfill their elective requirements.
3.2. Describe the process the program uses to ensure the curriculum is up-to-date. Describe any
innovative approaches in the curriculum.
All curricula are reviewed at the department retreat in the summer. Faculty members discuss
issues related to curricula and decide on solutions. Faculty who are assigned to teach the
courses are responsible for keeping up with new developments in the field.
Below are some examples of innovative approaches in the curricula of the three certificate
programs:
1. A blog is used in COHE 6000 to encourage students to reflect and write about issues in
health care systems. Popular readings like the Bitter Pill and documentary movies such as
Sicko are assigned to stimulate discussions.
2. Students in HIMA 6060 are required to attend a weekly Health Informatics research seminar
series with online participants from five institutions in the state – ECU, UNC-CH, NCCU,
UNCC, and Duke. Students are required to write a 500-word reflection journal on the weekly
research seminar. This keeps the course content current.
3. Mediasite recordings are used extensively in the delivery of course content. Faculty
members record either in the classroom or from their desktop, if there are no face- to -face
students. Some faculty members who use desktop recording, record multiple short lectures
on course content in place of a long lecture to accommodate the learning style of online
students.
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4. Many hands- on tools are introduced to the students to encourage experiential learning.
ECU Virtual Computing Lab is widely used in the technical courses to provide online students
with hands-on experience. In COHE 6410 Electronic Health Records, students used
NeehrPerfect and the OpenEMR, two electronic health record applications, to gain
experience using different electronic health record applications. Furthermore, students in
this class participate in weekly chat sessions using SABA meeting. The chat sessions allow
students to interact with each other and the instructor in real time.
5. COHE 6600 – students (group project) are required to complete a design of a simulated
Accountable Care Organization based on the federal government guidelines enacted under
the new health care laws of 2010. This project asks students to research this enactment and
align their mock organization with the requirements mandated by the government
guidelines.
6. COHE 6000 – use of up-to-date cases introduce students to blogging which allowed students
to post an analysis on articles or cases. This strategy has introduced more thoughtful
interaction among the students. The required readings for this course are updated annually
and new articles dealing with current topics are introduced.
7. COHE 6300 – use current textbook and 60% of the course grade is derived from 17 case
studies. Lectures include video segments from an attorney currently practicing health law.
8. COHE 6620 – Instructor uses his personal experience as a health care administrator, along
with a set of case studies, designed to stimulate learning, and teach strategic planning.
9. COHE 6310 – instructor uses the Monte Carlo simulation tool @Risk. Additionally, a new
case study has been added to current material. The Cleverley text is updated when new
editions come out.
10. COHE 6430 -- health care database management topics (such as de-identification, merging
disparate databases, data integrity and validity, data capture best practices, and ensuring
HIPAA compliance) are fully integrated into each lecture, example, project, and assignment
in both theoretical and applied fashion. Thus, upon course completion, students not only
understand database management, but also have practical experience planning, analyzing,
implementing, using, and securing health care systems consistent with the needs of industry.
11. COHE 6420 – students are required to complete a PHS 398 grant application for a project
related to Health IT or Health informatics.
Student Learning Outcome Assessment
3.3. Based on learning outcomes assessment reports/data, what are the identified strengths and
weaknesses in student learning outcomes?
HI: One purpose of the Health Informatics certificate program is to provide training for
professionals involved in the implementation of the electronic health record. Student learning
outcome assessment is performed in COHE 6410 Electronic Health Records and COHE 6430
Database Management in Health Care.
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In COHE 6410, a writing assignment focusing on the impact Health Information Technology has on
the cognitive capabilities of the health care provider was assigned to the students. One instructor
using a rubric based on the Structure of Observed Learning Taxonomy evaluated student work.
The rubric classifies students thinking along five dimensions: pre-structural (no idea), uni-
structural (identifies one idea), multi-structural (identifies several ideas), relational (relates ideas
into a whole), and extended abstract (new theories and generalization). The criterion for success
on this outcome is that 80 percent of the students in the class would be judged as being at the
relational level of cognitive thought.
During the spring of 2014, 15.4% (N=13) of the students scored at a relational level on the rubric.
Students had difficulty relating ideas to form clearly stated thesis statements and hypotheses
about how physicians think and how health information technology can be used to promote that
thinking process. Students also struggled to evaluate how extended use of the electronic health
record may influence the physician’s cognitive processing of a presented patient problem.
In COHE 6430, students were assigned a database project. Project requirement included: an
entity relationship diagram, a relational model, the code used to create the database, and a set of
queries for retrieving data stored in the database. An instructor using a rubric based on the
Structure of Observed Learning Outcomes Taxonomy graded projects. The rubric classifies
students’ abilities along four dimension: pre-structural (no idea), multi-structural (identify several
ideas), relational (relate ideas into a whole), and extended abstract (new theories and
generalizations). The criterion for success on this assignment was for 80% of the students to be
judged as being at the relational level of cognitive thought.
