August 4, 2008

Workers Wanted
By David Yeager
For The Record
Vol. 20 No. 16 P. 6

A study says the HIT field may be short some 40,000 professionals.

A couple of questions that aren’t often asked when people talk about the widespread use of digital technology in healthcare are “Who’s going to implement, service, and ultimately utilize these systems?” and “Where are these skilled workers going to come from?” William Hersh, MD, was wondering the same thing.

Hersh, who is chair of the department of medical informatics and clinical epidemiology at Oregon Health & Science University in Portland, and Adam Wright, PhD, a senior medical informatician for the Clinical Informatics Research & Development Group of Partners Healthcare in Boston, analyzed the HIMSS Analytics Database to determine how many additional HIT professionals will be needed in the coming years if the United States fulfills its current technology adoption goals.

“What we found,” says Hersh, “was that if the healthcare system were to move to a kind of higher level, the level of IT use associated with improving quality and safety (for example, computerized physician order entry and clinical decision support), there would be a need for another 40,000 IT professionals.”

Hersh adds that this does not necessarily signal a shortage of HIT workers, but it does recognize that the sources of these potential new workers have not yet been identified. “So whether there are 40,000 people out there who would be available is not clear,” he says.

What Will These Jobs Be?
What’s also unclear is how these potential workers will be utilized. “HIT is just sort of a generic term,” says Rebecca B. Reynolds, MHA, RHIA, program director of graduate programs in health informatics and information management at the University of Tennessee Health Science Center. “But you sort of get down to what kind of skill sets and what kind of competencies do these folks need to have in the workplace? And I think we’re still working that out.”

Hersh says this lack of definition is partially due to the fact that IT encompasses a broad range of disciplines. “The spectrum of jobs in informatics goes from the highly technical, where you may be programming or you may be running servers or applications and things like that, all the way to the user side,” he says.

Having people who can put data into action after it’s processed is a key part of the equation. “When people start talking about decision support and personal health records and things like that, it’s what people do with the information that they get out of the technology [that will be increasingly important],” Hersh says.

Reynolds agrees that end users will comprise a significant percentage of the workforce. The University of Tennessee’s program includes doctors trying to gain a better understanding of electronic medical record (EMR) systems and nurses who have decided that they want a change from direct care. These users don’t want to design software but want to know enough about how the systems work to benefit from the data.

And Hersh stresses that even people with strong IT backgrounds need to be educated about healthcare’s particular challenges. “Even if you come from an IT background and you’re going to be a high-level IT manager in a healthcare setting, you really do need to know about the issues in healthcare and also the issues in health IT, the ones that everyone talks about: standards, privacy issues, [etc],” says Hersh.

Filling the Pool
Where can people with these overlapping interests be found? “Well, one of the things that we do is try to attract people who are already working in healthcare,” says Reynolds. She adds that because healthcare covers so many areas and people are working longer, there is significant potential for attracting people to HIT. “There are a lot of folks out there who may be burned out with what they’ve been doing but still plan to work for 20 or so more years in the field,” Reynolds notes. “So I know we have quite a few students in our graduate program who want to have a second healthcare career, but they don’t want to do direct patient care or some of those things any longer.”

Reynolds believes the biggest challenge is getting the word out that HIT is a valuable part of the healthcare continuum affecting the quality of patient care. “The people who find us are very satisfied. They find a place that they can make a difference and that they can have the kind of career that they want to have,” she says. “So many folks, they just literally don’t even know it’s an option. We’re such a behind-the-scenes kind of profession.” Reynolds also advocates running a national ad campaign similar to the one Johnson & Johnson runs for nursing to get the word out.

Hersh thinks raising HIT’s profile could pay big dividends. “I think we need to start treating biomedical informatics as a health profession,” he says. “You’re part of the healthcare team; you manage the information. I think everyone recognizes—except maybe some of the most stalwart physicians—that healthcare in the future is going to be very team oriented. And part of that team is the people who deal with and manage the information.”

Information management is what will ultimately determine HIT’s success. “To me, the long-term goal is can you get your core measure data out without having to abstract that information out by hand?” says Reynolds.

“There are a lot of people who, to me, are not even health information technology workers but are definitely knowledge workers, who are now abstracting that information out of these systems,” she adds. “Hopefully, in the future, some of those jobs can change or potentially go away.”

If HIT enrollments lag, will that have a negative effect on digital technology adoption? “No one’s done a big study to prove that,” says Hersh. “But I think if you talk to people, one of the things they lament is the difficulty in finding people who are well trained across the spectrum of skills that they need.” He believes if there aren’t a sufficient number of workers to support widespread HIT adoption, the benefits will only be reaped by large, well-funded healthcare systems.

“So, I think the biggest onus is to attract more young people into the field and, of course, that starts to put you in competition with some of the other pressing healthcare needs, like nursing,” says Hersh. “But we need all of these kinds of people.”

— David Yeager is an editorial assistant at For The Record.