October 24, 2011

An Inside Job
By Annie Macios
For The Record
Vol. 23 No. 19 P. 28

Sometimes the best candidates for HIT positions are nearby.

Flying in the face of just about every other profession, HIT is experiencing an increased demand for qualified employees. According to the Office of the National Coordinator for Health Information Technology (ONC), hospitals and physician practices are expected to need an additional 50,000 HIT workers during the next five years to help organizations meet meaningful use criteria.

Where will these employees come from? Some healthcare facilities are plucking personnel from within their own ranks. The very nature of HIT can be broken down into two distinct components: healthcare and IT. Employees from both categories can successfully transition into HIT positions, each bringing their own advantages and disadvantages.

Beth Just, MBA, RHIA, FAHIMA, CEO of Just Associates, a healthcare data integration consulting company based in Centennial, Colo., and a member of the AHIMA board of directors, believes there are both pros and cons to hiring HIT professionals from within.

“In general, there are a lot of HIM professionals that can migrate over to system analyst or business analyst positions,” she notes. “Working with the deployment and setup of EHRs, I see it frequently, and it has been occurring for a while. For example, if a facility is putting in a radiology system, the radiology technologist often becomes the system analyst. It is very common because they already have the clinical domain knowledge for that particular product.”

With the increased demand for analyst-level roles at larger provider organizations, Just says these roles generally have to be filled by someone with a background in a particular domain. For example, HIM personnel have overarching experience in the EHR domain and could make a transition to HIT.

Filling the Gaps
Although it may not be an ideal strategy, Just says a new HIT employee typically will be trained on site by the vendor on a specific product. According to Just, the most common gap in knowledge occurs with Health Level Seven International (HL7) training.

“With the various types of training for information management people moving to IT roles, the one thing they have to learn the hard way is HL7. Many downstream systems send results back to the EHR via HL7 transactions; therefore an understanding of what HL7 is and how information is exchanged at a technical level is needed,” she says.

What happens when an IT person becomes immersed in a healthcare environment? Just notes that when working with analysts of many experience levels, the most common challenge is dealing with the fact that they often don’t understand the healthcare delivery process, which results in an operational gap.

She has learned to never assume that IT personnel know the process across the continuum of care for the data in the interface transaction.

“If I pull in a computer engineer from the banking industry, they can easily learn the technical side of HIT, but they have no idea what it is used for. Operationally caused problems happen just because they don’t understand the operational side,” says Just.

“However, if someone comes from the healthcare domain, they have a better sense of that, so we can teach them what they need to know from the technical side—for example, HL7 and the transaction log. I find that the easier thing to teach,” she adds.

Gretchen Koch, senior director of workforce development programs at CompTIA, an Illinois-based nonprofit trade association focused on advancing the global interests of IT professionals and companies, says it is a natural fit for someone already working on the IT staff to move into an HIT role and vice versa—healthcare personnel make strong candidates for HIT roles.

Koch says as EHR implementations have increased the need for HIT staff, more facilities are looking to train in-house healthcare staff on the computer aspects of the job. Some of the best candidates, she notes, include informatics personnel, database personnel, and experienced coders.

“Because HIT is a hybrid of healthcare as well as information technology, it can be complex. For example, a healthcare worker would have to know how to install a system and need IT expertise. From the IT side, they need training on healthcare terminology, regulations such as HIPAA and meaningful use, and knowledge of various types of healthcare facilities and how they operate,” says Koch.

Conversely, outside candidates with IT experience must be familiarized with the healthcare environment, including workflow and hospital culture.

When hiring internally for an HIT position, Steve Ostrowski, director of communications at CompTIA, recommends facilities take steps to properly educate, train, and credential candidates rather than simply hand them a job without support. If hiring from outside the organization, he says it’s important to hire a person with healthcare experience and the proper credentials to survive in today’s EHR environment.

First-Class Training
To ensure HIT personnel have the proper training, various courses are available to fill in knowledge gaps that may exist regarding technology or healthcare issues. For example, the CompTIA Healthcare IT Technician certificate exam covers regulatory requirements, organizational behavior, IT operations, medical business operations, and security.

“That’s what CompTIA does: It creates credentials for computer technicians and healthcare professionals to learn the network requirements, maintenance, security issues, and project management issues of EHR systems,” Koch says.

The ONC has awarded $116 million in funding for the Health IT Workforce Development Program to educate HIT professionals through community college consortia. The programs focus on training students for the following professional roles: practice workflow and information management redesign specialists, clinician/practitioner consultants, implementation support specialists, implementation managers, technical/software support, and trainers.

“We’re working with the Midwest Regional Consortium, since that is in our area, to align a credential through six-month courses on two aspects thus far: the installation of the EHR and ongoing maintenance and support,” says Koch, adding that someone who wants to gain the skills necessary to advance a career in HIT can also take courses at a community college or online to focus on areas where a knowledge gap exists.

Just says although some high-tech programs offer IT professionals a six-month training program that may teach the basics of EHR installation and maintenance, it won’t begin to scratch the surface of the knowledge needed to excel in HIT. Like with any job, it is important to have the broad perspective of what is needed to be successful, says Just. For HIT, a position must be filled by someone who has an understanding that there are many separate departments and clinical domains throughout a facility and meeting their needs is important across the continuum of care.

Regardless of whether candidates are hired from the healthcare or IT side, once qualified persons are placed in an HIT role, it is crucial for them to work closely with healthcare staff during EHR installation and training.

 “Every single facility will have special nuances, and IT must be aware of how the workflow occurs and ensure the system serves those working on it in a meaningful, useful way,” says Koch.

— Annie Macios is a freelance writer based in Calgary, Alberta, Canada.