The results from the spring of 2015 report that 75.0% (n=8) of the students were judged to be at
the relational level of cognitive thought or above. Students struggled with intermediate and
advanced concepts related to entity-relationship diagramming and the generation of sub-queries
and complex joins using the SQL programming language. Student’s strengths were found in their
understanding of basic entity-relationship modeling concepts.
In COHE 6410, student strengths were found in their ability to learn 15 core competencies that
are necessary for mastering the use of the electronic health record.
HCA/HCM: On the “Knowledge of Financial Concepts and Tools” measurement, students
displayed competency performing ratio analysis with the criterion being met. The results for the
self-study year were 91.4% of the students scoring at 70% or better. This measurement
improved from the previous year. The improvement was thought to be associated with the
additional recorded lecture the instructor used for reinforcement. In this same measurement
area, the criterion was not met for successfully using variance analysis: only 60% of the class
scored 70% or better. These data were for the self- study year; however, in previous years this
measurement performance had been met. To improve scores in this area, the instructor plans to
place more emphasis on this topic.
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Using the “Global and Local Issues” measurement, students have performed very well with 100%
of the students receiving a score of 100 on one question and 83.3% receiving a perfect score on
the second related question. This measurement has been very successful for the past several
years and was discontinued in 2014.
Using the “Strategic Direction in Health Care” measurement, students have performed well
overall, with 100% of the students scoring at or above 70% for the questions related to general
and health care environmental issue identification, and analysis, and service area competition
analysis. Therefore, the criterion was met for the self-study year. The criterion was met for the
previous year (2014); however, in prior years, the criterion was not met and the instructor
provided more instruction in this area to improve performance levels.
Based on the above three measurements, strengths have been identified in all areas: however,
the area of “Global and Local Issues” appeared to be the area with the most overall success. For
this reason, this measurement was discontinued in 2015, since certificates were only required to
include two measurements. The other measurement areas have performed well, but have had
some peaks and valleys, therefore, requiring additional input from faculty or the use of
additional teaching strategies. These strategies were successful in the self-study year and will
continue to be monitored over the next year.
3.4. Where applicable, are there any significant differences in student outcomes in face- to-face and
online programs?
Most of the courses have significantly more students in the online section than face-to-face
sections; therefore, it is not possible to state any significant differences in outcomes between
the two. In fact, the reduction of students in the face-to-face section has been significant over
the past few years, with only one to four students being typical for the face-to-face section. This
trend has been consistent in all courses for the certificate programs.
3.5. What decisions have been made and what changes have been instituted on the basis of on- going
assessments
HI: To improve performance on the course-embedded paper, students are given a set of learning
intentions that require them to think deeply about the concepts discussed in lectures and
assigned readings. The learning intentions are designed to help students build knowledge
structures so that important concepts can be related to other concepts, and then those concepts
can be used to develop new ways of thinking about the subject. Each week students are required
to turn in the learning intentions for a grade. The instructor reviews student submissions and
make comments that help students develop their formations of the concepts discussed in class. It
is hoped that the learning intentions will help promote student’s thinking which result in better
performance on the course-embedded paper.
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For the database project, increased instruction will be provided to students on the topic of
entity-relationship diagramming. Furthermore, a greater emphasis will be placed on presented
material on how to write sub-queries and complex joins, and students will be given more
exercises that will require them to generate sub-queries and complex joins in a functional
database.
HCA/HCM: The most significant changes that have been instituted over the past two years was
one of course scheduling. Previously, there were three courses in the fall semester, one in the
spring, and one in Summer I. This scheduling made it almost impossible for a student to
complete the certificate in 3 semesters.
3.6. How effective were the changes?
HI: In COHE 6410, the changes made to improve performance on the embedded writing
assignment are being implemented in the current spring semester. One initial finding from the
requirement to have students complete course learning intentions for a grade is that many of
them are struggling to complete the assignment using their own words to describe key concepts
discussed in class. So far, on feedback given to students, the instructor has stressed to students
the importance of explaining concepts in their own words, rather than using direct quotes from
the assigned readings and text. Requiring students to explain concepts in the own words will
signify that students are learning the material and have begun to construct their own knowledge
structures for the topic(s) under discussion. Furthermore, because writing reveals student
thinking, the ability to describe a concept in their own terms, is direct evidence that students are
beginning to think for themselves, which will be a key factor in whether they are able to think at
a relational level. When students are able to think at a relational level, and then on to an
abstract level, it will signify that students have moved beyond sheer memorization to higher
forms of thought that will allow them to generate solutions to problems encountered in the
workplace.
