Health IT Workforce Shortage Is the Next Big Challenge

The IT workforce shortage keeps many healthcare IT leaders up at night, not only because of the challenging prospect of finding experienced people to implement and run their systems but also the task of retaining them.

Shortages are not going away anytime soon. In a recent College of Healthcare Information Management Executives (CHIME) survey, 67 percent of CIOs reported IT staff shortages in 2012 compared with 59 percent in 2010. Likewise, in November 2012, Deloitte Consulting published a survey of American Medical Informatics Association members who identified the recruitment and training of qualified personnel as a significant challenge.

While the Office of the National Coordinator for Health IT (ONC) has been funneling money into training and education, some leaders look to their own clinical ranks for prospective health IT workers. In the meantime, CIOs do everything possible to keep the best workers from migrating to other opportunities.

Education & Training

As first promulgated by the ONC, 50,000 workers are needed by 2015 to meet the health IT demands.

Publicity surrounding the health IT worker shortage has spurred increased interest and enrollment in some programs, says W. Ed Hammond, PhD, director of the Duke Center for Health Informatics in the Duke Translational Medicine Institute, and director of applied informatics research at Duke Health Technology Solutions in Durham, N.C.
The attention comes not just from younger students but seasoned professionals in their 40s. “They’re seeing this as something new and stable that has great potential for the future,” he says.

In 2009, ONC launched the Workforce Development Program, which provides $10,000 per student who enrolls in health IT graduate certificate programs.

Duke’s Certificate in Health Informatics program, geared to students with undergraduate or graduate degrees in clinical specialties, teaches them how data, information and knowledge are represented and used in health applications. The program readies graduates for certain health IT roles identified by ONC: clinician/public health leader, health information and exchange specialist and IT sub-specialist.

“We’re not getting everybody a job,” admits Hammond, but he adds that the bulk of students already are employed and pursuing a certificate to keep their jobs.

Recently, Duke has taken another approach to train the healthcare community through its “short course” program. Essentially, a team either goes out to a provider or their workers go on the Duke University campus for intensive three- to five-day health IT training sessions. “We created a set of 90-minute courses and lectures that cover the span of informatics. Companies basically pick the courses they want from the buffet list.”

While the short course program is in its infancy, with only two completed and three more in the pipeline, Hammond hopes to take it on an international scale.

The changing landscape of healthcare demands a better understanding of informatics, Hammond says. “Now with translational medicine, personalized medicine, genomics and population health,  there needs to be the flow of data among all of those people, a common language that we use to discuss what we’re doing, so that is what we are trying to get across in our programs.” 

Recruiting From Within

For some CIOs, building a robust health IT workforce is an inside job.

“We are trying to grow our own here, primarily selecting clinical folks who have an interest in IT,” says Randy McCleese, VP of information systems and CIO at St. Claire Regional Medical Center, Morehead, Ky. “I can’t take IT people and teach them the clinical side, but I can take some clinical folks and teach them some IT.”

He estimates that those with a strong clinical background could get up to speed on IT issues within six months. “They are not going to get into the details of how to set up a network or anything along those lines, but just understanding the basics of how a computer system works and provides the data to take care of the patient,” McCleese says. “They need to understand a bit about databases and the workflow within the databases and how that’s presented to the end-users, especially to the doctors.”

He’s skeptical of programs that don’t require students to have extensive clinical backgrounds. “I’m concerned about those programs because it takes numerous years of clinical experience to understand the things that have to happen for the patient.”

In fact, McCleese, who also teaches information systems classes at Morehead State University, encourages his students to take clinical classes, so they have some concept of what goes on in patient care.

For now, McCleese worries about preparedness for the health IT challenges ahead such as implementation of EHRs. “I am concerned that we’re not going to have enough clinical folks who understand IT to bridge that gap that goes between the two, and that’s been an emphasis coming all the way from the [ONC]. I’m still concerned they are not going to be made as productive as they need to be in the short amount of time we’ve got to get there.”

Retaining the Best

Meanwhile, retaining qualified health IT staff worries many hospital executives. In the CHIME survey, 85 percent said they are worried about keeping their IT workers in 2012 vs. 76 percent of respondents in 2010.

Richard Paula, MD, CMIO and VP at Tampa General Hospital in Tampa, Fla., has experienced the loss of his best employees to consulting companies who lured them away with higher salaries. The firms offer up to $100 an hour, which rivaled the salaries of the hospital’s highest executives.

Phone calls and emails continue regularly for those people experienced with a top-selling EHR system that Tampa implemented, Paula says. Meanwhile, “our attrition rate has dropped off significantly.” He attributes this in part to changes in the EHR implementation curve, now that the system is in place. “Our work has become a lot less frenetic, a lot more predictable. The stress level has gone down.”

Employee retention programs have helped curb the exodus. Many efforts culminated after the hospital instituted a more formalized exit interview process. “We’ve had some very candid discussions with the folks who are leaving so that’s been very helpful,” says Paula, who adds that if someone offered an employee triple his or her salary that person would leave even if otherwise satisfied with the job.

To keep employees happy, the hospital offers flexible work hours and telecommuting options as well as employee morale-building activities like bowling nights and lunches. In the area of flexible employment, some employees can work four 10-hour days or take a Friday off every other week if they work nine nine-hour days.

Two former employees did attempt to come back. “One person who came back didn’t like the consulting lifestyle of living in a hotel room with suitcases and not seeing his family. All of a sudden the extra money becomes slightly tarnished by the lifestyle.”

But retention still needs to remain a focus of providers, he says. “We put a lot of effort into retention. It’s like a marriage; you have to work at it to be harmonious. If you took your eye off the prize, they’d start leaving again.”