More IT Systems Call For More IT Talent
Attracting and retaining qualified employees is a challenge in many fields but with health IT workforce shortages forecasted, the U.S. government has stepped in. Federally funded training programs are churning out health IT workers but the results have yet to be determined. Once hired, organizations have multiple ways they can encourage loyalty and longevity.
The U.S. federal government is doing its part to create a qualified health IT workforce. In April 2010, the Department of Health and Human Services awarded $84 million to designated universities and community colleges to support the training and development of more than 50,000 health IT professionals, including $32 million to the University-Based Training (UBT) program and $36 million to the Community College Consortia program.
As of October 2011, 82 participating community colleges have graduated 5,717 health IT professionals, with 10,065 more students currently in the training pipeline, according to a posting on HealthITBuzz by Farzad Mostashari, MD, national coordinator for health IT at the Office of the National Coordinator for Health IT (ONC). As of November 2011, nine participating universities have produced more than 500 post-graduate and master's level health IT professionals, with more than 1,700 individuals expected to graduate by July 2013.
Good health IT workers require diverse skills, says Helen Figge, PharmD, MBA, senior director of professional development at Career Services at HIMSS. She suggests the necessary skills in today's health IT roles include project management, understanding of clinician workflow, clinical concepts, data management and interoperability, as well as knowing the healthcare landscape and how technologies fit into that landscape.
With designated colleges and universities charged with promptly establishing new and/or expanded training programs while assuring that graduates are prepared to fill chosen health IT professional roles, UBT programs are targeting six roles, including: clinician/public health leader; health information management and exchange specialist; health information privacy and security specialist; research and development scientist; programmers and software engineer; and health IT subspecialist.
One challenge for potential health IT workers is there is no system for training on vendor systems outside of the workplace. Frances Morrison, MD, MPH, course director of the health IT certificate program at Columbia University Mailman School of Public Health in New York City, acknowledges the Catch-22 of wanting to enter into the health IT field, but not having the necessary experience with vendor systems. ONC's UBT program is seeking to close that gap. Columbia received $3.7 million to create a master's program and a certificate program to train individuals in partnership with Cornell University, also located in New York City.
The bulk of the grants that Columbia received help offset the tuition of the students. While the program costs $12,500 for six months, ONC could assist eligible students with up to $10,000 of that cost, says Herbert Chase, MD, director of health IT training program and professor of clinical medicine at the department of biomedical informatics at Columbia. The program plans to graduate 187 UBT program students by the end of funding in July 2013.
The backgrounds of the UBT certificate program's students vary. "Most of the participants have been seeking an entrée into the health IT field," says Morrison. The Columbia students generally have clinical, public health, technical or business backgrounds. Robert E. Burke, PhD, chair of health administration at the School of Public Health and Health Services at George Washington University in Washington, D.C., says that the majority of its UBT students are clinicians or public health officials. They know about the technical aspects, but have had little management training. They generally fall into three categories:
"The biggest feedback from recruiting organizations is they want students with project management and business management skills," says Morrison. Those participating in Columbia's UBT program learn about EHRs and meaningful use, how data are stored, coding, knowledge representation and the security of these systems.
"We want the students to understand how computers can accomplish these tasks placed in front of them," says Chase. "Because of meaningful use, all of these clinicians need to know how to implement these systems."
By creating a project plan for EHR and meaningful use as part of their education, students think about how to select appropriate systems, help people accept a new system, manage an IT group, provide IT support in an organization that previously didn't require it and ensure the initiative is on track and on budget. Morrison says that most graduates become analysts who translate between domains of IT, health and business.
However, health IT job descriptions have yet to be fully written. Healthcare reform is an ongoing effort, and Figge asserts that healthcare roles continue to evolve. She says it will become clearer over time what skills will be needed for future success in the health IT workspace. "As we go along, we pick up skills. Adaptability and versatility are integral for those moving forward in their careers."
Once IT staff members are trained on EMR systems, organizations run the risk of losing that health IT talent to consulting firms. Deaconess has a $5.3 million compensation budget with roles including application analysts (approximately $57,000 per year) and database administrators (approximately $65,000 per year). Healthcare organizations can have trouble competing with the higher pay that consultants are willing to spend for health IT experience. Plus, young professionals with a desire to see the world can be drawn to allure of the travel opportunities of consulting.