HCA: Making this change made a huge difference in the ease of finishing the certificate and
hopefully, will increase retention rates. This change is still somewhat new so it will probably take
another 6 months to see results in the overall graduation and retention rates.
Student Satisfaction
3.7. How satisfied are graduating students with the program?
We have not conducted a survey to measure the satisfaction of the graduating students. We will
consider embedding a survey link within DegreeWorks to collect the data. Anecdotally we
received accolades from students that confirmed their satisfaction with the program. Also, some
HI graduates continued their study in our MS HIIM program, which is indicative of the quality of
teaching and advising from the faculty and program directors.
3.8. How do graduating students/alumni evaluate the knowledge and skills they have
acquired in the program?
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We have not conducted a survey to have graduating students/alumni evaluate the
knowledge and skills they acquired in the program. Some students did let us know if
they changed to a new job after graduating from the program. This indicates the
knowledge and skills they gained from the certificate program have enable them to
develop a new career.
3.9. How do employers evaluate the graduates’ knowledge and skills? We have not been able to collect data from the employers. We will investigate a strategy to collect that type of data.
3.10. What actions has the program taken to improve student support, services, and
satisfaction?
The department has taken the following steps to improve student support,
services, and satisfaction in the past 7 years.
Program directors are given 1-2 section course reduction to allow time for student
support.
A certificate student dashboard, with the assistant of IPAR, has been created to
actively track the current standing of the students in each program.
The certificate program assessment plans, with assessment plans of other degree
programs, were discussed at the department summer retreat.
Action Plans
3.11. Are there new curricular and pedagogical changes that the program plans to implement in
the next seven years to improve student learning?
We plan to incorporate electives for the students in health informatics. If the MHA
program is approved and established, we will consider adding electives to the HCA
program as well.
We will continue to engage in the student learning outcome assessment especially with
the new curriculum map to make sure the assessments are meaningful and representative
of what students should learn and master after graduating from the program.
3.12. What will the program do to improve students’ educational experience and overall
satisfaction?
Since most of the students are online, there is no presence of community for them.
We plan to adopt the following strategies to engage these students:
Create a LinkedIn page for the certificate program students, especially the HI and
HCA students. We have a LinkedIn group page for the undergraduate degree
program and it has been successful in tracking students and alumni, generating
discussions, and sharing updates with the students. It also cultivates a sense of
community among the students.
Invite the students to a graduation reception so students can celebrate their
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achievements with fellow students and faculty. The current College graduation
ceremony does not include certificate students. We will communicate with the
College graduation committee to include the certificate students’ names in the
program.
3.13. Describe any additional resources needed to implement those changes. Additional resources will be needed in order for us to implement the changes proposed in section 3.12.
An additional faculty member in the department is needed to support the increased number of students.
A graduate student coordinator to help on admission, student advising, registration, and retention.
Partner with IPAR to collect data on graduates and employers about their satisfaction with the programs and assess the knowledge and skills learned in the programs.
4. Strength of Faculty: Teaching, Research and Scholarship
Faculty Sedona Generated CVs are attached
Faculty Resources
4.1. Faculty Profile: describe the current faculty affiliated with the department (e.g., percent full-
versus part-time, diversity, percent with terminal degree, tenure status, etc.).
As of the summer of 2015 (data from IPAR), there were 18 faculty members listed under HSIM.
Thirteen are full- time tenured (12) or tenure track faculty members (1). Five are part- time non-
tenure track faculty, a.k.a. adjunct faculty members who teach 1-2 courses each semester if
needed. Since then, 2 faculty members have retired and we are in the process searching for
their replacements. Among the 13 full-time faculty members, 12 hold doctoral degrees in
different fields. Historically health services management and health information management
did not require doctoral degree as the terminal degree so for most (11) of the faculty members,
the terminal degrees are not in the same CIP codes (51.2706 Medical Informatics or 51.0701
Health/Health Care Administration/Management). Through either terminal degree credentialing
or equivalent alternate credentialing, all faculty members including adjunct faculty are SACS
certified to teach at both graduate and undergraduate level. Among the tenured and tenure
track faculty, four are full professors, 8 are associate professors and 1 is assistant professor.
4.2. Faculty Resources: Does the department have the number and type of faculty to achieve its goals?
The current number of faculty members is sufficient to deliver the curriculum of both degree
and certificate programs. However, due to each faculty member teaching between 6 to 9
sections per year, it affects the research productivity of the faculty, especially in grant seeking.
