HIEs face ongoing staffing challenges

Despite the rapid growth of health information exchange (HIE), there has been little focus on the staffing and skills of those staffing HIEs, according to the participants of a panel discussion at the Centers for Medicare & Medicaid Services’ eHealth Summit on Dec. 6.

There’s a lack of significant studies in this area, said Scott MacLean, MBA, deputy CIO and director at Partners HealthCare in Boston. He cited the collaborative effort of the American Health Information Management Association (AHIMA) and the Health Information & Management Systems Society (HIMSS) that aims to identify current and future needs as well as determine ways to help people find work in this area, connecting them to organizations seeking employees.

“We wanted to identify what specific rules and responsibilities were key to the success and future of HIEs,” said Meryl Bloomrosen, MBA, vice president of AHIMA, “and what resources we could offer for additional training and ongoing support.”

Core Health Technologies, a health information security firm, surveyed HIEs and found that 86 percent of these health information organizations (HIOs) have 25 or fewer employees, said Charlie Rogers, CEO and member of the HIMSS HIE committee. “There is a lot of local competition for candidates,” he said, and people with HL7 expertise are difficult to find and keep. Since many of these organizations are quite similar in make-up to startups, they need to sell themselves to job candidates, he said.

Cynthia Hilterbrand, MBA, director of clinical solutions consulting firm Yeoman and Associates, shared more information about the survey, namely that few HIOs anticipated hiring for security positions, instead focusing on data integration and support. Going forward, the two associations suggest continuing to develop networks organizations can use to reach out to trusted sources, utilizing job boards, connecting with other professional organizations, planning ahead via creative staffing options and engaging in social media.

Hilterbrand also said that successful HIOs “will attract successful working staff.”

“The dynamic nature of those entities now called HIOs warrants additional scrutiny,” said Bloomrosen. “There is an evolutionary path in front of us as we continue to explore the ideal state for future staffing needs, skills and responsibilities to make sure the nationwide goal of exchanging data can be achieved.”

New models are emerging, such as an HIO run by a vendor with dominance in a geographic area. There may be different staffing needs depending on organizations’ business model “and that needs to be explored, she said.

Sustainability of HIEs has been an ongoing issue and Rogers said “strong employees are critical to sustainability and sustainability of HIOs is critical to getting and attracting strong employees.” With so many HIEs having small staff, each member needs strong talents to wear multiple hats.

Sustainability “depends on operational efficiency,” said MacLean. “We can’t be stodgy. We want to value our employees but we need to make sure they all are making significant and innovative contributions” because the money is going to come from more efficiency across the care spectrum.

With healthcare lagging behind other industries by 5 to 10 years, Rogers said CIOs are just “starting to sit at the table now as opposed to being glorified project managers.” Research is needed as well as leading organizations sharing their experience. “The organizations that get out front and lead, have a vision, can lead these discussions and drive the industry forward.”