"We've lost eight people in our IT department," says Richardson. "We've tried retention bonuses, but you can't fight it. The days of bringing in an entry-level worker who stays around for 40 years are over." Though the knowledge is difficult to lose, he says the turnover allows for hiring those who are a good fit with an organization's culture.
Employee retention "really starts with the hiring process and getting the right fit for a given position," says Diane Smith, director of information systems, Saint Francis Medical Center (SFMC) in Cape Girardeau, Mo. Besides technical skills, Smith looks for good work ethic, ability to work in a team environment, overall positive attitude and whether the position is one where the applicant can advance professionally, along with his or her desire to do so. "After [hiring], you have to watch for signs of frustration and try to resolve them as quickly as possible to keep the team moving forward. Once the team dynamics are positive, most people are willing to do their part," she says.
S. Shafiq Rab, MD, MPH, vice president and CIO at Greater Hudson Valley System in Middletown, N.Y., concurs that valuing employees fuels loyalty. "CMIOs and chief executives have to be honest that our entire success is directly dependent on the people who work for us," says Rab.
In addition to fair compensation and feeling valued, supervisors should encourage an air of openness. "Relationships keep people together," says Rab. Recently, he avoided an employee's resignation by talking out the reasons the person wanted to leave. The result was that the employee stayed out of loyalty to the team yet requested extra resources to help the IT team thrive. "When your people tell you they need help, they need to know that voicing their opinion is not the world's end. People stay because of relationships and a team environment," says Rab.
It's important for CMIOs and other C-suite executives to let employees have as much autonomy as possible, while placing value in their feedback before making decisions related to their work, says Smith. "Setting limitations and having unrealistic expectations is a definite barrier for employees to overcome and stay positive."
Transparent communication between hospital leadership and employees "is essential to building a cooperative and consensus-driven work environment," says Nicole Chance, human resources manager at SFMC. To achieve this, the provider holds a leadership meeting every month and employee forums quarterly. The town hall-style meetings encourage employees to ask questions and provide feedback. SFMC also conducts biennial employee opinion surveys to encourage feedback and candid thought-sharing.
"Obviously, finances play a significant role in retention," says Chance. To stay competitive in the market, SFMC participates in several annual salary surveys in which positions and industry pay grades are reviewed. "Necessary adjustments are made based on market data," she says. "All employees can earn individual merit increases based on annual performance evaluations."
Currently, the IT employee retention rate at SFMC is 96 percent. A tuition reimbursement program encourages employees to continue their education, including an MBA reimbursement program to cultivate future senior leadership. Since its inception in 1989, the tuition reimbursement program has provided more than $2.1 million in financial assistance. Educational assistance at SFMC is sometimes accompanied by service obligation though, in certain situations, the obligation is waived, Chance says.
Educating the health IT workforce helps employees feel invested in their position, says Richardson. "You've got to keep people current. Educational training in IT is like food." Supervisors must be responsible for managing and educating their staff. "Just because someone leaves doesn't mean it results from bad management," he adds.
As CMIOs prepare for the influx of patients and workforce, good management, ongoing training and fair pay will help ensure that highly skilled talent stick around.
The U.S. federal government is doing its part to create a qualified health IT workforce. In April 2010, the Department of Health and Human Services awarded $84 million to designated universities and community colleges to support the training and development of more than 50,000 health IT professionals, including $32 million to the University-Based Training (UBT) program and $36 million to the Community College Consortia program.
As of October 2011, 82 participating community colleges have graduated 5,717 health IT professionals, with 10,065 more students currently in the training pipeline, according to a posting on HealthITBuzz by Farzad Mostashari, MD, national coordinator for health IT at the Office of the National Coordinator for Health IT (ONC). As of November 2011, nine participating universities have produced more than 500 post-graduate and master's level health IT professionals, with more than 1,700 individuals expected to graduate by July 2013.