Having research oriented faculty members who can engage in grant seeking activities will be one
of the goals for the department in the coming years.
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4.3. What actions has the department taken to recruit and retain highly qualified, diverse faculty?
Due to the salary freeze and budget cut in the past seven years, the salaries of the faculty are
below national averages and other programs in the UNC system. Table 4 is a comparison of
faculty median salaries between HSIM and other programs in the UNC system. We also
compared the median salaries with the AUPHA national benchmark data published in 2012. It
clearly shows that our salary level is below the national median level. The compressed salary
makes faculty recruitment and retention a challenge. For example, we had two faculty
candidates decline job offers because they would have had to take a cut in current salary to join
the department.
TABLE 4. FACULTY MEDIAN SALARY COMPARISON BETWEEN HSIM AND OTHER PROGRAMS IN THE UNC SYSTEMS
AND THE 2012 BENCHMARK DATA FROM AUPHA
Assistant Professor Associate Professor Professor
ECU HSIM (12 months) $71,000 $77,684 $97,896
ASU (9 months) $88,000 $116,640 (program director) N/A
UNC-CH (12 months) $114,700 $157,808.50 $160,580
UNCC (9 months) $64,535 $78,205 $118,408
AUPHA (12 months) $91,265 $107,871 $156,260
The actions we have taken to recruit and retain a highly qualified, diverse faculty are:
a. Target PhD students ready to get into the job market as faculty candidates.
b. In addition to posting job announcements to conventional outlets such as the Chronicle of
Higher Education, post to professional organizations’ websites and online job search engines.
c. Respect academic freedom by assigning faculty members to courses they have interest and
expertise.
d. Nominating excellent faculty members for teaching, research, and service awards to
recognize their contribution.
e. When the opportunity presents itself, address the salary compression issue. The faculty’s
salaries were adjusted between 4-8% during academic year 2015-2016 by using part of the 2
salary lines from two retiring faculty members. This partially corrected the compression
issue caused by little raise during the past 7 years.
4.4. Describe the trend in student credit hour production in the department over the past seven
years, for both Distance Education and campus courses, highlighting the department’s
contribution to the Foundations Curriculum and other degree programs. Consider the trend
of average credit hour production per instructional faculty FTE.
The overall Student Credit Hours (SCHs) produced by the faculty in HSM range from 5865 (2012-
2013) to 6920 (2009-2010). Figure 7 shows the changes of the undergraduate and graduate
SCHs over the period.
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Three patterns in the figure need to be recognized:
1) There was a significant drop of SCHs from 2009-2010 to 2010-2011. The reason is that the
department decided to reduce the BS HSM enrollment from 80 to 65 in anticipation of the
increasing graduate level teaching and for better teaching quality of the undergraduate
students.
2) The number and percentage of graduate SCHs have increased over time. This pattern is
attributable to the increasing students in the certificate programs, additional certificate
program and graduate degree program.
3) There was a reduction of the graduate SCHs in 2012-2014, when overall graduate
enrollment decreased at ECU. There was a significant decrease in MBA enrollment, which
may have contributed to the lower number of students, who took the optional HCM
certificate program. In addition, the BS in HIM program was being transitioned to the MS in
HIIM program. Not all the graduate courses in the program had been made available to the
students.
According to the UNC enrollment growth funding model, all majors in HSIM are in Category III – 1.
FTE is equivalent to 406.25 undergraduate FTEs and 186.23 graduate FTEs. In 2014-2015, the
department generated 18.47 FTEs (excluding summer on campus and non- fundable SCHs).
Figure 7 shows the overall SCH generated by both undergraduate and graduate programs in the
department over the past 7 years. It also shows the ratio between the undergraduate and
graduate SHCs over the same time period. The number of graduate SCHs has increased in the
past 7 years due to the addition of new certificate programs, Master program, and increased
number of graduate students.
FIGURE 7 GRADUATE VS UNDERGRADUATE SCHS FROM 2008 TO 2015
Figure 8 shows the change of graduate SCHs, SCHs generated by the HI specific courses and SCHs
generated by HCA/HCM specific courses. Because all students entering the programs take COHE
6000 Health Care Systems and Problems, it is excluded from the calculation of the SCHs. The
6195 60985075 4806 4665 4786 5134
576 822
999 1212 1200 11821212
0
2000
4000
6000
8000
2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015
Undergraduate and Graduate SCHs in HSIM
Undergraduate Graduate
24
courses specific to HI certificate are: HIMA 6060 (5060), COHE 6410, COHE 6420, COHE 6430,
COHE 6440, and COHE 6450. The courses specific to HCA/HCM certificates are: COHE 6300, COHE
6310, COHE 6100, COHE 6600 COHE 6610, and COHE 6620. Please note that starting in 2013, all
HI specific courses have also been available to the graduate students.
Three patterns are notable here:
1) The number of overall Graduate SCHs has increased over time and currently stabilized
around 1200, which is equivalent to about 6.44 FTEs.
2) The number of HI specific SCHs has increased over time largely to the increased number of
enrolled students and the addition of new degree and certificate programs.
3) The percentage of the SCHs generated by HI specific courses has increased in relation to
HCA/HCM specific courses. Again, the addition of new degree and certificate program and
increased enrollment may have contributed to the pattern.
FIGURE 8 GRADUATE, HI AND HCA/HCM SCHS
4.5. Based on the Delaware Study data, what is the general teaching load of the
department faculty? What has the department done to adjust faculty teaching load?
According to the latest Delaware Study in the fall of 2013, the department offers
44 sections with 15.25 full-time faculty members. The average teaching load was
2.88 in the fall of 2013. Regular faculty members teach 2.77 course sections per
faculty member. Please note that the MS in HIIM just became available in fall 2013.
Not all courses were made available online at the time of the snapshot. In the fall
of 2015, the average teaching load per faculty member had increased to 3.08
course sections per faculty member (total number of faculty was 12 in fall 2015).
All faculty members in HSIM are on 12-month contract. The workload policy of
0
200
400
600
800
1000
1200
1400
2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015
HI vs HCA/HCM SCHs
Graduate HI Courses HCA/HCM Courses
25
CAHS specifies that a regular full- time faculty’s full workload is equivalent to 10 3-
credit hour courses per year. Faculty’s other commitments (research and services)
are converted to time in the unit of contact hours. For example, one published
peer reviewed journal article will be counted as half of a 3 credit hour course
depending on the authorship. A program director may be given one course section
reduction for their services.
In general, the teaching loads in the department are between 6- 9 sections per
faculty member per academic year (12 months). It is important to point out here
that the teaching load is not evenly distributed on purpose and by nature. There
are two reasons for the uneven distributions:
1) Teaching load reassignment: Junior faculty member are given lighter teaching loads by either
assigning fewer courses or teaching courses with fewer students so they can focus more on
research. If a faculty member serves administrative responsibilities such as the program
director, a 1-2 course section reduction will be assigned to the faculty members.
2) The MS HIIM program is still growing so in general the sections in that curriculum have fewer
students. We expect that to change after the program becomes mature in the coming several
years and has more students. By that time, the teaching load will be more equal among the
faculty members.
4.6. Describe the direct contributions (course sections taught) and indirect contributions (grading, tutoring, etc.) of graduate teaching assistants to the department’s teaching mission? There is no graduate teaching assistantship in the department. In 2015-2016, we have a .5 part-
time graduate research assistant position in the department whose responsibility is to help the
faculty members on research related activities – data collection, literature review, and drafting
reports. Because most of the graduate students in the department are online students, it makes
the recruitment of the graduate research assistant a challenge.
Having a graduate teaching assistant will be beneficial to the teaching effectiveness so faculty
will be able to focus on the pedagogy of the course content. The time saved by using a teaching
assistant will allow the faculty members to dedicate more time on research and scholarly work.
4.7. What are the major achievements of department faculty regarding teaching? What has
the department done to support faculty teaching?
The faculty members in the department are committed to excellence in teaching to help
students achieve success in and outside the classes. Six current faculty members have received
CAHS teaching awards. Four received university level teaching awards – 2 scholar teacher
awards, and 2 NC Board of Governors Distinguished Professor for Teaching Award. All faculty
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members strive for teaching excellence thorough innovative pedagogy and collaborations, which
is exemplified in the two scholarly teaching activities below:
Dr. Bonita Sasnett and Dr. Robert Campbell received a grant in 2010 from Association of
American Colleges and Universities to explore service learning and peer learning.
Sophomore students and senior students formed teams to participate in service learning
projects in the community. The senior students, with more academic experiences,
provided more guidance on project management to the sophomore students for their
hands-on service learning projects.
Dr. Leigh Cellucci, and other faculty members in the department, has received BB&T
leadership grants four years concurrently to incorporate leadership education in the
classroom. The projects include using social media for leadership in health care,
interviewing health care leaders, reflections on leadership in health care, and personal
leadership growth.
The department strives for teaching excellence. Whenever possible, we assign faculty to teach
the courses they have experiences or interest. Faculty will remain passionate in teaching if the
courses fit their interest and experiences. They will be more effective in preparing the pedagogy
and update their knowledge about the subject matter.