Greenlighting the health IT workforce
Healthcare Information and Management Systems Society's (HIMSS) Career Services has aligned itself with the ONC's Community College Consortia Program by hosting educational webinars on such topics as the concept of meaningful use and how to get, keep and grow into a position.Good health IT workers require diverse skills, says Helen Figge, PharmD, MBA, senior director of professional development at Career Services at HIMSS. She suggests the necessary skills in today's health IT roles include project management, understanding of clinician workflow, clinical concepts, data management and interoperability, as well as knowing the healthcare landscape and how technologies fit into that landscape.
With designated colleges and universities charged with promptly establishing new and/or expanded training programs while assuring that graduates are prepared to fill chosen health IT professional roles, UBT programs are targeting six roles, including: clinician/public health leader; health information management and exchange specialist; health information privacy and security specialist; research and development scientist; programmers and software engineer; and health IT subspecialist.
One challenge for potential health IT workers is there is no system for training on vendor systems outside of the workplace. Frances Morrison, MD, MPH, course director of the health IT certificate program at Columbia University Mailman School of Public Health in New York City, acknowledges the Catch-22 of wanting to enter into the health IT field, but not having the necessary experience with vendor systems. ONC's UBT program is seeking to close that gap. Columbia received $3.7 million to create a master's program and a certificate program to train individuals in partnership with Cornell University, also located in New York City.
The bulk of the grants that Columbia received help offset the tuition of the students. While the program costs $12,500 for six months, ONC could assist eligible students with up to $10,000 of that cost, says Herbert Chase, MD, director of health IT training program and professor of clinical medicine at the department of biomedical informatics at Columbia. The program plans to graduate 187 UBT program students by the end of funding in July 2013.
The backgrounds of the UBT certificate program's students vary. "Most of the participants have been seeking an entrée into the health IT field," says Morrison. The Columbia students generally have clinical, public health, technical or business backgrounds. Robert E. Burke, PhD, chair of health administration at the School of Public Health and Health Services at George Washington University in Washington, D.C., says that the majority of its UBT students are clinicians or public health officials. They know about the technical aspects, but have had little management training. They generally fall into three categories:
- Managers involved with health IT;
- State public health agency officials required to know about health IT; and
- Those promoted into a health IT management role.
"The biggest feedback from recruiting organizations is they want students with project management and business management skills," says Morrison. Those participating in Columbia's UBT program learn about EHRs and meaningful use, how data are stored, coding, knowledge representation and the security of these systems.
"We want the students to understand how computers can accomplish these tasks placed in front of them," says Chase. "Because of meaningful use, all of these clinicians need to know how to implement these systems."
By creating a project plan for EHR and meaningful use as part of their education, students think about how to select appropriate systems, help people accept a new system, manage an IT group, provide IT support in an organization that previously didn't require it and ensure the initiative is on track and on budget. Morrison says that most graduates become analysts who translate between domains of IT, health and business.
However, health IT job descriptions have yet to be fully written. Healthcare reform is an ongoing effort, and Figge asserts that healthcare roles continue to evolve. She says it will become clearer over time what skills will be needed for future success in the health IT workspace. "As we go along, we pick up skills. Adaptability and versatility are integral for those moving forward in their careers."
| Mostashari Notes Progress |
 Farzad Mostashari, MD, national coordinator for health IT at the Office of the National Coordinator for Health IT (ONC), noted in a Jan. 6 post on the ONC’s HealthITBuzz that, as of Nov. 30, 2011:
|
Workforce in the bank?
One of the main challenges with an EMR system, according to Todd F. Richardson, CIO of Deaconess Health System, a six-hospital system in Evansville, Ind., is not the implementation, but taking care of the system on a day-to-day basis. "The systems are in a constant state of upgrade," he says. Deaconess employs 82 IT staff members and 32 in clinical informatics to maintain and implement upgrades to their EMR system.Once IT staff members are trained on EMR systems, organizations run the risk of losing that health IT talent to consulting firms. Deaconess has a $5.3 million compensation budget with roles including application analysts (approximately $57,000 per year) and database administrators (approximately $65,000 per year). Healthcare organizations can have trouble competing with the higher pay that consultants are willing to spend for health IT experience. Plus, young professionals with a desire to see the world can be drawn to allure of the travel opportunities of consulting.
"We've lost eight people in our IT department," says Richardson. "We've tried retention bonuses, but you can't fight it. The days of bringing in an entry-level worker who stays around for 40 years are over." Though the knowledge is difficult to lose, he says the turnover allows for hiring those who are a good fit with an organization's culture.