Analysis of Research, Scholarship and Creative Activities
4.8. Major research and scholarship achievements
From 2011-2016, HSIM faculty members published 66 peer reviewed articles, 9 books, 19 book
chapters, and presented 97 times at different conferences. Faculty members serve on editorial
boards and reviewer boards of academic journals.
The department has not been strong in applying and receive external grants. According to the
data in ECU RAMSeS system, HSIM faculty members submitted 7 grant proposals since 2012 with
a total initial direct cost at $796,635.00. However, only two were funded with a total amount of
$9,500.
4.9. What are the relative strengths and weaknesses as compared to departments at peer institutions
or major competitors?
The following Radar Map (Figure 9) from Academic Analytics clearly shows the major deficiencies
in research and scholarly activities in the department by comparing the faculty to colleagues in
119 other departments in the country. The faculty achieve better in terms of the number of
published books and awards, which is correlated with data in Sedona. However, the number of
articles and citations of articles are below the national average, which means faculty do not
publish at the same level as colleagues at other institutions and the articles often are published
in journals that do not result in sufficient citations.
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FIGURE 9. ACADEMIC ANALYTICS RADAR MAP
4.10. What has the department done to support faculty research, scholarship and
creative activities?
Although all faculty members are on 12-month contracts, they can choose to
teach heavier course loads in fall and spring semester so they can use the
summer time to focus on research.
Funds are allocated to each faculty member to use for travel to conferences,
research and other scholarly activities.
A graduate assistant has been recruited to support faculty research – data
collection, literature searches, entering survey questions, preliminary analysis
of data, etc.
Analysis of Services and Outreach Activities
4.11. What major service and outreach initiatives have the faculty engaged in? What has the
department done to support faculty service/outreach activities?
HSIM encourage faculty to serve at all levels. We also specify that a faculty member must gain
national recognition by serving at professional associations. The faculty members are service
oriented and actively participate in services at all levels. For example, currently the two faculty
senators and two faculty senator alternates are all faculty members in the department. All
faculty members serve at the college level. Nine faculty members serve on committees at the
university or division level. Faculty members are actively sought by the campus leaders to serve
on ad hoc task forces or special committees.
Our faculty members are active at the national level as well. Five faculty members chair
Association of University Programs of Health Administration (AUPHA) review teams, some have
served at that capacity for several years. One faculty serves on the board of directors for AUPHA
and co-chaired the undergraduate committee. One faculty member served as the editor of the
Journal of Case Studies. Two faculty member (one has retired) serve as program reviewers for
28
the Commission on Health Informatics and Information Management Education (CAHIIM) Many
other faculty members serve as committee members and reviewers for academic journals to
contribute to the professional society.
The faculty members also serve at local community levels. The organizations that faculty serve at
include March of Dimes, Pitt County Literacy Volunteers, ECU Phi Kappa Phi, the Ulster Project,
Greenville Chinese School, North Liberty Community Food and Clothing Pantry, North Carolina
Medical Society Doctors on Call, Beaufort County Mental Health Association, Dream factory of
Eastern NC and Children’s Miracle Network Telethon. Faculty members reach out to the
communities and contribute to the health and growth of the society.
It is also worth mentioning because we are the only department teaching and training
professionals in health care management and health information management, our faculty are
often sought to share the knowledge and expertise. For example, Dr. Kulesher participates in
North Carolina Medical Society Doctor’s On Call program to answer calls related to health
insurance and ACA. The other faculty member, Dr. Susie Harris, provided a series of trainings on
ICD-10 coding in the state before the national medical coding system was upgraded from ICD-9
system to ICD-10 system.
4.12. Action plans
It is obvious from the analysis that the strengths of faculty in HSIM are in teaching and service.
Faculty members care about teaching and are dedicated to the excellence of teaching. However,
one area that we need to improve as a group is in research, especially in grant seeking activities.
The department will consider taking the following action plans to address the deficiencies in
research and scholarly activities, especially in external grant supported activities:
Recruiting research- oriented faculty members, especially those who are interested in
seeking external grants as part of their career plans at ECU.
Nurturing junior faculty members in research by assigning them both teaching and research
mentors. Junior faculty members will receive fewer courses to teach in order to build strong
research portfolio.
Assisting junior faculty members to successfully receive startup funds to support their
research that could result in external grant funding. Working with the Associate Dean for
Research and Division of Research, Economic Development, and Engagement to supervise
the progress of start- up funds supported research and grant activities.
Supporting faculty member’s ability to attend workshops on grant writing by paying for their
travel expenses.
Increasing the weight of external grants and referred journal articles in grading research
activities during annual evaluation.
Consider adding the statement about applying for external grant to the tenure and
promotion guidelines.
29
Encouraging current faculty members to partner with other productive scholars within and
outside the department to collaborate on research especially on grant supported researches.
Faculty members who are preparing grant proposals will receive course reassignment, which
will result in a lighter teaching load.
Travel will be supported only if faculty members present at the conference.
Having adjunct faculty members to teach low level courses in the curriculum so faculty
members can pursue research and scholarly work. This will require additional resources.
5. Regional Transformation – Economic Development/Public Service
5.1. Summary of regional transformation activities in the past 7 years
Due to the short curriculum with no internship or practicum course included, the three
certificate programs have limited impact on regional transformation, other than continuously
training and educating current health care workers who will apply the knowledge gained in
terms of health management and informatics to their places of employment.
The summary below highlights some of the regional transformation activities in the department
in the past 7 years:
Capstone Internship: The BS in HSM program has a 160 contact hour internship and the MS
in HIIM program has a 120 contact hour internship. The internship courses are taken during
the last semester of the study in the programs. Students are assigned to different health
care organizations, under the supervision of onsite preceptors, to engage in routine
managerial activities. The activities include preparing financial reports, health program
marketing, patient education, or workflow improvement. The students gain real world
knowledge, insight and skills during the internships. The hosting organizations were able to
accommodate the student interns in an effort to provide better services to their clients.
Service learning course: HSMA 2000 Professional Roles and Environments in Health Care is a
service-learning course that examines the interdisciplinary professional roles and
environments in health care. Students are required to work in teams with several
organizations (Walter B. Jones Alcohol and Drug Abuse Treatment Center, Cypress Glen
Retirement Community, ECU Telemedicine, Vidant Surgical Center) to conduct service-
learning projects. The outcomes of the course include solidifying student’s commitment to
their future careers in allied health and maintaining the relationships with the service
learning sites.
Patient Centered Medical Home Project: Currently Collaborating with Community Care North
Carolina (CCNC), we have started a project in 2015 that HSM students were provided
classroom education on Patient Center Medical Home (PCMH) and sent to different primary
care providers in rural Eastern North Carolina to assist these health care organizations to
gain the Patient Center Medical Home (PCMH) designation. PCMH is a way of organizing
primary care that emphasizes care coordination and communication to transform primary
care into a Patient Centered delivery model that can lead to higher quality and lower cost.
Five students have been recruited and received training in PCMH. They will go to 4 different
30
sites to help them gain PCMH designation from National Committee for Quality Assurance
(NCQA).
ECU Physicians Patient Portal project: ECU Physicians started to roll out their new EPIC
Electronic Medical Record (EMR) system in 2013. One ongoing project is to achieve
Meaningful Use recognition from CMS at different stages. The CMS Meaningful Use program
mandates that a qualified health care facility allow at least 50% of the patients to access
their health information in an online format, in most situations, through an electronic
patient portal. HSM students were recruited by ECU Physicians to help patients to learn
about the patient portal and use the portal to communicate with the providers. They helped
ECU Physicians to achieve Meaningful Use recognition.
Health Informatics Job Fair and Symposium：On Oct 22, 2014, HSIM, collaborating with
College of Business, the department hosted a health informatics career and job
fair/symposium. Faculty and students from other universities – Duke, UNC Chapel Hill, UNC
Charlotte, and NC Central University attended the event. More than 20 employers exhibited
at the event. The vendors include SAS, IBM, EPIC, AllScripts etc. The event showcased the job
prospects in the field of health informatics and health information technology and
stimulated discussions on health informatics education and research.
REACH project: Redesigning Education to Accelerate Change in Healthcare (REACH) is an
American Medical Association (AMA) grant-funded initiative to transform the Brody Medical
School curriculum so that it better prepares future physicians in patient safety, quality
improvement and population health in an environment of team-based, patient-centered
care. The grant addresses the substantial gap that now exists between what physicians have
been taught in the past and what they will need to know now and in the future to provide
safer, higher quality patient care. Two faculty members from HSIM (Dr. Kennedy and Dr.
Ross) participated in the first phase of the project Teachers of Quality Academy to become
the instructors of quality in health care. Both faculty members have continued to serve as
instructors for selected Brody medical students.
5.2. What does the department plan to do to support regional transformation? What resources will it
need?
We will discuss the possibility to include an elective capstone project in the curriculum so
students can work with the regional organizations on real world projects.
Continue the PCMH project to engage more students with community health care
organization partners.
Market the certificate programs to health care providers in the region to increase
awareness of the program and interest from the current health care workers to use the
program to gain more knowledge.
6. Resources
31
6.1. Based on analysis of the operating budget and revenue sources supporting the department as well
as annual expenditures, discuss the adequacy of the resources provided and required for
maintaining program quality.