Employee retention "really starts with the hiring process and getting the right fit for a given position," says Diane Smith, director of information systems, Saint Francis Medical Center (SFMC) in Cape Girardeau, Mo. Besides technical skills, Smith looks for good work ethic, ability to work in a team environment, overall positive attitude and whether the position is one where the applicant can advance professionally, along with his or her desire to do so. "After [hiring], you have to watch for signs of frustration and try to resolve them as quickly as possible to keep the team moving forward. Once the team dynamics are positive, most people are willing to do their part," she says.
S. Shafiq Rab, MD, MPH, vice president and CIO at Greater Hudson Valley System in Middletown, N.Y., concurs that valuing employees fuels loyalty. "CMIOs and chief executives have to be honest that our entire success is directly dependent on the people who work for us," says Rab.
In addition to fair compensation and feeling valued, supervisors should encourage an air of openness. "Relationships keep people together," says Rab. Recently, he avoided an employee's resignation by talking out the reasons the person wanted to leave. The result was that the employee stayed out of loyalty to the team yet requested extra resources to help the IT team thrive. "When your people tell you they need help, they need to know that voicing their opinion is not the world's end. People stay because of relationships and a team environment," says Rab.
It's important for CMIOs and other C-suite executives to let employees have as much autonomy as possible, while placing value in their feedback before making decisions related to their work, says Smith. "Setting limitations and having unrealistic expectations is a definite barrier for employees to overcome and stay positive."
Transparent communication between hospital leadership and employees "is essential to building a cooperative and consensus-driven work environment," says Nicole Chance, human resources manager at SFMC. To achieve this, the provider holds a leadership meeting every month and employee forums quarterly. The town hall-style meetings encourage employees to ask questions and provide feedback. SFMC also conducts biennial employee opinion surveys to encourage feedback and candid thought-sharing.
"Obviously, finances play a significant role in retention," says Chance. To stay competitive in the market, SFMC participates in several annual salary surveys in which positions and industry pay grades are reviewed. "Necessary adjustments are made based on market data," she says. "All employees can earn individual merit increases based on annual performance evaluations."
Currently, the IT employee retention rate at SFMC is 96 percent. A tuition reimbursement program encourages employees to continue their education, including an MBA reimbursement program to cultivate future senior leadership. Since its inception in 1989, the tuition reimbursement program has provided more than $2.1 million in financial assistance. Educational assistance at SFMC is sometimes accompanied by service obligation though, in certain situations, the obligation is waived, Chance says.
Educating the health IT workforce helps employees feel invested in their position, says Richardson. "You've got to keep people current. Educational training in IT is like food." Supervisors must be responsible for managing and educating their staff. "Just because someone leaves doesn't mean it results from bad management," he adds.
As CMIOs prepare for the influx of patients and workforce, good management, ongoing training and fair pay will help ensure that highly skilled talent stick around.
| More Medicare Access Will Increase IT Needs Too |
| Assuming that the legislation isn’t decreed unconstitutional in the Supreme Court this month*, the Patient Protection and Affordable Care Act (PPACA) provides for more individuals to have newly granted access to healthcare insurance services. Some estimates have predicted that under PPACA, the Medicaid eligibility threshold for nonelderly adults will rise to 133 percent of the federal poverty level (about $30,000 for a family of four) in 2014 (N Engl J Med 2011;364:493-495). In this study, Ku and colleagues examined the potential gaps between Medicaid demand and capacity by computing measures of potential Medicaid expansion and current primary care in each state and Washington, D.C. They found examples of states which are expected to have large Medicaid expansion yet currently have weak primary care capacity, including in Oklahoma, Georgia, Texas, Louisiana, Nevada, North Carolina and Kentucky. “In the absence of additional efforts, the demand for care by the newly insured patients could outstrip the supply of primary care providers in these states.” Primary care providers won’t be the only resource in demand if PPACA stays on its legislative target. With the influx of meaningful use requirements for health IT utilization, a need to electronically capture the newly insured’s patient data within an EHR/EMR also will be a much-needed requirement. * Information is accurate at the time of publication. |