The department operating budget has been decreased since the starting of the economic
downturn in 2009 from a total amount of near $100,000 (operating budget and DE funds) to
$55,378 in 2015-2016 fiscal year, which is equivalent to $4260 per faculty member. In the past,
the accreditation annual fees were paid by the Dean’s office, now it will be paid using the
department operating budget, which makes the budget even tighter. The department would like
to support the faculty members to go to one national conference per year. The requirement now
is either presentation or serve as an officer at the national organization. Each faculty member is
given a $2,500 pool to manage. The funds in the pool could be used for travel, research, and
teaching needs. The $2,500 is a “soft” limit meaning the additional expenses will be paid by the
department if there are funds available. If the current trend of budget restriction continues,
faculty will be asked to prioritize their travels based on the nature of the trips and the $2,500 will
at some point become a “hard” limit. Any expenses above the amount will not be paid using the
operating budget.
The department has limited additional income. The amount of annual donation to our medical
and health sciences foundations is between $2,000 and $2,500. We have started an annual
alumni reception at the state NCHIMA meeting since 2014. However, we have not seen increased
donations from the Health Information Management graduates. The alumni from the BS in HSM
program do not have a specific conference they may attend, which increases the difficulty of
fundraising. We will continue to devise strategies in development within the alumni groups. One
such strategy is to offer some of the courses such as HIMA 3000 Medical Terminology for Health
Professions through the Office of Continuing Study to generate additional income. We also would
like to have resources to simulate managerial and informatics scenarios. For example, a
simulation lab for health information exchange needs to be developed to help the students to
understand the concepts of exchangeable and actionable health information across different
system.
6.2. Describe the quality, scope, and projected needs for space to support the program.
Although the programs are offered in both face-to-face and online format, a majority of the
students choose online instead of on campus. Therefore, the need for teaching space is
minimum. We have a computer lab with 26 workstations, which is sufficient for the usual size of
the face-to-face sections. However, additional office spaces may be needed for additional faculty
members in the department if faculty lines become available for increased enrollment and new
degree program.
Although space is not needed, we need quality instructional technology tools and supporting
staff for online teaching. ECU is the leader in online education in the state. We have a variety of
tools that can be employed to deliver high quality online classes. For example, most of the
32
courses are recorded using Mediasite and shared with the online students to meet their learning
needs. Synchronous tool like Saba meeting is used to enhance the sense of community in online
classes. There is only one instructional technology staff member in the college to support all
faculty members. If resource allows, we would like to have a dedicated person in the
department to support online course delivery. The responsibilities of this staff member is not
only to support the using of the tools but also working as a consultant with the faculty to
improve the design of the course based on the principles of instructional design.
7. Other operational or Programmatic Outcomes
7.1. Describe other assessed outcomes that enable the program/department to achieve its
objectives, e.g., academic advising, graduate student support, operational efficiency,
structural re-organization, etc. Summarize strengths and weaknesses identified in the
assessment and actions taken to improve these outcomes.
Given the short curriculum of the certificate programs, we did not have a graduate student
advisor for the program. Faculty members, serve in the capacity as the program director, are the
primary advisors of the students. Each advisor will have a one section course reduction for the
administrative duties. Department office assistants, due to their limited training in graduate
education and advising, haves provided limited support of the graduate advising. They can only
offer the help as the initial screener of the incoming inquires. The program directors provide
majority of the support of the students – reviewing application materials, admitting students,
orientation, advising students, and graduating students. Additionally, the program directors will
also be responsible for assessment of student learning outcomes and preparing self study for
program reviews. Due to the current turnovers of the administrative staff members, support to
the program directors has not reached the objective of serving the students in an efficient and
effective way.
7.2. Action Plans: What does the department plan to do to improve these outcomes? What resources
will it need?
We would like to have a dedicated graduate program advisor for the graduate certificate
programs and the graduate programs in the department. We are proposing a new Master of
Health Administration (MHA) program. If that is approved to establish, we will soon have 2
graduate degree programs – MS HIIM and MHA and 4 graduate certificate programs – HCM,
HCA, HI, and HIM. These programs are interrelated with each by sharing courses, transferring
courses, or each offering dual degrees. Coordination across the programs will be strengthened in
order to serve the students better. Additional resources will be needed to establish a position as
the graduate student advisor for all graduate programs. The faculty program directors will
transition their role to become consultants and representatives. This will add value to the
students’ experience in the department and increase the students’ satisfaction. We are
considering experimenting with one of the part-time office assistant to support such a role.
However, we envision a full-time person is needed in order to serve this role. The person can
33
also help on marketing the programs. The financial resources could be supported by adding
supplemental tuition fee that is not in the current tuition and fee structure from the department.
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